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1

Mangombe, Kudzaishe, and Ishumael Kalule-Sabiti. "PREDICTORS OF MALE CIRCUMCISION AMONG MEN AGED 15–35 YEARS IN HARARE, ZIMBABWE." Journal of Biosocial Science 50, no. 2 (2017): 193–211. http://dx.doi.org/10.1017/s0021932017000128.

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SummaryMedical male circumcision has been recommended by the World Health Organization as part of a comprehensive approach to HIV prevention. Zimbabwe is one of the fourteen sub-Saharan countries that embarked on the Medical Male Circumcision (MMC) programme. However, the country has not yet met male circumcision targets. This paper examines the predictors of male circumcision in Zimbabwe. A cross-sectional survey was conducted on 784 men aged 15–35 years in Harare, Zimbabwe. Negative log-log logistic regression analysis was used to determine the predictors of male circumcision. The main predictors of circumcision were age, employment status, ever tested for HIV, approval of HIV testing prior to circumcision, knowledge about male circumcision and attitudes towards male circumcision. By and large, participants had good knowledge about male circumcision and viewed HIV prevention with a reasonably positive attitude. The identification of these predictors can be used to scale up the demand for male circumcision in Zimbabwe.
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2

Mangenah, Collin, Webster Mavhu, Karin Hatzold, et al. "Estimating the Cost of Early Infant Male Circumcision in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 69, no. 5 (2015): 560–66. http://dx.doi.org/10.1097/qai.0000000000000699.

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3

Mutusva, Ronard, and Sindile Dlodlo. "‘Ngena ku Smart’." DANDE Journal of Social Sciences and Communication 2, no. 1 (2017): 29–44. http://dx.doi.org/10.15641/dande.v2i1.32.

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This study brings out circumcision dilemmas and conflicts among the Xhosa people of Lortondale area in the Matabeleland North province of Zimbabwe. The problem befell this community immediately after 2009 when Zimbabwe adopted results from Kenya, Uganda and South Africa in Orange farm that circumcision can curb HIV transmission by 60% from female to male and thus attention was given to medical circumcision, which is known as ‘smart’. Family disunity and disintegration are some of the results of conflicts, within some families whose members shunned the traditional practice. Interviews and focus group discussions were employed in gathering primary data for this study. They allowed access to first-hand information from the Xhosa people themselves. On the same note, one of the researchers has worked closely with this community for a year in other HIV/AIDS programs. This counteracted the element of secrecy associated with the subject of circumcision among the Xhosa people which a number of scholars and news reporters fail to tackle and finally produce general results. Finally, a synergy is proposed as a way that restores peace and order in the society under study.
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4

Awad, Susanne F., Sema K. Sgaier, Gertrude Ncube, et al. "A Reevaluation of the Voluntary Medical Male Circumcision Scale-Up Plan in Zimbabwe." PLOS ONE 10, no. 11 (2015): e0140818. http://dx.doi.org/10.1371/journal.pone.0140818.

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5

Chikutsa, Antony, Alfred C. Ncube, and Shephard Mutsau. "Male Circumcision and Risky Sexual Behavior in Zimbabwe: Evidence from the 2010-11 Zimbabwe Demographic and Health Survey." African Population Studies 28 (August 6, 2014): 1057. http://dx.doi.org/10.11564/28-0-557.

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Mangenah, Collin, Webster Mavhu, Karin Hatzold, et al. "Comparative Cost of Early Infant Male Circumcision by Nurse-Midwives and Doctors in Zimbabwe." Global Health: Science and Practice 4, Supplement 1 (2016): S68—S75. http://dx.doi.org/10.9745/ghsp-d-15-00201.

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7

Schutte, Carl, M. Tshimanga, Owen Mugurungi, et al. "Comparative Cost Analysis of Surgical and PrePex Device Male Circumcision in Zimbabwe and Mozambique." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (June 2016): S96—S100. http://dx.doi.org/10.1097/qai.0000000000000797.

