Maputo, Mozambique–AM Sigauque learned the hard way that partying without protection can lead to serious health consequences for a young man in Mozambique, where more than one in every 10 adults is living with HIV.
The 25-year-old mason, who lives in a village about an hour’s drive from Mozambique’s capital, acquired a sexually transmitted infection after having sex with “a pretty girl” he had just met at a party. “She did not tell me she had an infection, and I did not protect myself,” he says, recalling the evening encounter. When he developed a rash on his penis, his brother advised him to seek help at the local health facility.
It was a fortuitous decision—a health care provider there successfully treated Sigauque’s infection and encouraged him to seek voluntary medical male circumcision (VMMC) to help protect him against HIV and other sexually transmitted infections.
“In the following week, I returned to the health center and had a friendly conversation with counselor Pelembe,” says Sigauque. “He explained the advantages and benefits of medical male circumcision, and he also told me that although the risk of being infected with HIV was less after circumcision, it did not mean that I could continue with unprotected sex. I agreed with the circumcision. It was done the same day, all went well.”
Sigauque joined the half a million Mozambican men and youth who have participated in the Ministry of Health’s (MOH’s) National Program for the Expansion of VMMC, supported by Jhpiego and funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC). As part of its strategy to reduce new HIV infections and save lives, the MOH plans to provide VMMC as part of a comprehensive package of HIV prevention and health services to 2 million males aged 10 to 49 by 2018.
Sigauque is a grateful, committed advocate. “I feel much more aware of the risks [of HIV infection],” he says. “I practice safe sex. I feel myself cleaner. I tell my friends to be careful. I tell them to get circumcised.”
More than 40 government health facilities supported by Jhpiego/CDC currently provide VMMC free of charge in five provinces of Mozambique with the highest prevalence of HIV infection and the lowest prevalence of circumcised males.
To ensure that men and their families have access to these lifesaving services, the partnership between the MOH, Jhpiego and the CDC is using a variety of approaches to spread the word about the lifesaving benefits of VMMC. The singer from a prominent Zambezia-based band composed and sang the official song of the national program and has since become circumcised and an activist for the health and well-being of his community. A health fair held at a local juvenile detention center offered VMMC services. Mobile surgical units bring services closer to communities without available sites for VMMC, and transportation is provided for clients whose closest service center is far from their neighborhood.
Community supporters of VMMC include Mozambicans from all walks of life—the 64-year-old subsistence farmer and father of 12 sons who posts HIV prevention pamphlets throughout his community, a 33-year-old school teacher who is concerned about the health of her students, and the wife of a 27-year-old hair stylist who persuades her husband to put aside his fears and undergo the procedure for the health of their family.
For Maputo city taxi driver EI Sabonete, circumcision was the last thing on his mind until he picked up a passenger, a Jhpiego-employed nurse, who began talking about a VMMC campaign underway in the city. “I decided to open up and mention that my wife had been wishing that I got circumcised; nevertheless I was afraid and helpless on what to do,” says the 34-year-old father of one son. “Nurse Manuela promptly suggested that I visit the Maputo Military Hospital [one of the facilities offering male circumcision in Maputo city]. I decided to go for it.”
When Sabonete surprised his wife with this “gift,” he says, “I can tell you that nowadays my relationship with her improved a lot, as well as my sexual satisfaction.”
As a part of its activities to curb the HIV epidemic, the Mozambique MOH is strongly supporting and expanding VMMC as an effective HIV prevention measure with the support of PEPFAR through several US government agencies and cooperating partners. To date, the program is near its target of 80% coverage in three of the seven provinces where the program is implemented and is steadily progressing in the other four.