Advocacy Perspectives and Links

Medical male circumcision for HIV prevention is still a relatively new strategy that brings opportunities and challenges for advocates, providers, people living with HIV/AIDS, and many other communities engaged in fighting HIV/AIDS.

While these data provide a strong rationale for proceeding with pilot programmes and scale-up, there is also a range of areas where additional research is needed. The following are some of the areas that advocates have identified as being particularly critical to consider:

• These trials do not provide clear answers about the safety and potential risks and benefits of male circumcision for HIV-positive men and their female partners.

• There is still a need to gather and analyse data on rates of risk behaviour among circumcised and uncircumcised men in long-term follow-up from clinical trials and as pilot programmes develop.

• The trials to date do not provide any data about whether male circumcision provides protection during anal sex.

This page will be developed with links to opinion pieces, educational materials and other resources developed by or relevant to civil society groups working on HIV prevention and male circumcision in particular.

As advocates build their knowledge base and develop perspectives and priorities on this topic, additional resources will be added. Please share any materials you have with us, and visit regularly to see what's new.

Task-shifting

Additional providers will be needed to scale up male circumcision services, thus decision-makers need to consider the role of non-physician providers to meet this need. The successful use of non-physician providers (e.g., nurses and clinical officers)to perform more complex clinical and surgical procedures has been well-documented in various countries. Experience has also shown that appropriately trained non-physician providers can safely conduct procedures such as Caesarean sections, mini-laparotomy under local anaesthesia for female sterilisation, no-scalpel vasectomy, repair of simple obstetric fistula, manual vacuum aspiration, and a variety of other surgical procedures. Specifically, it has been successfully demonstrated that well trained staff (including clinical officers) can be used to perform male circumcision. In Kenya, clinical officers who routinely conducted consultations and selected surgical procedures were trained in the techniques of adult male circumcision. Thus, in order to scale up the availability of male circumcision services, it is recommended that countries should identify non-physician providers that can be trained to perform this procedure and provide comprehensive services. Read more>>.

Resources

A New Way to Protect Against HIV? Understanding the Results of Male Circumcision Studies for AIDS Prevention (PDF, 268 KB)

Meeting Report: Civil Society Dialogue on Male Circumcision for HIV Prevention: Implications for Women (PDF, 208 KB). 22-23 June 2008, Mombasa, Kenya. AVAC, 2008.