As part of a combined package of prevention efforts, voluntary medical male circumcision can dramatically reduce a man’s risk of acquiring HIV. In Lilongwe, the capital city of Malawi, the new I-TECH-supported Bwaila Voluntary Medical Male Circumcision Center recently opened its doors, ready to provide services to eligible men. But I-TECH and local leaders didn’t stop there. With funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR), they are also supporting an innovative community mobilization effort.
In this three-part series, Pius Mtike, an I-TECH Malawi male circumcision community mobilization specialist, reports on this effort.
Part II: Engaging the Media
As part of efforts to generate demand for voluntary medical male circumcision (VMMC) in Lilongwe, local media have recently been awash in positive stories related to the procedure. This is thanks in large part to a day-long media orientation that took place in early October. The orientation, organized by the Lilongwe District Health Office in collaboration with I-TECH Malawi, was patronized by representatives from 16 media houses, including both print and electronic media. This intervention was organized to engage media personnel and improve their knowledge of VMMC as an HIV prevention intervention, which in turn may foster more, and more positive, reporting on VMMC issues.
In his keynote address, Dr. Mwai Mwale, District Health Officer for Lilongwe, observed that strategically engaged media can be very effective in creating demand, and urged participants to build a positive agenda for VMMC services in Lilongwe and beyond.
“The doors of my office are open to support you with relevant information on our VMMC program in Lilongwe so that the eligible men . . . [are] better informed on the role of VMMC in HIV prevention,” said Dr. Mwale.
He also observed that VMMC services offered at Bwaila VMMC site are on track to reach target numbers, and again urged eligible men between the ages of 15 and 49 in Lilongwe to visit the newly-opened Bwaila Voluntary Medical Male Circumcision Center.
A “Social Responsibility”
Presenting a national overview of VMMC services in Malawi, Amoni Nkhata, National Coordinator for VMMC, reminded participants that there is convincing evidence from randomized controlled trials conducted in Uganda, South Africa, and Kenya that VMMC reduces aquisition of HIV among men.
“There is now conclusive evidence that the removal of the foreskin, which is rich in Langerhans cells, which are the initial targets of HIV, during VMMC [can reduce] HIV infections by up to 60%” said Nkhata. “However,” he cautioned, “we also want to remind everyone in the population that, since VMMC offers only partial protection, condoms and abstinence should also be used to increase protection.”
He also observed that the media has a social responsibility to promote positive messages about the procedure—even if service providers don’t “come and knock on their door” to urge them to do so. Nkhata also highlighted the difference between traditional circumcision and voluntary medical male circumcision as an area that requires more awareness in the community, specifically mentioning that traditional circumcision is often incomplete, and as such does not offer the benefit provided by VMMC.
According to Nkhata, the media can also be instrumental in ensuring that the general public is aware of the human rights, legal, and ethical and medical principles associated with the VMMC program.
The media can play a role in disseminating accurate information on many other aspects of VMMC, as well.
For example, media can help efforts by reporting on the gender implications of VMMC as a complimentary HIV prevention method and by accurately reporting that men must abstain from sex for six weeks after circumcision to ensure that the wound is completely healed. To ensure that they support one another, it’s good for couples to discuss the procedure before it is done.
Asked why VMMC is not encouraged among men who are HIV-positive, Nkhata explained that VMMC does not reduce HIV infection among those already living with the virus. He cautioned that if a person living with HIV is already experiencing some health concerns from the disease (i.e., has low CD4 counts), VMMC can cause additional concerns.
As part of the orientation program, media personnel also toured the new Bwaila Voluntary Male Circumcision Center in Lilongwe, where they built a greater understanding and appreciation of the quality and practicality of VMMC service delivery. The new site is implemented as a partnership between I-TECH Malawi, the Lilongwe District Health Office, and the Ministry of Health in Malawi, with funding from the United States President’s Emergency Plan for AIDS Relief.
Read more about I-TECH’s work in Malawi.