Background: Lesotho has the second highest HIV prevalence in the world, in an effort to curb the incidence of HIV; VMMC services were initiated in early 2012 and scaled up to 14 government hospitals in the first two years of program implementation. Services were however, not accessed by some men who expressed concerns with their privacy, the usually long queues and crowded waiting areas at public facilities. In an effort to reach out to these clients, Jhpiego approached private doctors to provide VMMC free of charge
Methods: The objective of the partnership was to determine the feasibility of VMMC and HIV testing at the private clinics. Private clinics capacity to provide high-volume VMMC was done using the Lesotho VMMC site assessment tool. Three Clinics were assessed in 2014 and met the required standards and criteria partnered with Jhpiego from June 2014. An additional five clinics were assessed and partnered with Jhpiego in 2015. Jhpiego provided VMMC training to teams, each comprising of a doctor, two nurses and a counselor, from the partner clinics. Jhpiego contributed with MC kits, as well as mentorship and compensated for the time worked by private providers.
Results: Through this partnership, 697 clients were circumcised at three private clinics between June and December 2014. This number contributed 3.6% to the 19,543 achieved during the 2014 winter campaign. A total of 835 males were circumcised at eight clinics during the winter campaign of 2015, bringing to 1,532 the number of men reached through this approach during both campaigns. Of these, 478 males were aged between 15-29 years. This translates to 31% of adult males who received services. The model improved the number of men testing at the private clinics during these periods with 100 men (6.5%) testing HIV positive and 52 were successfully linked to care and treatment.
Conclusions: Access to VMMC/ HIV services can be improved by using independent providers. This is an opportunity in a context such as Lesotho where men have raised concern in the quality of customer care at public facilities. Active participation of private practitioners increases uptake of VMMC services.