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8

Halperin, Daniel T., Katherine Fritz, Willi McFarland, and Godfrey Woelk. "Acceptability of Adult Male Circumcision for Sexually Transmitted Disease and HIV Prevention in Zimbabwe." Sexually Transmitted Diseases 32, no. 4 (2005): 238–39. http://dx.doi.org/10.1097/01.olq.0000149782.47456.5b.

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9

Hove, Joseph, Lewis Masimba, Vernon Murenje, et al. "Incorporating Voluntary Medical Male Circumcision Into Traditional Circumcision Contexts: Experiences of a Local Consortium in Zimbabwe Collaborating With an Ethnic Group." Global Health: Science and Practice 7, no. 1 (2019): 138–46. http://dx.doi.org/10.9745/ghsp-d-18-00352.

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10

Shumba, Kemist, and Musara Lubombo. "Cultural competence: a framework for promoting voluntary medical male circumcision among VaRemba communities in Zimbabwe." African Journal of AIDS Research 16, no. 2 (2017): 165–73. http://dx.doi.org/10.2989/16085906.2017.1337040.

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11

Kang’ethe, S. M., and Gutsa Takudzwa. "Exploring the Stumbling Blocks on the Way to a Successful Male Circumcision Campaign in Zimbabwe." Journal of Human Ecology 49, no. 1-2 (2015): 71–76. http://dx.doi.org/10.1080/09709274.2015.11906825.

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12

Mavhu, Webster, Raluca Buzdugan, Lisa F. Langhaug, et al. "Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe." Tropical Medicine & International Health 16, no. 5 (2011): 589–97. http://dx.doi.org/10.1111/j.1365-3156.2011.02744.x.

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13

Tshimanga, Mafuta, Karin Hatzold, Owen Mugurungi, et al. "Safety Profile of PrePex Male Circumcision Device and Client Satisfaction With Adolescent Males Aged 13–17 Years in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (June 2016): S36—S42. http://dx.doi.org/10.1097/qai.0000000000000799.

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14

DeCelles, Jeff, Rebecca B. Hershow, Zachary A. Kaufman, et al. "Process Evaluation of a Sport-Based Voluntary Medical Male Circumcision Demand-Creation Intervention in Bulawayo, Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (October 2016): S304—S308. http://dx.doi.org/10.1097/qai.0000000000001172.

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15

Mavhu, Webster, Karin Hatzold, Susan M. Laver, et al. "Acceptability of Early Infant Male Circumcision as an HIV Prevention Intervention in Zimbabwe: A Qualitative Perspective." PLoS ONE 7, no. 2 (2012): e32475. http://dx.doi.org/10.1371/journal.pone.0032475.

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16

Chikutsa, Antony, and Pranitha Maharaj. "Support for Voluntary Medical Male Circumcision (VMMC) for HIV Prevention among Men and Women in Zimbabwe." African Population Studies 29, no. 1 (2015): 1587. http://dx.doi.org/10.11564/29-1-722.

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17

Makoni, Talent M., Pruthu Thekkur, Kudakwashe C. Takarinda, et al. "Linkage of voluntary medical male circumcision clients to adolescent sexual and reproductive health (ASRH) services through Smart-LyncAges project in Zimbabwe: a cohort study." BMJ Open 10, no. 5 (2020): e033035. http://dx.doi.org/10.1136/bmjopen-2019-033035.

