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Novel Device Shows Promise for Reducing HIV Among Men

Promising study results published in the May issue of JAIDS show that a novel medical device has the potential to revolutionize how male circumcision services are offered in countries hardest hit by the HIV epidemic. Conducted by EngenderHealth, a global reproductive health organization, and Weill Cornell Medical College, the study found the device, known as the Shang Ring, is highly acceptable to men and safe for further study in Africa.

“These positive results confirm that the Shang Ring is safe and acceptable,” said Dr. Mark Barone, Senior Clinical Advisor at EngenderHealth. “Not only is it a sutureless procedure with little or no bleeding, but it is faster to perform and takes less time to heal than conventional circumcision. Evidence is also mounting that the Shang Ring will be feasible in low-resource settings.”

The Shang Ring is a disposable device consisting of two concentric plastic rings that lock together over the foreskin. Surgical circumcisions typically take 20-40 minutes to complete and pose risks related to bleeding. But unlike conventional surgery, the Shang Ring does not require sutures, involves minimal bleeding and offers patients shorter procedure times (3-5 minutes).

“One of the unique and compelling features of the Shang Ring is that it is so simple to perform that all health care professionals, not only surgeons, could be trained to safely use the device,” said Dr. Marc Goldstein, Professor of Urology, and Reproductive Medicine at Weill Cornell Medical College and Surgeon-in-Chief, Male Reproductive Medicine and Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center. “This is critical in countries where trained surgeons and physicians are scarce.”

Evidence has shown that male circumcision can reduce the risk of heterosexual HIV transmission by up to 64%. The World Health Organization and Joint UN Programme on HIV/AIDS (UNAIDS) recommend that countries include male circumcision as part of their HIV prevention programs. But because surgical circumcision requires a trained physician or surgeon, circumcision rates remain low in many developing countries.

Through a grant to FHI from the Bill & Melinda Gates Foundation, EngenderHealth and Cornell are working with FHI to conduct additional studies to better understand how the Shang Ring might transform the provision of male circumcision services in Africa. The research consists of a safety study and a randomized controlled trial to compare the Shang Ring with conventional surgery.

 

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