Use of devices for adult male circumcision for HIV prevention in East and Southern Africa
Meeting report - Entebbe, Uganda. 13-14 November 2013
The World Health Organization (WHO) introduced a new guidance with recommendations on the use of devices for performing adult male circumcision at a November 2013. WHO convened the meeting to inform key stakeholders about the guidance, share findings from research studies, discuss programmatic considerations, and identify next steps for potential use of devices in national programmes. Introduction of MC devices presents an opportunity to improve the entire package of medical male circumcision services and programmes, including reaching priority age groups during the catch-up phase for which use of the device is currently recommended (i.e. men 18 years and above).
Key programmatic considerations for the introduction and use of devices were addressed. Pilot studies to date have provided valuable lessons, and further studies will add to the information that needs to be shared across countries. Participants were reminded that, as with any medical intervention, there are benefits and risks to all MC methods, and a balanced perspective is needed. All serious AEs to date have been successfully managed with complete resolution. The currently known risks with the devices can be mitigated through provider training, client selection, education and appropriate surgical backup services. Conventional surgical MC also has its risks, which are addressed by standard operating procedures. Introduction of a new method provides an opportunity to strengthen monitoring and reporting systems, regardless of the MC method.