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ObjectivesWHO recommended strengthening the linkages between various HIV prevention programmes and adolescent sexual reproductive health (ASRH) services. The Smart-LyncAges project piloted in Bulawayo city and Mt Darwin district of Zimbabwe established a referral system to link the voluntary medical male circumcision (VMMC) clients to ASRH services provided at youth centres. Since its inception in 2016, there has been no assessment of the performance of the referral system. Thus, we aimed to assess the proportion of young (10–24 years) VMMC clients getting ‘successfully linked’ to ASRH services and factors associated with ‘not being linked’.DesignThis was a cohort study using routinely collected secondary data.SettingAll three VMMC clinics of Mt Darwin district and Bulawayo province.Primary outcome measuresThe proportion of ‘successfully linked’ was summarised as the percentage with a 95% CI. Adjusted relative risks (aRR) using a generalised linear model was calculated as a measure of association between client characteristics and ‘not being linked’.ResultsOf 1773 young people registered for VMMC services, 1478 (83%) were referred for ASRH services as they had not registered for ASRH previously. Of those referred for ASRH services, the mean (SD) age of study participants was 13.7 (4.3) years and 427 (28.9%) were out of school. Of the referred, 463 (31.3%, 95% CI: 30.0 to 33.8) were ‘successfully linked’ to ASRH services and the median (IQR) duration for linkage was 6 (0–56) days. On adjusted analysis, receiving referral from Bulawayo circumcision clinic (aRR: 1.5 (95% CI: 1.3 to 1.7)) and undergoing circumcision at outreach sites (aRR: 1.2 (95% CI: 1.1 to 1.3)) were associated with ‘not being linked’ to ASRH services.ConclusionLinkage to ASRH services from VMMC is feasible as one-third VMMC clients were successfully linked. However, there is need to explore reasons for not accessing ASRH services and take corrective actions to improve the linkages.
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18

Njeuhmeli, Emmanuel, Katharine Kripke, Karin Hatzold, et al. "Cost Analysis of Integrating the PrePex Medical Device into a Voluntary Medical Male Circumcision Program in Zimbabwe." PLoS ONE 9, no. 5 (2014): e82533. http://dx.doi.org/10.1371/journal.pone.0082533.

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19

Mavhu, Webster, Sasha Frade, Ann-Marie Yongho, et al. "Provider Attitudes toward the Voluntary Medical Male Circumcision Scale-Up in Kenya, South Africa, Tanzania and Zimbabwe." PLoS ONE 9, no. 5 (2014): e82911. http://dx.doi.org/10.1371/journal.pone.0082911.

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20

McGillen, Jessica B., John Stover, Daniel J. Klein, et al. "The emerging health impact of voluntary medical male circumcision in Zimbabwe: An evaluation using three epidemiological models." PLOS ONE 13, no. 7 (2018): e0199453. http://dx.doi.org/10.1371/journal.pone.0199453.

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21

Feldacker, Caryl, Aaron F. Bochner, Vernon Murenje, et al. "Timing of adverse events among voluntary medical male circumcision clients: Implications from routine service delivery in Zimbabwe." PLOS ONE 13, no. 9 (2018): e0203292. http://dx.doi.org/10.1371/journal.pone.0203292.

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22

Kaufman, Z. A., J. DeCelles, K. Bhauti, H. A. Weiss, C. N. Chaibva, and D. A. Ross. "P3.373 Male Circumcision Prevalence, Knowledge, Perceptions, and Intent Among Men in Bulawayo, Zimbabwe: A Cross-Sectional Study." Sexually Transmitted Infections 89, Suppl 1 (2013): A266.1—A266. http://dx.doi.org/10.1136/sextrans-2013-051184.0826.

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23

Victor, Omollo, Marongwe Phiona, Murenje Vernon, et al. "Adverse Event Trends Within a Large-Scale, Routine, Voluntary Medical Male Circumcision Program in Zimbabwe, 2014–2019." JAIDS Journal of Acquired Immune Deficiency Syndromes 88, no. 2 (2021): 173–80. http://dx.doi.org/10.1097/qai.0000000000002751.

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24

Bochner, Aaron F., Caryl Feldacker, Batsi Makunike, et al. "Adverse event profile of a mature voluntary medical male circumcision programme performing PrePex and surgical procedures in Zimbabwe." Journal of the International AIDS Society 20, no. 1 (2017): 21394. http://dx.doi.org/10.7448/ias.20.1.21394.

