Tag Archives: Voluntary Medical Male Circumcision (VMMC)

Documentary on Male Circumcision for HIV Prevention

Launching of a new film documenting Male Circumcision for HIV/AIDS Prevention

Increasing evidence has shown male circumcision to be a primary tactic in the fight against the spread of HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immunodeficiency Syndrome) in continental Africa [1].  Wednesday June 22, 2011, a short film describing Voluntary Medical Male Circumcision (VMMC) for decreasing the spread of HIV was released [2].  This film entitled In It to Save Lives: Scaling Up Voluntary Medical Male Circumcision for HIV Prevention for Maximum Public Health Impact, was produced by AIDSTAR-One and the film was made by Lisa Russell.  AIDSTAR-ONE is a PEPFAR-funded USAID project [2].

About the AIDSTAR-ONE Film on Male Circumcision for HIV/AIDS transmission reduction

The film discusses how Kenya and Swaziland have supported male circumcision for HIV prevention in of the epidemic in their countries [2].  The film provides information on how to implement circumcision for HIV/AIDS and includes interviews with a HIV/AIDS experts and policymakers.  Importantly the video and shows that VMMC programs can be implemented in other affected areas and provides instruction on how to maximize VMMC participation for improving HIV/AIDS statistics.

How does male circumcision help decrease HIV/AIDS transmission?

At first glance, how male circumcision participates to decrease HIV/AIDS transmission does not seem obvious.  However, there is growing evidence that circumcision can reduce transmission up to 50%.   It is estimated that there was a majority of males circumcised, then HIV realted deaths could potentially be reduced by 3 million [1,3].  In a papers published in JIDC, the Journal of Infection in Developing Countries and the New England Journal of Medicine, the authors discuss how voluntary male circumcision has partially prevented HIV transmission in African nations

Map from Lonely Planet

[1,3].  Three groundbreaking studies have set the trend for randomized, controlled trials of circumcision [4–6].  These studies showed a significant reduction in transmission following circumcision.  The published paper describes Orange Farm, South Africa, to be the first community to participate in a voluntary circumcision trial that statistically showed this practice decreased HIV transmission where HIV infection in heterosexual men was reduced by 60% [4].  Following the results of this trial, Kenya and Uganda since also participated in similar trials and confirmed the results from South Africa in two papers by Gray and Bailey [5,6]. 

Currently the scientific theory behind circumcision decreasing HIV transmission suggests the foreskin to be reservoir for secretions that contain viruses such as HIV [1,3].  This reservoir then concentrates the interaction between virus and target cells as well as increases the contact time maximizing the possibility for infection. 

Since male circumcision only partially prevents new HIV/AIDS infections, the WHO has established a set of guidelines for HIV prevention, entitled a HIV prevention package [7].  Along with circumcision, the WHO recommends HIV testing and counselling services, treatment for other sexually transmitted diseases, campaigning of safe sex procedures, and the administration of condoms for both males and females.  A PLoS One paper published in April 2011 reviews the current challenges and future directions of implementing voluntary circumcision for HIV prevention programs. 

 

Alyson

References

 

        1.    Addanki KC, Pace DG, Bagasra O (2008) A practice for all seasons: male circumcision and the prevention of HIV transmission. J Infect Dev Ctries 2: 328-334.

        2.    AIDSTAR-ONE  (2011 July) In It to Save Lives: Scaling Up Voluntary Medical Male Circumcision for HIV Prevention for Maximum Public Health Impact. http://www.cvent.com/events/aidstar-one-premiere-of-the-short-film-in-it-to-save-lives/event-summary-4dec87f1a8fb4eaa9d4a0996fc455642.aspx.

        3.    Katz IT, Wright AA (2008) Circumcision–a surgical strategy for HIV prevention in Africa. N Engl J Med 359: 2412-2415. 359/23/2412 [pii];10.1056/NEJMp0805791 [doi].

        4.    Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med 2: e298. 05-PLME-RA-0310R1 [pii];10.1371/journal.pmed.0020298 [doi].

        5.    Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, Williams CF, Campbell RT, Ndinya-Achola JO (2007) Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 369: 643-656. S0140-6736(07)60312-2 [pii];10.1016/S0140-6736(07)60312-2 [doi].

        6.    Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, Kiwanuka N, Moulton LH, Chaudhary MA, Chen MZ, Sewankambo NK, Wabwire-Mangen F, Bacon MC, Williams CF, Opendi P, Reynolds SJ, Laeyendecker O, Quinn TC, Wawer MJ (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 369: 657-666. S0140-6736(07)60313-4 [pii];10.1016/S0140-6736(07)60313-4 [doi].

        7.    2011 July) WHO Male circumcision for HIV prevention. http://www.who.int/hiv/topics/malecircumcision/en/index.html.

 

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