Opportunities and Challenges for Male Circumcision in HIV Prevention

NEW YORK, April 4, 2007—EngenderHealth voiced strong support today for the recent statement by the World Health Organization and UNAIDS recommending male circumcision as an additional important tool to reduce the risk of heterosexually acquired HIV infection in men. This endorsement is based on evidence from three recent studies finding that male circumcision reduces HIV infection among men by approximately 60%. The findings bring both great opportunities and important challenges for countries as they introduce this new prevention technology. While this is a significant step forward, implementing male circumcision services will heighten the need to strengthen health systems, integrate male circumcision with other health services, counsel men and their sexual partners, and respect clients’ human rights.

Drawing on more than 60 years’ experience in strengthening health systems worldwide, EngenderHealth stresses that national governments must ensure that male circumcision is performed safely by well-trained practitioners, in hygienic settings, and under conditions of informed consent, confidentiality, and risk reduction counseling. In addition, it is critical that adequate equipment and supplies are readily available and that new services are monitored and evaluated. As the international donor community and organizations move to support male circumcision, countries with high HIV prevalence, generalized heterosexual HIV epidemics, and low rates of male circumcision should give serious and urgent consideration to scaling up access to male circumcision services. These services should be offered free of charge or at the lowest possible cost to the client, as with other essential health services.

“This is indeed a significant breakthrough for HIV prevention,” said Paul Perchal, Director of the HIV/STI Program at EngenderHealth. “But male circumcision is not a magic bullet. It is one tool in a combination of preventive approaches, including voluntary HIV counseling and testing services, treatment for sexually transmitted infections, promotion of safer sex practices, and the provision of male and female condoms.”

Based on EngenderHealth’s experience in the successful introduction of no-scalpel vasectomy in many different countries, linking male circumcision with other health services whenever possible can prevent disruption of other health programs and achieve greater success and sustainability. In addition, integrating services offers a unique opportunity to reach men and their partners with a range of other health services and information.

Because male circumcision does not provide complete protection from infection with HIV, counseling for men and their partners is especially critical to prevent men from developing a false sense of security after being circumcised and then engaging in high-risk behaviors. By employing innovative approaches to engage men in reproductive health and HIV/AIDS programs, EngenderHealth’s Men As Partners® Program has proven that interventions such as counseling result in measurable changes in men’s behavior and attitudes. When accessing circumcision services, men should be targeted by similar programs, where they can learn more about how to prevent HIV, reduce gender-based violence, and ensure the health of their families and communities. Male circumcision services should also be provided in a culturally sensitive manner, based on medical ethics and human rights.

About EngenderHealth
EngenderHealth works to improve the health and well-being of people in the poorest communities of the world. We do this by sharing our expertise in sexual and reproductive health and transforming the quality of health care. We promote gender equity, advocate for sound practices and policies, and inspire people to assert their rights to better, healthier lives. Working in partnership with local organizations, we adapt our work in response to local needs. EngenderHealth currently supports projects in 40 countries throughout Asia, Africa, and Latin America.

EngenderHealth and HIV/AIDS
For more than a decade, EngenderHealth has applied its expertise in sexual and reproductive health to create comprehensive and locally relevant programs that expand and improve access to HIV/AIDS prevention, care, and treatment. Partnering with public, private, nongovernmental, and community partners in 13 countries across Africa, Asia, Latin America, and Eastern Europe, EngenderHealth works to strengthen the skills of health workers to provide high-quality clinical care and services; to reduce women’s vulnerability to HIV infection; to engage men in HIV/AIDS services; to build the capacity of networks of people living with HIV; and to challenge HIV/AIDS stigma in the health sector. EngenderHealth emphasizes local capacity-building through sustainable training and quality improvement programs and the involvement of people living with HIV.

Media Contacts
Theresa Kim, 212-993-9834

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