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25

Feldacker, Caryl, Batsirai Makunike-Chikwinya, Marrianne Holec, et al. "Implementing voluntary medical male circumcision using an innovative, integrated, health systems approach: experiences from 21 districts in Zimbabwe." Global Health Action 11, no. 1 (2018): 1414997. http://dx.doi.org/10.1080/16549716.2017.1414997.

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26

Feldacker, Caryl, Aaron F. Bochner, Vernon Murenje, et al. "Correction: Timing of adverse events among voluntary medical male circumcision clients: Implications from routine service delivery in Zimbabwe." PLOS ONE 13, no. 9 (2018): e0205113. http://dx.doi.org/10.1371/journal.pone.0205113.

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27

Montaño, Daniel E., Danuta Kasprzyk, Deven T. Hamilton, Mufuta Tshimanga, and Gerald Gorn. "Evidence-Based Identification of Key Beliefs Explaining Adult Male Circumcision Motivation in Zimbabwe: Targets for Behavior Change Messaging." AIDS and Behavior 18, no. 5 (2014): 885–904. http://dx.doi.org/10.1007/s10461-013-0686-7.

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28

Kasprzyk, Danuta, Mufuta Tshimanga, Deven T. Hamilton, Gerald J. Gorn, and Daniel E. Montaño. "Identification of Key Beliefs Explaining Male Circumcision Motivation Among Adolescent Boys in Zimbabwe: Targets for Behavior Change Communication." AIDS and Behavior 22, no. 2 (2017): 454–70. http://dx.doi.org/10.1007/s10461-016-1664-7.

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29

Printer, Nkala Printah, and Mbuisa, B. "The Attitudes of Males towards Male- Circumcision in Matobo District of Zimbabwe with Special Reference to Gulathi Area in Matabeleland South Province." IOSR Journal of Humanities and Social Science 19, no. 7 (2014): 97–105. http://dx.doi.org/10.9790/0837-197197105.

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30

Feldacker, Caryl, Vernon Murenje, Batsirai Makunike-Chikwinya, et al. "Balancing competing priorities: Quantity versus quality within a routine, voluntary medical male circumcision program operating at scale in Zimbabwe." PLOS ONE 15, no. 10 (2020): e0240425. http://dx.doi.org/10.1371/journal.pone.0240425.

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31

Mavhu, Webster, Karin Hatzold, Getrude Ncube, et al. "Perspectives of Parents and Health Care Workers on Early Infant Male Circumcision Conducted Using Devices: Qualitative Findings From Harare, Zimbabwe." Global Health: Science and Practice 4, Supplement 1 (2016): S55—S67. http://dx.doi.org/10.9745/ghsp-d-15-00200.

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32

Mugauri, Hamufare, Owen Mugurungi, Gerald Shambira, Tsitsi Juru, Notion Tafara Gombe, and Mufuta Tshimanga. "A Comparative Evaluation of the Voluntary Medical Male Circumcision Program for Seke and Goromonzi Districts, Mashonaland East Province, Zimbabwe, 2017." Open Journal of Preventive Medicine 07, no. 07 (2017): 138–50. http://dx.doi.org/10.4236/ojpm.2017.77011.

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33

Mavhu, Webster, Karin Hatzold, Getrude Ncube, et al. "Safety and Acceptability of the PrePex Device When Used in Routine Male Circumcision Service Delivery During Active Surveillance in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (June 2016): S63—S68. http://dx.doi.org/10.1097/qai.0000000000000721.

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34

Bertrand, Jane T., Dino Rech, Dickens Omondi Aduda, et al. "Systematic Monitoring of Voluntary Medical Male Circumcision Scale-Up: Adoption of Efficiency Elements in Kenya, South Africa, Tanzania, and Zimbabwe." PLoS ONE 9, no. 5 (2014): e82518. http://dx.doi.org/10.1371/journal.pone.0082518.

