Imperial College London
Dr Bethan Davies

DrBethanDavies

Faculty of Medicine, School of Public Health

Clinical Senior Lecturer in Epidemiology
 
 
 
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Contact

 

bethan.davies06

 
 
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Location

 

Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ensor:2019:10.1002/jia2.25299,
author = {Ensor, S and Davies, B and Rai, T and Ward, H},
doi = {10.1002/jia2.25299},
journal = {Journal of the International AIDS Society},
pages = {40--53},
title = {The effectiveness of demand creation interventions for voluntary male medical circumcision for HIV prevention in Sub-Saharan Africa; a mixed methods systematic review},
url = {http://dx.doi.org/10.1002/jia2.25299},
volume = {22},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - IntroductionUNAIDS has recommended that in 14 countries across subSaharan Africa (SSA), 90% of men aged 10 to 29 years should be circumcised by 2021 to help reduce transmission of HIV. To achieve this target demand creation programmes have been widely implemented to increase demand for Voluntary Medical Male Circumcision (VMMC). This review explores the effectiveness of demand creation interventions and factors affecting programme implementation.MethodsWe completed a mixed methods systematic review searching Medline, Embase, Global health, psycINFO and CINAHL databases in August 2018 with no time restrictions. Demand creation interventions conducted in SSA were categorized and quantitative data about VMMC uptake was used to compare relative and absolute effectiveness of interventions. Qualitative data were summarized into themes relevant to the delivery and impact of programmes.Results and discussionEighteen of the 904 titles were included in the review. Effective interventions were identified in each demand creation category: financial incentives, counselling or education, involvement of influencers and novel information delivery. Of the 11 randomized controlled trials (RCTs), the greatest absolute impact on VMMC prevalence was seen with a complex intervention including VMMC promotion training for religious leaders (compared to control: 23% (95% CI 22.8 to 23.8) absolute increase; odds ratio (OR) 3.2 (1.4 to 7.3)). Financial incentives generally produced the largest relative effects with men up to seventimes more likely to undergo VMMC in the intervention arm compared to control (adjusted OR 7.1 (95% CI 2.4 to 20.8), 7.1% (3.7 to 10.5) absolute increase). Qualitative findings suggest that interventions are more impactful when they are judged appropriate and acceptable by the target population; delivered by people with relevant personal experience; and addressing broader social and cultural influences through partnership with and education of community leaders.Con
AU  - Ensor,S
AU  - Davies,B
AU  - Rai,T
AU  - Ward,H
DO  - 10.1002/jia2.25299
EP  - 53
PY  - 2019///
SN  - 1758-2652
SP  - 40
TI  - The effectiveness of demand creation interventions for voluntary male medical circumcision for HIV prevention in Sub-Saharan Africa; a mixed methods systematic review
T2  - Journal of the International AIDS Society
UR  - http://dx.doi.org/10.1002/jia2.25299
UR  - https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25299
UR  - http://hdl.handle.net/10044/1/71723
VL  - 22
ER  -
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