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Voluntary Medical Male Circumcision for HIV Prevention: a Global Overview

  • Voluntary Medical Male Circumcision: Progress and Challenges (S Vermund, Section Editor)
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Abstract

Purpose of Review

With the promise of HIV prevention, there has been a scale-up of voluntary medical male circumcision (VMMC) in high HIV incidence/low circumcision prevalence nations worldwide. Nonetheless, debates over the implementation and the effectiveness and safety of the VMMC in real-world settings persist. We revisit the role of VMMC in HIV prevention to inform health professionals, policymakers, and advocates or opponents in this new era.

Recent Findings

There has been substantial progress on VMMC scale-up to date, but this has varied considerably by region. The evidence of solid and direct protection of VMMC is available for heterosexual men and older adolescent boys in sub-Saharan Africa. The protective effect in men who have sex with men is suggested by systematic reviews but is not confirmed by clinical trials. Sexual partners, including women, likely benefit indirectly from the increased VMMC coverage through a decreased risk of exposure to infected male partners. Fortunately, the preponderance of studies does not suggest higher sexual risk behaviors among circumcised men, so-called risk compensation.

Summary

VMMC requires health systems strengthening and continued promulgation of other evidence-based HIV prevention strategies to be successful. Health authorities in high HIV incidence areas that have low circumcision coverage should implement VMMC within a context of complementary biomedical and behavioral prevention strategies.

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Funding

Supported by NIH grant #P30MH062294.

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  1. School of Nursing, University of Rochester, 265 Crittenden Blvd, Rochester, NY, 14620, USA

    Chen Zhang

  2. Yale School of Public Health, New Haven, CT, USA

    Sten H. Vermund

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Zhang, C., Vermund, S.H. Voluntary Medical Male Circumcision for HIV Prevention: a Global Overview. Curr HIV/AIDS Rep 19, 474–483 (2022). https://doi.org/10.1007/s11904-022-00632-y

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