Male Circumcision is being used in Africa to combat HIV. A new, simple plastic device, which needs no anaesthetic, surgery or stitches is being used to circumcise up to two million men in Rwanda. Male circumcision reduces the chances of men in heterosexual relationships becoming infected with HIV.
Staff need very little training to fit it – something extremely important in a country with only 300 doctors for ten million people. Rwandan nurses & doctors will be carrying out the procedure.
The World Health Organisation says there is compelling evidence that male circumcision can reduce the risk of HIV infection by around sixty percent in high-risk areas such as sub-Saharan Africa.
However, those involved in the fight against AIDS stress that using condoms and staying faithful to one partner offer far more reliable protection. Experts give several reasons for this including that the foreskin traps HIV in a moist environment allowing the virus to live longer.
The new procedure involves the use of a device called a PrePex, a three piece mechanism consisting of two plastic rings and an elastic mechanism. It is clamped onto the penis without any need for sutures or anaesthesia.
As such, the procedure can ben done in any clean, sheltered environment releasing Rwanda’s already stretched surgical theatres for more urgent matters. Moreover, the device is simple and can be taught to nurses in just two days, allowing medical professionals to concentrate on other complex operations.
The objective is to scale up use for a mass circumcision initiative across the country. The campaign intends to halve Rwanda’s HIV incidence rate of three percent by circumcising two million men. Nursing have been undergoing a two day training course as opposed to the fifteen days it takes to learn surgical circumcision. The health ministry estimates that with 500 health facilities in the country Rwanda can perform approximately 250,000 procedures every two weeks.
However, circumcision is still a foreign concept to Rwandans. Only fifteen percent of adult males are circumcised. In rural areas where illiteracy is high and traditional customs are more entrenched, this falls to as low as 1-2 percent.
The government has launched a public education sensitisation campaign on the radio with the help of local leaders and community health workers.
- There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately sixty percent
- Three randomised controlled trials have shown that male circumcision provided by well-trained health professionals in properly equipped settings is safe
- Male circumcision should be only one element of a comprehensive HIV prevention package which includes:
– the provision of HIV testing and counselling services
– treatment for sexually transmitted infections
– the promotion of safer sex practices such as condom use
Source: World Health Organisation