MCUTS Trial:
A sport-based intervention to increase uptake of
voluntary medical male circumcision among adult
male football players: results from a clusterrandomised trial in Bulawayo, Zimbabwe
Background
VMMC in Zimbabwe*
• National target: 80% VMMC coverage by 2015
• HIV-negative men aged 15-29 years
• Could avert 570,000 (42%) new HIV infections by 2025
• Roughly 1 infection averted per 4 VMMCs
Sport-based HIV prevention**
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•
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Strong effects on knowledge, attitudes, behaviour
Overall, low-quality studies conducted to date
Few studies assessing effects on HIV service uptake
GRS conducting two RCTs, planning others
* Njeuhmeli (2012)
** Kaufman, Spencer and Ross (2013) in AIDS and Behavior
‘Make The Cut’ Intervention
Short, scalable, soccer-based intervention
• 60 min session facilitated by circumcised men with soccer teams
• Most men play and watch soccer
Logistical and behavioural reinforcement
• Transport provided
• Biweekly SMS reminders
• Priority status at clinic
MCUTS Trial: Methods
Soccer teams randomised into three groups
• Delivery by soccer pros (n=15)
• Delivery by non-soccer-pros (n=14)
• Control group (n=18)
Primary outcome: VMMC uptake over 4 months
• Clinic register and consent form
• Linkage via national ID, name, DOB, age, phone number
Baseline surveys using Open Data Kit
• Assessing reported MC prevalence, knowledge, intentions
MCUTS Trial: Methods
MCUTS Trial: Results
Round
1
2
3
• Roughly 9.8-times higher odds of
VMMC
uptake in intervention than control group:
OR=9.81, 95% CI=0.93-103.2, p=0.057
Comparing uptake of VMMC between groups, main outcome
analysis by intention-to-treat
MCUTS Trial: Results
Round 3
1
2
• Hints of difference of effectiveness by age
• Lower uptake among men over 30 years
Comparing VMMC uptake between study groups across age
MCUTS Trial: Discussion
Round 2
1
• Weak evidence of strong relative effect and
modest absolute effect
• Smaller sample size than anticipated
- Less statistical power than planned
• Limited generalizability beyond soccer
players
• MCUTS II with adolescent males and
Weekend Special with adult males
Acknowledgements
MCUTS Collaborators
Zak Kaufman, David Ross, Jeff DeCelles, Kenneth Bhauti, Karin
Hatzold, Cynthia Chaibva, & Fennie Mantula
Advisor
Thomas Clark
Implementation Staff
Grassroot Soccer Zimbabwe & PSI Zimbabwe
Funding
Bill & Melinda Gates Foundation
Doris Duke Charitable Foundation