Voluntary medical male circumcision (VMMC) is an evidence-based prevention approach that can reduce HIV transmission. However, sustaining demand and lowering costs of this core intervention can be challenging. In Tanzania, engagement and use of a volunteer community-based cadre of lay workers to promote and create demand for VMMC led to an almost five-fold increase in VMMCs performed in health facilities. This increase was sustained over time, with a cumulative 45,182 VMMCs performed eighteen months after the introduction of this model. Moreover, this model also reduced costs by 13%.
Through the support of the United States Government’s President’s Emergency Plan for AIDS Relief (PEPFAR), Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) introduced comprehensive men’s clinics at selected high-volume health facilities in order to scale-up the Test and Start approach among HIV-infected men. The men’s clinics provide a male-friendly environment that encourages men to get tested for HIV, and therefore be identified as HIV positive and linked to HIV care and treatment services.