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Health Equity in Africa

Voluntary medical male circumcision – considerations for policy and practice

Voluntary medical male circumcision – considerations for policy and practice

In 2007, the WHO and UNAIDS issued recommendations that voluntary medical male circumcision (VMMC) be implemented in countries with a generalised HIV epidemic and low circumcision prevalence. A total of 13 countries were identified in southern and eastern Africa as high priority countries for rapid VMMC scale-up. In view of this, the following policy brief provides policy guidelines for including VMMC as a safe and sustainable HIV prevention strategy. Recommendations are centred around the following: respect for human rights; gender; integrated package of HIV prevention services; provision of safe male circumcision; human resources; information and communication; cultural sensitivity and collaboration; and strategic partnerships of VMMC delivery. The development of culturally sensitive national strategic plans for VMMC in countries with high HIV prevalence rates should be encouraged. The clear communication of the risks and benefits of VMMC in the context of HIV prevention is critical. Furthermore, specific focus should be directed towards ethical and human rights issues with VMMC in the context of research and practice. Research, policy and interventions need to give consideration to the direct impact on women, and ensure that they are not placed at increased risk of HIV infection. Ideally, VMMC should include comprehensive sexual and reproductive services that target both men and women and should include counselling, testing, treatment and gender transformative education.

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