Modelling data estimate that circumcising 1.9 million Zimbabwean men aged 15-49 by 2015 could avert 42% (600,000) of new HIV infections that would have otherwise occurred by 2025. The data additionally suggest that initially prioritizing males aged 15-29 will lead to the greatest reduction in HIV incidence in the short-term, whilst scaling-up male circumcision to reach the targeted number will likely yield US$2.9 billion net savings in antiretroviral treatment costs over 15 years. Since 2009, Zimbabwe has provided voluntary medical male circumcision (VMMC) to adult and adolescent men. The programme aims to reach 1.3 million 15-29 year-old men by 2017.

The scaling up of Voluntary Medical Male Circumcision (VMMC) – cost-effectiveness of models

Funding Source: Bill and Melinda Gates Foundation, through PSI Zimbabwe

Funding Period October 2016 to May 2019

A number of ways to deliver VMMC models in rural and urban Zimbabwe have been developed to maximise demand, uptake and acceptability. In some place coverage of VMMC is already high and models for sustaining high coverage need to be evaluated. This project aims to determine the relative cost effectiveness of various models (including models for demand creation) and their likely population level impact.

CeSHHAR Zimbabwe researchers have been involved in several studies designed to guide male circumcision programming in Zimbabwe and the wider region including the following:

  • October – November 2009 representative population-based survey conducted in rural Zimbabwe that assessed acceptability of adult and infant male circumcision
  • June – October 2010 qualitative study conducted in 5 of Zimbabwean provinces to explore in-depth, acceptability of adult and infant male circumcision as well as feasibility of introducing infant male circumcision
  • January – December 2011 longitudinal study with a cohort of Zimbabwean men to explore decision-making process around male circumcision, sexual behaviour and risk compensation
  • January 2011 – December 2012 study that systematically monitored voluntary medical male circumcision scale-up in Kenya, South Africa, Tanzania and Zimbabwe
  • June – August 2013 study that assessed the pilot implementation of VMMC services conducted by nurses as main providers in Zimbabwe
  • November 2012 – September 2014 study that piloted implementation of early infant male circumcision using devices in Zimbabwe (study registered with Pan African Clinical Trial Registry):
  • April – Dec 2014 study that explored acceptability and satisfaction with the PrePex male circumcision device among adult men and health-care workers in Zimbabwe