Voluntary medical male circumcision key in Africa HIV prevention

The World Health Organization has recommended voluntary medical male circumcision as an essential option in the toolkit of effective HIV prevention interventions in east and southern Africa.

According to Avert, an international HIV and AIDS charity based in Brighton in the United Kingdom, east and southern Africa are the regions most affected by HIV in the world and are home to the largest number of people living with HIV.

The organization said in 2018, 20.6 million people were HIV infected and about 800,000 were newly infected. In the same year, 310,000 AIDS-related deaths were recorded in the region.

South Africa has the highest number of people living with HIV in the region, standing at 7.5 million, followed by Tanzania with 1.7 million as of 2019, according to Avert.

Frank Lule, medical officer at the WHO African regional office, said new guidelines by the UN agency recommends voluntary medical male circumcision services for adolescents aged 15 years and older, and for men, particularly those at higher risk of HIV infection.

"Considerations are also presented on whether to offer voluntary medical male circumcision to younger adolescent boys, aged 10-14 years, taking into account their diversity in physical and cognitive development, including their capacity to consent," Lule said in a statement released on Sunday.

The WHO guidelines update recommendations on the use and safety of WHO-prequalified, device-based male circumcision methods, including new techniques and devices.

The UN agency said such innovative surgical methods may further improve safety, simplify the procedure and possibly increase acceptability and access.

The additional methods may have advantages over conventional surgery, but their use has been limited and need to be further expanded, with safety measured in real-world settings, the WHO said.

The guidelines also outline a health systems framework to guide transitioning to adolescent-focused sustainable services and maintaining high voluntary medical male circumcision coverage.

"Voluntary medical male circumcision has reached over 25 million men in east and southern Africa through 2019, averting an estimated 650, 000 to 1.5 million HIV infections by 2030, depending on the scale up of other prevention interventions," said Lycias Zembe, technical and prevention officer of the United Nations Joint Program on HIV/AIDS in Switzerland.