title: Implementation of a National Semen Testing and Counseling Program for Male Ebola Survivors - Liberia, 2015-2016.
abstract: According to World Health Organization (WHO) data, the Ebola virus disease (Ebola) outbreak that began in West Africa in 2014 has resulted in 28,603 cases and 11,301 deaths (1). In March 2015, epidemiologic investigation and genetic sequencing in Liberia implicated sexual transmission from a male Ebola survivor, with Ebola virus detected by reverse transcription-polymerase chain reaction (RT-PCR) 199 days after symptom onset (2,3), far exceeding the 101 days reported from an earlier Ebola outbreak (4). In response, WHO released interim guidelines recommending that all male survivors, in addition to receiving condoms and sexual risk reduction counseling at discharge from an Ebola treatment unit (ETU), be offered semen testing for Ebola virus RNA by RT-PCR 3 months after disease onset, and every month thereafter until two consecutive semen specimens collected at least 1 week apart test negative for Ebola virus RNA (5). Male Ebola survivors should also receive counseling to promote safe sexual practices until their semen twice tests negative. When these recommendations were released, testing of semen was not widely available in Liberia. Challenges in establishing and operating the first nationwide semen testing and counseling program for male Ebola survivors included securing sufficient resources for the program, managing a public health semen testing program in the context of ongoing research studies that were also collecting and screening semen, identification of adequate numbers of trained counselors and appropriate health communication messages for the program, overcoming Ebola survivor-associated stigma, identification and recruitment of male Ebola survivors, and operation of mobile teams.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Purpura
authors.forename: Moses
authors.initials: M
authors.lastname: Soka
authors.forename: April
authors.initials: A
authors.lastname: Baller
authors.forename: Stephen
authors.initials: S
authors.lastname: White
authors.forename: Emerson
authors.initials: E
authors.lastname: Rogers
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Choi
authors.forename: Nuha
authors.initials: N
authors.lastname: Mahmoud
authors.forename: Christine
authors.initials: C
authors.lastname: Wasunna
authors.forename: Moses
authors.initials: M
authors.lastname: Massaquoi
authors.forename: Kristin
authors.initials: K
authors.lastname: Vanderende
authors.forename: Jomah
authors.initials: J
authors.lastname: Kollie
authors.forename: Straker
authors.initials: S
authors.lastname: Dweh
authors.forename: Philip
authors.initials: P
authors.lastname: Bemah
authors.forename: Athalia
authors.initials: A
authors.lastname: Christie
authors.forename: Victor
authors.initials: V
authors.lastname: Ladele
authors.forename: Onyekachi
authors.initials: O
authors.lastname: Subah
authors.forename: Satish
authors.initials: S
authors.lastname: Pillai
authors.forename: Margaret
authors.initials: M
authors.lastname: Mugisha
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kpaka
authors.forename: Stuart
authors.initials: S
authors.lastname: Nichol
authors.forename: Ute
authors.initials: U
authors.lastname: Ströher
authors.forename: Neetu
authors.initials: N
authors.lastname: Abad
authors.forename: Shauna
authors.initials: S
authors.lastname: Mettee-Zarecki
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Bailey
authors.forename: Pierre
authors.initials: P
authors.lastname: Rollin
authors.forename: Barbara
authors.initials: B
authors.lastname: Marston
authors.forename: Tolbert
authors.initials: T
authors.lastname: Nyenswah
authors.forename: Alex
authors.initials: A
authors.lastname: Gasasira
authors.forename: Barbara
authors.initials: B
authors.lastname: Knust
authors.forename: Desmond
authors.initials: D
authors.lastname: Williams
mesh_terms: D003376:Counseling / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control*; D029043:Ebolavirus / Q000302:isolation & purification; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007988:Liberia / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D016730:Program Development; D012661:Semen / Q000821:virology; D017741:Survivors / Q000706:statistics & numerical data