Barbara M Nanteza, Fredrick Makumbi and Diana Atwine
Johns Hopkins, USA Makerere University, Uganda Ministry of Health, Uganda
Posters & Accepted Abstracts: J Infec Dis Treat
Introduction:Use of cumulative number of circumcisions as a measure of success of SMC scale up may not indicate how well access risky populations are receiving this intervention.
Objective: To determine the number of circumcisions per male population, and ascertain if circumcisions conducted in Uganda between the period Jul’ 2013-Mar’ 2018 are associated with key risk sexual behaviours, HIV and STI prevalence, and urbanization.
Method: Circumcision data is accrued from DHIS2 and HMIS for the period Jul’ 2013- Mar’ 2018, while data on adult male HIV prevalence, SMC coverage, multiple partners and prevalence of syphilis men are obtained from Uganda Population HIV Impact Assessment report. The average number of district quarterly circumcisions per calendar year was determined using a randomeffects Poisson regression model. We obtained regional and district level factors associated with the number of circumcisions. Measure of association was incidence rate ratios (IRR) from this Poisson model, with corresponding 95% confidence intervals and p-value. Key variables were adjusted to provide adjusted (adj.) IRR.
Summary of key findings: Nearly four million circumcisions were conducted between Jul’ 2013-Mar’ 2018, districts averaged only 15 (13.3,16.5) circumcisions per 1000 males quarterly, after controlling for male population, regional, district factors and calendar year. Circumcisions were higher in districts located in regions with high-risk sexual behaviour and high prevalence of syphilis as an important co-factor for HIV infection, circumcisions were lower in rural districts located in regions with a high adult male HIV prevalence compared to low HIV prevalence.