Delivery of Male Circumcision Services

Three randomised clinical trials on the effects of male circumcision on HIV acquisition in men have been stopped by their data safety and management boards as the interim analyses showed a large protective effect in the range of 50 to 60%. It is not only this large effect that makes male circumcision very appealing as an intervention for HIV prevention. Male circumcision is a one-time intervention and unlike other prevention tools such as use of condoms vaginal microbicides and pre-exposure prophylaxis it is not dependent on high compliance by the users for its effectiveness. However this is the first time in the history of modern medicine that a surgical procedure has been recommended as an intervention to prevent a major public health problem and there are major challenges ahead in the design and implementation of male circumcision programmes. In this paper we will discuss issues in the delivery of male circumcision services in particular services for adult men. We will try and identify the essential components of male circumcision services and examine which model of service delivery is likely to be the most cost-effective and discuss some of the challenges involved. (excerpt)

Environmental health · Family medicine · Health services · Male circumcision · Political science · Population · Female Genital Mutilation/Cutting Issues · Genital Health and Disease · Medicine · Urologic and reproductive health conditions

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