GENEVA, 7 June 2013—The Joint United Nations programme on HIV/AIDS (UNAIDS) welcomes the recent announcement by the World Health Organization (WHO) that for the first time a non-surgical device (PrePex™) has been pre-qualified for the purpose of adult male circumcision for HIV prevention.
There is compelling evidence that medical male circumcision reduces sexual transmission of HIV from women to men by 60%. WHO and UNAIDS urge countries with high HIV prevalence and low levels of male circumcision to expand access to safe, voluntary medical male circumcision as part of their HIV prevention efforts.
However, many countries are facing challenges in scaling up voluntary medical male circumcision as for HIV prevention, in particular due to the shortage of surgically trained and skilled providers to perform the current conventional surgical procedure.
In comparison to the surgical procedure, PrePex™ does not routinely require injectable anaesthesia or suturing, and safe use has been demonstrated by appropriately trained physicians and mid-level providers with surgical back-up as needed.
“This kind of innovation that may contribute to improving efficiency, access, and safety, while increasing demand for voluntary medical male circumcision is very welcome,” said Michel Sidibé, Executive Director of UNAIDS. “It could have a significant impact on HIV prevention efforts in areas with high HIV prevalence and low levels of male circumcision if uptake increases.”
Since voluntary medical male circumcision programmes for HIV prevention started in 2007, an estimated 2 million men have undergone circumcisions for HIV prevention in Eastern and Southern Africa. UNAIDS estimates that voluntary medical male circumcision has the potential to prevent an estimated 1 in 5 new HIV infections in the region by 2025. However, programmes will need to be significantly scaled-up to maximize public health impact.
Medical male circumcision provides partial protection to men from heterosexual transmission, and WHO and UNAIDS recommend that it be firmly placed in a combination approach to prevent HIV infection that includes the correct and consistent use of male and female condoms; a reduction in the number of sexual partners; the promotion of safe sexual practices such as avoidance of penetrative sex; treatment for sexually transmitted infections; and the provision of antiretroviral therapy for people living with HIV who are eligible for treatment.