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Kripke, Katharine, Karin Hatzold, Owen Mugurungi, et al. "Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20–29 in Zimbabwe." PLOS ONE 11, no. 10 (2016): e0164144. http://dx.doi.org/10.1371/journal.pone.0164144.

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36

Moyo, Stanzia, Marvellous Mhloyi, Tafadzwa Chevo, and Oswell Rusinga. "Men's attitudes: A hindrance to the demand for voluntary medical male circumcision – A qualitative study in rural Mhondoro-Ngezi, Zimbabwe." Global Public Health 10, no. 5-6 (2015): 708–20. http://dx.doi.org/10.1080/17441692.2015.1006241.

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37

Patel, Eshan U., Michelle R. Kaufman, Kim H. Dam, et al. "Age Differences in Perceptions of and Motivations for Voluntary Medical Male Circumcision Among Adolescents in South Africa, Tanzania, and Zimbabwe." Clinical Infectious Diseases 66, suppl_3 (2018): S173—S182. http://dx.doi.org/10.1093/cid/cix951.

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38

Feldacker, Caryl, Isaac Holeman, Vernon Murenje, et al. "Usability and acceptability of a two-way texting intervention for post-operative follow-up for voluntary medical male circumcision in Zimbabwe." PLOS ONE 15, no. 6 (2020): e0233234. http://dx.doi.org/10.1371/journal.pone.0233234.

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39

Jennings, Larissa, Jane Bertrand, Dino Rech, et al. "Quality of Voluntary Medical Male Circumcision Services during Scale-Up: A Comparative Process Evaluation in Kenya, South Africa, Tanzania and Zimbabwe." PLoS ONE 9, no. 5 (2014): e79524. http://dx.doi.org/10.1371/journal.pone.0079524.

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40

Kripke, Katharine, Karin Hatzold, Owen Mugurungi, et al. "Correction: Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20–29 in Zimbabwe." PLOS ONE 12, no. 1 (2017): e0169696. http://dx.doi.org/10.1371/journal.pone.0169696.

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41

Rech, Dino, Jane T. Bertrand, Nicholas Thomas, et al. "Surgical Efficiencies and Quality in the Performance of Voluntary Medical Male Circumcision (VMMC) Procedures in Kenya, South Africa, Tanzania, and Zimbabwe." PLoS ONE 9, no. 5 (2014): e84271. http://dx.doi.org/10.1371/journal.pone.0084271.

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42

Montaño, Daniel E., Mufuta Tshimanga, Deven T. Hamilton, Gerald Gorn, and Danuta Kasprzyk. "Evidence-Based Identification of Key Beliefs Explaining Infant Male Circumcision Motivation Among Expectant Parents in Zimbabwe: Targets for Behavior Change Messaging." AIDS and Behavior 22, no. 2 (2017): 479–96. http://dx.doi.org/10.1007/s10461-017-1796-4.

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43

Vandament, Lyndsey, Naminga Chintu, Nanako Yano, et al. "Evaluating Opportunities for Achieving Cost Efficiencies Through the Introduction of PrePex Device Male Circumcision in Adult VMMC Programs in Zambia and Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (June 2016): S90—S95. http://dx.doi.org/10.1097/qai.0000000000000722.

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44

Ashengo, Tigistu Adamu, Karin Hatzold, Hally Mahler, et al. "Voluntary Medical Male Circumcision (VMMC) in Tanzania and Zimbabwe: Service Delivery Intensity and Modality and Their Influence on the Age of Clients." PLoS ONE 9, no. 5 (2014): e83642. http://dx.doi.org/10.1371/journal.pone.0083642.

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45

Hatzold, Karin, Webster Mavhu, Phineas Jasi, et al. "Barriers and Motivators to Voluntary Medical Male Circumcision Uptake among Different Age Groups of Men in Zimbabwe: Results from a Mixed Methods Study." PLoS ONE 9, no. 5 (2014): e85051. http://dx.doi.org/10.1371/journal.pone.0085051.

