Voluntary medical male circumcision safely reduces the risk of female-to-male HIV transmission by up to 60 percent and few men have any post-operative complication. However, current practice throughout most of sub-Saharan Africa requires male circumcision patients to return for multiple, in-person post-operative visits that have become a burden for providers and patients – threatening achievement of critical human immunodeficiency virus (HIV) prevention targets.
Now, a two-way texting model studied by University of Washington School of Public Health researchers in Zimbabwe offers a new way to address this barrier by reducing provider workload while also safeguarding patient safety.
In the study, 721 male circumcision patients communicated directly with a healthcare worker through interactive text messaging for the critical 13 days after operation, rather than returning for required in-person visits. By giving men the option to heal safely at home, or to return to care when desired or if complications arise, the method dramatically reduced in-person visits by 85 percent. Texting also reduced follow-up costs by about one-third while improving the quality of care.
Compared to routine in-person care, the study yielded twice the number of reported complications. “This increased identification and reporting is a positive result that is likely attributable to improved counseling and men’s engagement in care,” said Dr. Caryl Feldacker, assistant professor of global health at the UW Schools of Public Health and Medicine and an investigator for the International Training and Education Center for Health (I-TECH).Friday Letter Submission, Publish on November 22