Clients presenting for VMMC undergo a full physical examination – including measurement of vital signs and screening for diseases and penile abnormalities to confirm viability for the procedure. In addition to a physical examination, VMMC provides an opportunity for HIV counseling and testing. As part of comprehensive health care and strengthening of HIV prevention efforts, VMMC provides a gateway for linking clients to other health services, such as sexual and reproductive health, non-communicable disease screening, and HIV treatment.
Because of diverse barriers and social constructs, many men do not frequently access health services. Presenting for VMMC might be their first interaction with formal health care. For this reason, it is crucial to optimize the package of services offered to men during VMMC. Although HIV counseling and testing is not a prerequisite for circumcision, it is highly recommended and should be offered to all VMMC clients. Clients needing further services outside of VMMC should be referred to relevant points of care and steps taken to assure that successful linkage is made.
- Assuring that VMMC clients found to be HIV-positive or having a sexually transmitted infection are effectively linked to care and treatment
- Documenting effective referral and linkage to care of VMMC clients
- Assuring that VMMC services are consistently integrated into the general primary health care
- Gaps in training to support understanding and appreciation of service integration
- Poor communication and sharing of data between VMMC unit and MOH staff
- Lack of implementation guidelines at the facility level, affecting staff knowledge and capability to fully integrate services