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46

Mavhu, Webster, Natasha Larke, Karin Hatzold, et al. "Safety, Acceptability, and Feasibility of Early Infant Male Circumcision Conducted by Nurse-Midwives Using the AccuCirc Device: Results of a Field Study in Zimbabwe." Global Health: Science and Practice 4, Supplement 1 (2016): S42—S54. http://dx.doi.org/10.9745/ghsp-d-15-00199.

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47

Fram, Francine, Fred Church, Maaya Sundaram, et al. "Employing Demand-Based Volumetric Forecasting to Identify Potential for and Roles of Devices in Scale-Up of Medical Male Circumcision in Zambia and Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (June 2016): S83—S89. http://dx.doi.org/10.1097/qai.0000000000000991.

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48

Xiao, Y., A. F. Bochner, B. Makunike, et al. "Challenges in data quality: the influence of data quality assessments on data availability and completeness in a voluntary medical male circumcision programme in Zimbabwe." BMJ Open 7, no. 1 (2017): e013562. http://dx.doi.org/10.1136/bmjopen-2016-013562.

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49

Sgaier, Sema K., Sunny Sharma, Maria Eletskaya, et al. "Attitudes and decision-making about early-infant versus early-adolescent male circumcision: Demand-side insights for sustainable HIV prevention strategies in Zambia and Zimbabwe." PLOS ONE 12, no. 7 (2017): e0181411. http://dx.doi.org/10.1371/journal.pone.0181411.

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50

Mangombe, Aveneni, Philip Owiti, Bernard Madzima, et al. "Does peer education go beyond giving reproductive health information? Cohort study in Bulawayo and Mount Darwin, Zimbabwe." BMJ Open 10, no. 3 (2020): e034436. http://dx.doi.org/10.1136/bmjopen-2019-034436.

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ObjectivePeer education is an intervention within the voluntary medical male circumcision (VMMC)–adolescent sexual reproductive health (ASRH) linkages project in Bulawayo and Mount Darwin, Zimbabwe since 2016. Little is known if results extend beyond increasing knowledge. We therefore assessed the extent of and factors affecting referral by peer educators and receipt of HIV testing services (HTS), contraception, management of sexually transmitted infections (STIs) and VMMC services by young people (10–24 years) counselled.DesignA cohort study involving all young people counselled by 95 peer educators during October–December 2018, through secondary analysis of routinely collected data.SettingAll ASRH and VMMC sites in Mt Darwin and Bulawayo.ParticipantsAll young people counselled by 95 peer educators.Outcome measuresCensor date for assessing receipt of services was 31 January 2019. Factors (clients’ age, gender, marital and schooling status, counselling type, location, and peer educators’ age and gender) affecting non-referral and non-receipt of services (dependent variables) were assessed by log-binomial regression. Adjusted relative risks (aRRs) were calculated.ResultsOf the 3370 counselled (66% men), 65% were referred for at least one service. 58% of men were referred for VMMC. Other services had 5%–13% referrals. Non-referral for HTS decreased with clients’ age (aRR: ~0.9) but was higher among group-counselled (aRR: 1.16). Counselling by men (aRR: 0.77) and rural location (aRR: 0.61) reduced risks of non-referral for VMMC, while age increased it (aRR ≥1.59). Receipt of services was high (64%–80%) except for STI referrals (39%). Group counselling and rural location (aRR: ~0.52) and male peer educators (aRR: 0.76) reduced the risk of non-receipt of VMMC. Rural location increased the risk of non-receipt of contraception (aRR: 3.18) while marriage reduced it (aRR: 0.20).ConclusionWe found varying levels of referral ranging from 5.1% (STIs) to 58.3% (VMMC) but high levels of receipt of services. Type of counselling, peer educators’ gender and location affected receipt of services. We recommend qualitative approaches to further understand reasons for non-referrals and non-receipt of services.
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