US Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Acquir Immune Defic Syndr. 2012 Aug 15;60 Suppl 3(0 3):S88-95. doi: 10.1097/QAI.0b013e31825cac4e.
As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President's Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya's Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods-such as medical devices that remove the foreskin without injected anesthesia and/or sutures-are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all.
随着科学为预防艾滋病而大力证明自愿男性包皮环切术（VMMC）的有效性，总统艾滋病紧急救援计划（PEPFAR）已与国际机构、捐助者和伙伴国政府合作，支持 VMMC 规划。数学模型预测，在战略选择的人群中，迅速为大量未割礼的男性提供 VMMC，可能会显著降低社区层面的 HIV 发病率，并节省数十亿用于 HIV 护理和治疗的费用。由于 VMMC 是一次性手术，可提供终身部分预防 HIV 的保护，因此针对成年男性的计划是具有长期利益的重要短期投资。VMMC 还为男孩和男性提供了一个独特的机会，提供 HIV 检测和咨询服务，并转介其他 HIV 服务，包括治疗。在 2007 年世界卫生组织正式建议之后，优先国家已经在扩大 VMMC。迄今为止，已有超过 100 万男性接受了 VMMC，其中最显著的成功案例来自肯尼亚的 Nyanza 省。然而，由于需要考虑到许多必要的文化、政治和伦理问题，总体成功的步伐有所放缓。因为现在有更多的未割礼男性可以从 VMMC 服务中受益，美国总统巴拉克·奥巴马承诺 PEPFAR 将在 2014 年之前为 470 万男性提供 VMMC。正在严格评估创新的割礼方法，例如无需注射麻醉剂和/或缝合线即可去除包皮的医疗器械。将安全创新纳入外科 VMMC 计划可能会为更快地为更多男性提供服务提供机会，并为所有人显著降低 HIV 发病率。
