Voluntary Medical Male Circumcision as part of the National Program and the Combination Prevention Project in Botswana under the President's Emergency Plan for AIDS Relief

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Twenty-five percent of adults 15-49 years of age in Botswana are HIV-positive. Voluntary Medical Male Circumcision (VMMC) is one of the key prevention strategies for control of HIV. The goal of this funding opportunity announcement (FOA) is to assist the Government of Botswana in its VMMC activities over the next 5 years. There are two main activities to be implemented. First, the awardee will a) create demand for VMMC services, b) ensure that all males seeking VMMC are offered testing for HIV, and c) conduct at least 60,000 VMMC procedures among HIV-negative males or males of unknown HIV status 13-49 years of age in three geographic areas of the country during a 5-year period (>4,000 procedures per site per year). There is the possibility of expansion to additional areas during the course of the award if the implementation model is successful. Second, the awardee will collaborate with the ongoing Botswana Combination Prevention Project (BCPP) which was begun in late 2013 and is scheduled to last for 5 years. This award will begin at year 1.5 of the study. The timeframe for BCPP activities in this FOA is dependent on study progression. The awardee will be prepared and able to circumcise at least 80% of HIV-negative males or males of unknown HIV status 16-49 years of age, and as many HIV-negative males or males of unknown HIV status 50-64 years of age as possible, in 15 Botswana Combination Prevention Project (BCPP) sites by the end of year 3 of the study. The awardee will then maintain these coverage levels at all 15 BCPP intervention sites for years 3-5 of the study if the VMMC component of the project is continued beyond the period planned for achieving the initial targets. For both main activities, the awardee must implement a robust system of monitoring and evaluating (M&E) all VMMC-related activities that is aligned with the existing national M&E system. There must be an emphasis on providing high quality services and meeting VMMC targets at an acceptable cost per circumcision performed.

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