Lusaka, Zambia–While accompanying a friend to an urban health clinic, Aaron Hamusonde learned about an HIV prevention strategy that would help protect him from the virus that causes AIDS. The 19-year-old student was so impressed with the counseling and education session on voluntary medical male circumcision (VMMC) that he decided to undergo the procedure to safeguard his future.
On the very next day, Hamusonde returned to the clinic in the Matero township to be circumcised. Today, he is among the nearly 38,000 Zambian youths and men who have undergone the procedure as part of Jhpiego’s work in implementing a Ministry of Health-supported HIV prevention strategy across Zambia, which began in 2008. The most recent, Jhpiego-supported VMMC campaign ended at the end of March.
Research has shown that male circumcision (MC) has helped reduce heterosexual men’s risk of acquiring HIV by 60 percent. When used in concert with other HIV prevention measures—including condoms, partner reduction and abstinence—MC is an important addition to men’s HIV-prevention options.
“The benefits that really excited me are the reduction in some STIs (sexually transmitted infections) and HIV by 60 percent,” says Hamusonde, who hopes to be an air traffic controller one day. “I am also happy that I can easily clean myself now, and above all, that I can also protect my future partner from cancer of the cervix.”
Hamusonde has since become a champion of VMMC, encouraging friends, family and fellow parishioners at his church to visit one of the 20 health facilities participating in the Jhpiego-supported, Zambia Male Circumcision program. This project to scale up MC in the Southern African country is funded by the U.S. Centers for Disease Control and Prevention (CDC).
In Zambia, where the national adult HIV prevalence has reached close to 15 percent, many semi-urban areas have been hit hard by the AIDS epidemic. One of these areas is Matero, a densely populated township west of Lusaka that faces water and food challenges.
Hamusonde, a secondary school student in Chunga, a residential compound next to Matero, was unfamiliar with the benefits of MC. Orphaned as a child, Hamusonde was raised by his uncle with whom he lives in Chunga. He is an active member of his Christian church’s youth group and says he has not been sexually active. Last fall, a close friend asked Hamusonde to accompany him to the Matero clinic where MC services were being offered free of charge. Hamusonde had no intention of participating in the MC campaign, but he was eager to support his friend. So he joined him at the education and counseling session, where he learned how MC can help to prevent STIs, can reduce HIV infection by 60 percent, and can prevent cervical cancer among female partners.
Hamusonde was inspired by the messages he learned from the counseling session and decided to return to the clinic the following day and be circumcised.
Since undergoing the procedure, Hamusonde has been an outspoken advocate for MC among his peers. “I have joined the people who are involved in advocating for MC. I now openly talk about it at school. I talk about sex with friends, and I tell them that I will only have sex when I am ready for it. That is when I marry. I promote abstinence,” he says.
At church, his youth group director has held him up as a role model and urged other youth to follow his example and get circumcised. Hamusonde’s experience motivated his close friend, Joseph Tembo, to visit the clinic.
At first, Tembo was not sure that he could be circumcised. At a young age, he developed phimosis, a condition in which the foreskin cannot be fully retracted over the penis. However, with Hamusonde’s encouragement and advice, Tembo attended the clinic’s counseling session, from which he learned that MC is actually the best treatment for phimosis. The counseling gave him the courage to proceed with the MC. “After attending the counseling session, I was a very happy man,” says Tembo, who wants to go to college to become a journalist. “The benefits were so many. I didn’t even know that I can even protect my girlfriend from getting cancer of the cervix. The benefits made me very happy.
Although fear of pain from the procedure does inhibit some men from getting circumcised, Hamusonde says that is not a reason to delay the procedure. “People are scared of the pain, like I was. But I discovered that I did not have pain during the operation. Even afterwards, I did not experience much pain,” he says. “Within a week, I was all right! I am glad that my friend, Joseph, finally decided to come and get circumcised.”
Because of Jhpiego’s MC program, both Hamusonde and Tembo have become fully aware of the positive impact of MC on their community. Both say that when they become fathers, they will have their sons circumcised, extending HIV prevention to the next generation of Zambians.