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Background: Meeting the UNAIDS targets for 90:90:90 will require strategies to reach more men with HIV counselling and testing and ART services. In South Africa men have lower rates of HIV testing, more men are unaware of their HIV positive status than women (62% versus 45%) (Shisana, Rehle et al; 2014) and men tend to access HIV services in the public sector later and with poorer health outcomes (Ramkissoon et al,2011). Medical male circumcision (MMC) services have the potential to provide an entry point to HIV care for males.
Description: Routine data on 68,627 men accessing MMC services during October 2012-September 2015 in 4 districts in KwaZulu-Natal was reviewed to determine uptake of HIV testing, men newly diagnosed as HIV positive, geographic location and acceptability of services.
Lessons learned: Of the 68,627 men accessing services, 64,900 (95%) were either tested on site (70%) or had been tested within the last 3 months (25%). Only 5% of males refused the voluntary HIV test. 4% were newly diagnosed as HIV positive. Most (97%; n=66,299) of those accessing services underwent MMC procedures, 91% of whom were HIV negative, 4% HIV positive and 5% did not know their status. 80% of males accessing MMC services were 10-24 years. 94.1% received services at a public sector hospital/clinic, 5.5% at a general practitioner and 0.4% in a correctional service. Prevalence rates were highest among prison populations (38.5%) and in informal settlements (7.88%).
Conclusions/Next steps: Men are willing to attend free MMC services in the public sector or at general practitioners and the majority consented to HIV screening services as part of this package. This is an opportunity to screen males for TB, STI and refer men for CD4 tests and ART. MMC services provide a feasible and acceptable way of getting males into HIV services and should be scaled up.