Defining the Global Research and Programmatic Agenda and Priority Actions for Voluntary Medical Male Circumcision for HIV Prevention

Abstract

Purpose of Review Since 2007, voluntary medical male circumcision (VMMC) programs have been associated with substantially reduced HIV incidence across 15 prioritized countries in Eastern and Southern Africa. Drawing on the programmatic experience of global VMMC leaders, this report reviews progress made in the first 15 years of the program, describes programmatic and research gaps, and presents considerations to maximize the impact of VMMC. Recent Findings Overall, key programmatic and research gaps include a lack of robust male circumcision coverage estimates due to limitations to the data and a lack of standardized approaches across programs; challenges enhancing VMMC uptake include difficulties reaching populations at higher risk for HIV infection and men 30 years and older; limitations to program and procedural quality and safety including variations in approaches used by programs; and lastly, sustainability with limited evidence-based practices. Considerations to address these gaps include the need for global guidance on estimating coverage, conducting additional research on specific sub-populations to improve VMMC uptake, implementation of responsive and comprehensive approaches to adverse event surveillance, and diversifying financing streams to progress towards sustainability. Summary This report’s findings may help establish a global VMMC research and programmatic agenda to inform policy, research, and capacity-building activities at the national and global levels.

Adolescent Experience in Performing Sifon Tradition (PostCircumcision Sex) in the Village of Fatumonas- Middle Amfoang, East Nusa Tenggara

“…Strong and consistent research results from diverse designs and research methods have proven that circumcision reduces the risk of HIV infection in heterosexual men. Circumcision is also one of the most cost-effective and critical interventions to maintain progress towards the end of the HIV/AIDS epidemic [6] [7][8] [9]. Similarly, traditional circumcision can reduce the risk of HIV/AIDS infection in men [10].…”

Voluntary Medical Male Circumcision’s (VMMC) Strategy for HIV prevention in Sub-Saharan Africa, prevalence, risks, costs, benefits and best practice: A scoping review of progress and unfolding insights

“…The World Health Organization has been continuously issuing guidelines and practice manuals which countries have been adapting and adopting to their local context. Figure 1 highlights some of the main reference documents issued by the Organizations and the key message or update in each of them (1,(5)(6)(7)(8)(9)(10)(11).…”