Three randomized controlled clinical trials have demonstrated that male circumcision can be effective at preventing men from being infected with HIV, reducing risk of men acquiring HIV through female-to-male transmission by approximately 60 percent. A joint WHO/UNAIDS technical consultation recommended the scale-up of male circumcision services in areas with a high prevalence of HIV infection. The challenge, then, is to meet the current demand for safe, voluntary male circumcision in these areas and to ensure the scale-up of effective programs.
Population Council focus
The Council is the primary research partner of the Male Circumcision Partnership, led by Population Services International (other partners include Marie Stopes International and Jhpiego). The Council is conducting formative, longitudinal, and operations research activities in Swaziland and Zambia over the next four years to monitor and evaluate the activities of the partnership. Formative research studies will help determine the best method to help men accurately self-identify their circumcision status and to make recommendations for standardizing and streamlining the informed consent process while assessing comprehension of the procedure. A longitudinal study among sexually active men will assess behavior change and risk compensation postcircumcision. Finally, operations research will contribute to the efficacy and safety of the services by addressing such questions as the quality and cost of physician versus non-physician-led procedures, mobile versus fixed sites, and the most optimal postoperation visit schedules.
Future directions
The Council’s research will generate evidence to recommend male circumcision service-delivery models suitable to different countries and contexts. The partnership’s activities will provide lessons learned and best practices that will educate other donors, governments, and organizations about scaling up male circumcision activities more broadly.
Projects
Male Circumcision Partnership: Achieving Scale (more)
The Male Circumcision Partnership is establishing multisectoral provider networks for high-quality adult male circumcision services.
(1/2009 - 11/2013)
Swaziland, Zambia
Community Mobilization for Preventive Action (COMPACT) (more)
Council researchers are developing and determining the feasibility of "community compacts" as an innovative approach to prevent HIV in Zambian communities.
(7/2010 - 7/2013)
Zambia
Resources
Female sex workers, male circumcision and HIV: A qualitative study of their understanding, experience, and HIV risk in Zambia (abstract) (HTML)
Abbott,Sharon; Haberland,Nicole; Mulenga,Drosin; Hewett,Paul C.
PLoS ONE 8(1): e53809. doi:10.1371/journal.pone.0053809-
Publication date: 2013
How informed are clients who consent? A mixed-method evaluation of comprehension among clients of male circumcision services in Zambia and Swaziland (abstract)
Friedland,Barbara A.; Apicella,Louis; Schenk,Katie D.; Sheehy,Meredith; Hewett,Paul C.
AIDS and Behavior Published online ahead of print, 8 February
Publication date: 2013
"The Population Council's HIV and AIDS program," fact sheet (PDF)
Population Council
Publication date: 2012
Assessing and improving self-reporting of male circumcision in Zambia and Swaziland (PDF)
Hewett,Paul C.; Haberland,Nicole; Mensch,Barbara S.; Apicella,Louis
Population Council Research and Evaluation of Male Circumcision Scale-Up Report (no. 2)
Publication date: 2012
On the cutting edge: Improving the informed consent process for adolescents in Zambia undergoing male circumcision for HIV prevention (abstract)
Schenk,Katie D.; Friedland,Barbara A.; Apicella,Louis; Sheehy,Meredith; Munjile,Kelvin; Hewett,Paul C.
Vulnerable Children and Youth Studies 7(2): 116-127
Publication date: 2012
Sex with stitches: The resumption of sexual activity during the post-circumcision wound healing period in Zambia (abstract)
Hewett,Paul C.; Hallett,Timothy B.; Mensch,Barbara S.; Dzekedzeke,Kumbutso; Zimba-Tembo,Susan; Garnett,Geoffrey P.; Todd,Petra E.
AIDS 26(6): 749-756
Publication date: 2012
The (mis)reporting of male circumcision status among men and women in Zambia and Swaziland: A randomized evaluation of interview methods (abstract) (HTML)
Hewett,Paul C.; Haberland,Nicole; Apicella,Louis; Mensch,Barbara S.
PLoS ONE 7(5): e36251-
Publication date: 2012
Assessing comprehension of key informed consent concepts among clients undergoing male circumcision during scale-up of services in Zambia and Swaziland (abstract) (PDF)
Poster presentation at the 19th meeting of the International Society for Sexually Transmitted Diseases Research, Quebec City, 10-13 July
Friedland,Barbara A.; Apicella,Louis; Sheehy,Meredith; Schenk,Katie D.; Munjile,Kelvin; Adams,Alfred; Hewett,Paul C.
Publication date: 2011
Evaluation of the informed consent process for male circumcision scale-up in Swaziland (PDF)
Friedland,Barbara A.; Apicella,Louis; Schenk,Katie D.; Sheehy,Meredith; Hewett,Paul C.
Population Council Research and Evaluation of Male Circumcision Scale-up Report (no. 3)
Publication date: 2011
Evaluation of the informed consent process for male circumcision scale-up in Zambia (PDF)
Friedland,Barbara A.; Apicella,Louis; Schenk,Katie D.; Sheehy,Meredith; Hewett,Paul C.
Population Council Research and Evaluation of Male Circumcision Scale-Up Report (no. 1)
Publication date: 2011
Impact of a comprehension assessment among adult and adolescent clients on scale up of male circumcision services in Zambia (abstract) (PDF)
Poster presentation at the 6th International AIDS Society Conference, Rome, Italy, 17-20 July
Friedland,Barbara A.; Apicella,Louis; Sheehy,Meredith; Schenk,Katie D.; Munjile,Kelvin; Adams,Alfred; Hewett,Paul C.; Katzen,Lauren L.
Publication date: 2011
Sex with stitches: The resumption of sexual activity during the post-circumcision healing period in Zambia (abstract) (PDF)
Presentation at the 19th meeting of the International Society for Sexually Transmitted Diseases Research, Quebec City, 10-13 July
Hewett,Paul C.; Hallett,Timothy B.; Mensch,Barbara S.; Garnett,Geoffrey P.; Kumbutso,Dzekedzeke; Todd,Petra E.
Publication date: 2011
The Shang Ring device for adult male circumcision: A proof of concept study in Kenya (abstract) (PDF) (HTML)
Barone,Mark; Ndede,Frederick; Li,Philip S.; Masson,Puneet; Awori,Quentin; Okech,Jairus; Cherutich,Peter; Muraguri,Nicholas; Perchal,Paul; Lee,Richard; Kim,Howard H.; Goldstein,Marc
Journal of Acquired Immune Deficiency Syndromes 57(1): e7-e12
Publication date: 2011
COMPACT: Community mobilization for preventive action (PDF)
Population Council
Publication date: 2010
High complication rates challenge the implementation of male circumcision for HIV prevention in Africa (abstract)
Kim,Howard H.; Goldstein,Marc
Nature Clinical Practice Urology 6(2): 64-65
Publication date: 2009
More data needed before male circumcision is advocated (PDF)
Population Briefs, Spring 2002 (HIV/AIDS edition)
Publication date: 2002
Male circumcision and HIV infection in four cities in sub-Saharan Africa [Circoncision masculine et infection au VIH dans quatre villes d'Afrique sub-saharienne] (abstract) (PDF)
Auvert,Bertran; Buve,Anne; Lagarde,E.; Kahindo,Maina; Chege,Jane; Rutenberg,Naomi; Musonda,R.; Laourou,M.; Akam,E.; Weiss,Helen A.
AIDS 15(suppl 4): S31-S40
Publication date: 2001
Male circumcision and HIV prevention: Directions for future research (PDF)
van Dam,C.Johannes; Anastasi,Marie Christine
Horizons Report
Publication date: 2000
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