Preventing HIV in excessive HIV burden settings by voluntary medical male circumcision

Preventing heterosexually acquired HIV and attaining international HIV incidence targets require a mix of interventions. Voluntary medical male circumcision (VMMC) is considered one of these interventions in settings with a excessive burden of HIV. New tips from
the World Health Organization (WHO) updates earlier suggestions on VMMC for HIV prevention.

These new tips current extra proof in assist of continuous VMMC providers as a part of mixture prevention for grownup males and adolescent boys ages 15 years and older, in addition to, on the protection of prequalified device-based male circumcision
strategies and on interventions to boost service uptake amongst males. The tips additionally define a well being techniques framework to information transitioning to adolescent-focused sustainable providers and sustaining excessive VMMC protection.

“In 2007 three ‘gold customary’ randomized managed trials confirmed that VMMC decreased males’s danger of heterosexually acquired HIV by 59%. Now, greater than 10 years of additional proof reveals that VMMC is having a considerable impact in real-world
settings. This contains an impartial prevention impact in settings the place different HIV prevention interventions, akin to Pre-exposure prophylaxis (PrEP) and anti-retroviral remedy have been taken to scale. VMMC is a cost-saving intervention – eliminating
the prices of lifelong HIV remedy amongst these protected against an infection. We should do all that we will to advocate for larger political assist and funding to extend and preserve VMMC service protection in East and Southern Africa, the place the HIV burden
and potential affect is best.” stated Meg Doherty, Director, Global HIV, Hepatitis and STIs Programmes, WHO.

“Similar to stopping COVID through the use of a number of interventions, VMMC is a vital possibility within the toolkit of efficient HIV prevention interventions in East and Southern Africa. The new tips advocate VMMC providers for adolescents age 15 years
and older and for males, notably these at greater danger of HIV an infection. Considerations are additionally offered on whether or not to supply VMMC to youthful adolescent boys (ages 10-14 years), bearing in mind their variety in bodily and cognitive improvement,
together with their capability to consent. When communities, mother and father and companions are engaged, they will assist selections about this prevention possibility.” stated Frank Lule, Medical Officer, WHO African Regional Office.

“VMMC has reached over 25 million males in East and Southern Africa by 2019, averting an estimated 650 000 to 1.5 million HIV infections by 2030 relying on the dimensions up of different prevention interventions. As international locations obtain greater VMMC protection
ranges, providers will transition to sustainable approaches targeted on every new era of adolescents. Embedding service supply inside established well being techniques aligns with international efforts to strengthen well being techniques. These new tips provide
issues to maintain VMMC providers through the use of the WHO well being techniques ‘building blocks’.” stated Lycias Zembe, Technical Officer, Prevention, United Nations Joint Programme on HIV/AIDS, Switzerland.


In the rules, WHO emphasizes the significance of offering secure and efficient VMMC providers. Patient security measures and monitoring for opposed occasions is vital for all VMMC programmes.

“Patient security is a high precedence for VMMC programmes in Zambia. The nation’s National Surgical, Obstetric, and Anaesthesia Strategic Plan (NSOASP), 2017−2021 supplies a broad framework for the planning, supply and administration of high quality
surgical (together with VMMC), obstetric and anaesthesia providers in any respect ranges of well being supply techniques. One of the aims of this technique is to construct secure and high-quality surgical techniques. For the VMMC intervention, keys to this success are
efficient and well timed monitoring of opposed occasions and enhancing a tradition of studying by strengthened well being administration info techniques and analysis capabilities.” defined Albert Kaonga, HIV Prevention Program Manager, Ministry of
Health, Zambia.

The WHO tips replace suggestions on the use and security of WHO-prequalified device-based male circumcision strategies, together with new methods and gadgets. Such revolutionary surgical strategies could additional enhance security, simplify the process and probably
enhance acceptability and entry. These extra strategies could have benefits over standard surgical procedure, however their use has been restricted and must be additional expanded and security measured in real-world settings.

“VMMC providers are reaching males and adolescent boys, who usually don’t hunt down well being care. Services embrace a bundle with safer intercourse training, condom promotion and the identification and remedy of sexually transmitted infections. VMMC contributes
to lowering the chance of different STIs akin to human papillomavirus, which causes cervical most cancers. HIV, STI and sexual and reproductive well being programmes and providers must work extra carefully collectively to ship a number of well being providers wanted by adolescent
boys and males. Service supply have to be enhanced and reoriented to be extra male-friendly, together with for adolescents.” stated Sinokuthemba Xaba, National VMMC Program Coordinator, Ministry of Health and Child Care, Zimbabwe.