Voluntary medical male circumcision in resource-constrained settings

  title={Voluntary medical male circumcision in resource-constrained settings},
  author={Aaron A. R. Tobian and Tigistu Adamu and Jason Bailey Reed and Valerian Kiggundu and Youseph Yazdi and Emmanuel Njeuhmeli},
  journal={Nature Reviews Urology},
Throughout East and Southern Africa, the WHO recommends voluntary medical male circumcision (VMMC) to reduce heterosexual HIV acquisition. Evidence has informed policy and the implementation of VMMC programmes in these countries. VMMC has been incorporated into the HIV prevention portfolio and more than 9 million VMMCs have been performed. Conventional surgical procedures consist of forceps-guided, dorsal slit or sleeve resection techniques. Devices are also becoming available that might help… 

An evidence-based analysis of voluntary medical male circumcision devices

The two available Unicirc® articles published in peerreviewed journals by Millard and colleagues did not include complete circumcision as a study outcome and did not explicitly state the level of efficacy of the Unicirc®, method, so it could not ascertain whether the device alone was successful at removing the foreskin.

Surgical Efficiencies and Quality in the Performance of Voluntary Medical Male Circumcision (VMMC) Procedures in Kenya, South Africa, Tanzania, and Zimbabwe

Surgical efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT are confirmed and reduced TEOT and PPTC in high volume setting did not result in decreased quality of surgical care.

Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography

The results of mathematical modeling using the Decision Makers’ Program Planning Tool Version 2.0, the Actuarial Society of South Africa model, and the age structured mathematical (ASM) model are presented, helping countries examine the potential effects on program impact and cost-effectiveness of prioritizing specific subpopulations for VMMC services.

Institutional Factors Affecting Uptake Of Voluntary Medical Male Circumcision Among The Sexually Active Male Populations In Busia County

  • D. Okumu
  • Medicine
    International Journal of Scientific and Research Publications (IJSRP)
  • 2021
The study concludes that Voluntary Medical Male Circumcision (VMMC) is a proven biomedical intervention that has the potential to save millions of lives and significant resources if it can be scaled up in high HIV prevalence regions where male circumcision is uncommon.

A Comparative Study on the Efficacy of Four Types of Circumcision for Elderly Males with Redundant Prepuce.

The Shang Ring circumcision caused the shortest operation time and the least bleeding, accompanied by the longest pain duration and recovery time, and the application of sleeve circumcision or a suturing device was recommended for elderly males suffering from redundant prepuce.

Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age

To achieve further scale-up, a combination of evidence, analysis, and impact estimates can usefully guide strategic planning and funding of VMMC services and related demand-creation strategies in priority countries.

A Comparative Study on the Clinical Efficacy of Modified Circumcision and Two Other Types of Circumcision.

Modified circumcision, with its advantages of shorter operation time, less blood loss and pain, lower cost, and better postoperative penile appearance, is easily accepted by patients and deserves wide clinical application.

Providers’ Perceptions and Training Needs for Counseling Adolescents Undergoing Voluntary Medical Male Circumcision

  • A. TobianK. Dam M. Kaufman
  • Medicine, Psychology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2018
Preconceptions hinder counseling that supports comprehensive HIV preventive behaviors and complete wound care information, particularly for younger adolescents, according to providers and facility managers.



Rapid, minimally invasive adult voluntary male circumcision: a randomised trial of Unicirc, a novel disposable device.

This study finds that Excising the foreskin with the Unicirc instrument and sealing the wound with cyanoacrylate tissue adhesive in adults is quicker, easier to learn, and is potentially safer than open surgical VMMC.

Adverse Events Profile of PrePex a Non-Surgical Device for Adult Male Circumcision in a Ugandan Urban Setting

PrePex is feasible for mass safe male circumcision scaling up and would recommend the device to their friends, and AEs of a moderate or severe nature associated with PrePex were low and reversible.

No-Needle, Single-Visit Adult Male Circumcision with Unicirc: A Multi-Centre Field Trial

Unicirc is rapid, easy to learn, heals by primary intention with excellent cosmetic results, obviates the need for a return visit for device removal, and is potentially cheaper and safer than other methods.

Male circumcision: a globally relevant but under-utilized method for the prevention of HIV and other sexually transmitted infections.

Although MC is a globally valuable tool to prevent HIV and other sexually transmitted infections, it is underutilized and barriers to MC uptake include supply-side and demand-side challenges.

HIV Prevention: Male Circumcision Comparison Between a Nonsurgical Device to a Surgical Technique in Resource-Limited Settings: A Prospective, Randomized, Nonmasked Trial

PrePex, the nonsurgical MC, takes significantly less time than surgical, is as safe, does not require injections or sterile settings, is bloodless and seems to be suitable for nurses.

Safety and Efficacy of the PrePex Device for Rapid Scale-Up of Male Circumcision for HIV Prevention in Resource-Limited Settings

The PrePex device was safe and effective for nonsurgical adult male circumcision without anesthesia or sterile settings and may be useful in mass circumcision programs to reduce the risk of HIV infection, particularly in resource-limited settings.

The Acceptability and Safety of the Shang Ring for Adult Male Circumcision in Rakai, Uganda

The Shang Ring is highly acceptable and safe in this setting, and could improve the efficiency of MMC services, however, back-up surgical services are needed in cases of Ring placement failures.

The Safety and Acceptance of the PrePex Device for Non-Surgical Adult Male Circumcision in Rakai, Uganda. A Non-Randomized Observational Study

The PrePex device was well accepted, but healing was slower than with dorsal slit surgery, and the need to return for removal and delayed healing may increase Program cost and client burden.

Safety, Effectiveness and Acceptability of the PrePex Device for Adult Male Circumcision in Kenya

The PrePex device was effective for MMC in Kenya, and well-accepted, and the AE rate was higher than reported for surgical procedures there, or in previous prePex studies.