Evidence map›Paper›PMID 33397801›Full record

ArticleSexually transmitted infections2021

Sexually transmitted infections (STI) and antenatal care (ANC) clinics in Malawi: effective platforms for improving engagement of men at high HIV risk with voluntary medical male circumcision services.

Wezi Msungama, Geoffrey Menego, Frackson Shaba, Nicole Flowers, Melissa Habel, Abigail Bonongwe, Masford Banda, Steven Shire, Alice Maida, Andrew Auld and 10 more

Open access · hybridAbstract read
In one paragraph

Article in Sexually transmitted infections, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Observational
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 3 institutions in 3 countries.

Wezi MsungamaDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Geoffrey MenegoHIV and Infectious Disease Unit, Jhpiego, Lilongwe, Malawi.
Frackson ShabaHIV and Infectious Disease Unit, Jhpiego, Lilongwe, Malawi.
Nicole FlowersDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Melissa HabelDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abigail BonongweHIV and Infectious Disease Unit, Jhpiego, Lilongwe, Malawi.
Masford BandaDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Steven ShireHIV and Infectious Disease Unit, Jhpiego, Lilongwe, Malawi.
Alice MaidaDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Andrew AuldDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Sam John Peter PhiriExecutive Director, Lighthouse Trust, Lilongwe, Malawi.
Kayira DumbaniDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Nicole BuonoDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Mishek LuhangaDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Martin KapitoDepartment of HIV and AIDS, Ministry of Health, Lilongwe, Malawi.
Hannah GibsonHIV and Infectious Disease Unit, Jhpiego, Lilongwe, Malawi.
Catey LaubeHIV and Infectious Disease Unit, Jhpiego, Nairobi, Kenya.
Carlos ToledoDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Evelyn KimDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lilongwe, Malawi.
Stephanie Marie DavisDivision of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA sd135626@gmail.com.ORCID 0000-0003-4878-9701
Centers for Disease Control and Prevention · USLighthouse Trust · MWMinistry of Health · MW

Funding

PEPFAR
6 · The paper itself

Abstract

introductionVoluntary medical male circumcision (VMMC), an effective HIV prevention programme for men, is implemented in East and Southern Africa. Approximately 50% of VMMC clients are aged below 15 years. More targeted interventions to reach older men and others at higher short-term HIV risk are needed.

methodsWe implemented a quality improvement project testing the effectiveness of an active referral-based VMMC recruitment approach, targeting men attending STI clinics and those escorting partners to antenatal care (ANC) clinics, at Bwaila Hospital in Lilongwe, Malawi. We compared the proportions aged older than 15 years among men who received VMMC following referral from STI and ANC clinics with those among men referred from standard community mobilisation. We also analysed referral cascades to VMMC.

resultsIn total, 330 clients were circumcised after referral from STI (242) and ANC (88) clinics, as compared with 3839 other clients attributed to standard community mobilisation. All clients from ANC and STI clinics were aged over 15 years, as compared with 69% from standard community mobilisation. STI clinics had a higher conversion rate from counselling to VMMC than ANC (12% vs 9%) and a higher contribution to total circumcisions performed at the VMMC clinic (6% vs 2%).

conclusionsIntegrating VMMC recruitment and follow-up in STI and ANC clinics co-located with VMMC services can augment demand creation and targeting of men at risk of HIV, based on age and STI history. This approach can be replicated at least in similar health facilities with ANC and STI services in close proximity to VMMC service delivery.

Indexed as

Ambulatory Care FacilitiesCircumcision, MaleAdolescentAdultHealth Services Needs and DemandHIV InfectionsHumansMalawiMalePatient ParticipationPatient SelectionPilot ProjectsQuality ImprovementReferral and ConsultationVoluntary ProgramsYoung AdultAfricacircumcisionHIVmaleprenatal carepreventive health services

Identifiers

PMID33397801
PMCPMC8311083
OpenAlexW3119099754

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.