Male Circumcision
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Male Circumcision

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Male Circumcision is one form of HIV prevention that needs to be combined with other HIV prevention techniques in a \'package of care\'. Other HIV prevention techniques include staying faithful to......

Male Circumcision is one form of HIV prevention that needs to be combined with other HIV prevention techniques in a \'package of care\'. Other HIV prevention techniques include staying faithful to one sexual partner and using condoms.

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  • 1. Media Briefing – Male Medical Circumcision In Preparation for the SANAC Plenary Meeting on 27 th November 2008
  • 2. SANAC = South African NationalAIDS Commission http://www.info.gov.za/issues/hiv/sanac.htm
  • 3. SANAC = South African NationalAIDS Commission http://www.info.gov.za/issues/hiv/sanac.htm
  • 4. Context
    • Highest number of people infected with HIV in world
    • Vaccines not on horizon
    • Microbicides also not looking good for near future
    • Social and behaviour change – progress but not fast enough
  • 5. MALE CIRCUMCISION
  • 6. MALE CIRCUMCISION
    • Does it Work?
    • How Does it Work?
    • When should it be done?
    • How should it be done?
    • Where should it be done?
    • Who should do it?
  • 7. Issues
    • Culture – at birth, at a young age, as a rite of passage, others see as unmanly. Cultural circumcision – not always complete.
    • Women – not clear that women protected
    • ? Tied to VCT – increased transmission after if not healed
    • Costs – opportunity costs
    • MSM – not clear if protective
  • 8. Process
    • National SANAC discussions - ensure best policies
    • Communication – health workers, public – incomplete protection MUST still reduce sexual partners, always use condoms
  • 9. Circumcision by Province Department of Health, 2007: HSRC/Nelson Mandela Household Survey 2005 Province Circumcision Rate % HIV Prevalence Rate Western Cape 68 3 Free State 71 19 Limpopo 48 11 Eastern Cape 44 16 Mpumalanga 36 23 Northern Cape 34 9 North West 33 18 Kwazulu-Natal 27 22 Gauteng 25 16
  • 10. Western Cape vs Gauteng Difference: circumcision & fewer sexual partners SA National Communication Survey 2008 Western Cape % Gauteng % HIV Prevalence 3 16 Male Circumcision 68 16 Condoms used @ last sexual encounter 50 59 Men with > 1 partner 9 17
  • 11. Limpopo vs Mpumalanga Difference: circumcision SA National Communication Survey 2008 Limpopo% Mpumalanga % HIV Prevalence 11 23 Male Circumcision 48 36 Condoms used @ last sexual encounter 58 63 Men with > 1 partner 17 13
  • 12. Eastern Cape vs Kwazulu-Natal Difference: circumcision SA National Communication Survey 2008 Eastern Cape % Kwazulu-Natal % HIV Prevalence 16 22 Male Circumcision 44 27 Condoms used @ last sexual encounter 73 56 Men with > 1 partner 13 11
  • 13. Free State SA National Communication Survey 2008 Free State% HIV Prevalence 19 Male Circumcision 71 Early Sexual Debut 57% before age of 17 National = 47%