title: A program evaluation report of a rapid scale-up of a high-volume medical male circumcision site, KwaZulu-Natal, South Africa, 2010-2013.
abstract: BACKGROUND
  Male circumcision can provide life-long reduction in the risk of acquiring HIV infection. In South Africa, the KwaZulu-Natal Provincial Department of Health committed to rolling out circumcision programs to address the HIV epidemic. The Department of Health enlisted the help of St. Mary's Hospital in Mariannhill and the Operation Abraham Collaborative.
  
  
  METHODS
  St. Mary's Hospital and the Operation Abraham Collaborative partnered to establish a voluntary medical male circumcision facility, called Asiphile, and to train surgeons, nurses and health clinic staff to serve KwaZulu-Natal.
  
  
  RESULTS
  Over the course of the implementation period, 9,980 circumcisions were conducted at the Asiphile facility. The uptake numbers increased throughout 2010 and 2011 and began to level off as the demand of early adopters may have been met. Uptake spiked during school vacations and staff training sessions. Additionally, 92 % of clients returned for post-operation follow-up and only 2 % of clients experienced any adverse event.
  
  
  CONCLUSIONS
  St. Mary's Hospital and the Operation Abraham Collaborative were able to cooperate and successfully implement a voluntary medical male circumcision facility in KwaZulu-Natal. Although uptake was lower than projected, lessons learned from efforts to overcome challenges in recruitment, transportation, and coordination can help inform and improve new and existing population-based male circumcision programs.
authors.affiliation: Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, California. Adriane.wynn@ucla.edu.
authors.forename: Adriane
authors.initials: A
authors.lastname: Wynn
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California. ccbristow@gmail.com.
authors.forename: Claire C
authors.initials: CC
authors.lastname: Bristow
authors.affiliation: St Mary's Hospital, Mariannhill KZN, Johannesburg, South Africa. drsross@iafrica.com.
authors.forename: Douglas
authors.initials: D
authors.lastname: Ross
authors.affiliation: Operation Abraham Collaborative, Jerusalem, Israel. inon@operation-ab.org.
authors.forename: Inon
authors.initials: I
authors.lastname: Schenker
authors.affiliation: Division of Infectious Diseases, Center for World Health, Department of Epidemiology, David Geffen School of Medicine and Fielding School of Public Health, University of California, 9911 W Pico Blvd Suite 955, Los Angeles, California. JDKlausner@mednet.ucla.edu.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D000293:Adolescent; D000328:Adult; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D013019:South Africa; D055815:Young Adult