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Arbogast Oyanga Family AIDS Care and Education Services (FACES)

Factors associated with post-operative follow-up after voluntary medical male circumcision in Nyanza Province, Kenya. Arbogast Oyanga Family AIDS Care and Education Services (FACES). Program Background. Family AIDS Care and Education Services (FACES) Family-focused program

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Arbogast Oyanga Family AIDS Care and Education Services (FACES)

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  1. Factors associated with post-operative follow-up after voluntary medical male circumcision in Nyanza Province, Kenya Arbogast Oyanga Family AIDS Care and Education Services (FACES)

  2. Program Background • Family AIDS Care and Education Services (FACES) • Family-focused program • Collaboration between Kenya Medical Research Institute (KEMRI) and University of California, San Francisco (UCSF) • Operational since September 2004 in Nyanza and Nairobi • FACES program areas • Provider Initiated Testing and Counseling (PITC) • Prevention of Mother to Child Transmission (PMTCT) • HIV Care and Treatment • Voluntary Medical Male Circumcision (VMMC)

  3. Background • Voluntary medical male circumcision (VMMC) reduces HIV risk acquisition by upto 60% • In Kenya, VMMC services has reached over 395,000 men in less than four years • Current guidelines require a 7-day post-surgery follow-up visit to; • Monitor outcomes • Identify and treat adverse events (AEs) • Reinforce risk reduction and sexual abstinence for 6 weeks post-surgery • A large proportion of men fail to return for follow-up

  4. Study Goal • To understand the characteristics of men who undergo VMMC and the factors associated with post-surgery follow-up

  5. Methods • A retrospective cohort study was conducted • VMMC data extracted from medical records • 11,483 men • 12 FACES-supported HIV clinics in Nyanza • Between January 2011 – August 2012 • Associations between client characteristics(age, clinic locality and referral source) and 7-day visit attendance were analyzed • Logistic regression

  6. Results – Patient Characteristics

  7. Results - Associations

  8. Conclusion • Post-surgery 7-day follow-up was infrequent, particularly in more rural regions • Adverse events (AEs) reporting was uncommon

  9. Limitation • There could be other factors with urban men, like education level, socio-economic status and distance to clinic, that influence follow-up that were not evaluated

  10. Recommendations • Innovative interventions for clinic follow-up may • help improve adverse event ascertainment and; • provide an opportunity to reinforce risk reduction and sexual abstinence post-surgery

  11. Acknowledgements Authors Affiliations • Family AIDS Care and Education Services (FACES), Kisumu, Kenya • Departments of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco (UCSF), San Francisco, California, USA • Research Care and Training Program, Center for Microbiology Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya

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