Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

05 December 2011

Medical Male Circumcison's Potential Yet to Emerge in Practice

via The Financial Times, by Andrew Jack

A mural promotes the benefits of circumcision at a clinic in KenyaTzameret Fuerst whips two plastic rings out of her handbag and prises them together around her forefinger with a black rubber band, simulating a simple way to carry out male circumcision that she hopes will soon be widely adopted across Africa.

“This is a safe, simple, non-surgical device that needs no anaesthetic and is scaleable in resource-limited settings, using nurses to carry out the procedure in tents in rural areas,” she says. “It’s virtually painless, completely bloodless and does not require a sterile setting.”

The PrePex device that her company Circ MedTech has developed is one of a growing number of experimental tools in search of a market that has the potential to help radically reduce HIV transmission.
But circumcision is also a practice that – despite the evidence – has yet to be adopted as much or as fast as experts had hoped.

Many years after observational studies indicated that circumcised cultures had lower HIV prevalence, progress remains extremely slow. In 2005, the results of the first carefully randomised controlled clinical trials in Orange Farm in South Africa demonstrated that sexual transmission was reduced by 60 per cent in men who were circumcised.

A recent estimate published by UNAids highlighted a jump in adult male circumcisions, especially in Kenya, South Africa and Zambia. But with 555,000 interventions in men aged 15-49 across sub-Saharan Africa by the end of last year, less than 3 per cent has been achieved of a target of 21m set for 2015 to reduce significantly new infections in the region.

“It’s going to be a big challenge to reach this target,” concedes Gottfried Hirnschall, head of the World Health Organization’s HIV programme.

International organisations have publicly endorsed the importance of circumcision, and a number of guidelines have been established, but the response so far has been haphazard and funding remains modest.

Read the rest.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

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