Intervention groups
pain
COMPLICATIONS
Those residing in the intervention clusters (IPC, DSO, and combined IPC + DSO) were reached with the respective intervention within two weeks of study enrollment. For the IPC arm, we developed a toolkit consisting of common barriers and facilitators related to VMMC based on a literature review and from TASCO’s formative data on VMMC uptake in Nyanza Region. The toolkit was used to facilitate one-on-one discussions between RAs and uncircumcised men, which permitted the RAs to respond to and address personal concerns about circumcision communicated by uncircumcised men. The topics covered in the IPC toolkit included accurate information about pain during and after VMMC surgery, likelihood of complications, dealing with recommended sexual abstinence post-surgery, etc. In the DSO arm, the physical layout of included VMMC sites was modified to accommodate older men’s preferences. The DSO arm was based on literature from sub-Saharan African countries implementing VMMC that suggested that older men seeking VMMC services preferred separate waiting areas at clinics, male-only service providers, shorter waiting times, and flexible service delivery hours. Thus, the study services provided in DSO locations included male-only providers, separate waiting areas, private access to the theater in some facilities, and flexible hours for selected facilities, (e.g., two weekends a month or two evenings a week to serve only men ≥ 25 years of age). RAs went to the homes of eligible men in the Locations randomized to the DSO arm and referred them to these DSO sites. In the combined IPC + DSO arm, we used the toolkit to address men’s reasons for not going for circumcision and referred them to DSO sites. In the routine standard of care arm, routine demand creation activities under the VMMC program continued [