Hines Jonas Z, Ntsuape Onkemetse Conrad, Malaba Kananga, Zegeye Tiruneh, Serrem Kennedy, Odoyo-June Elijah, Nyirenda Rose Kolola, Msungama Wezi, Nkanaunena Kondwani, Come Jotamo, Canda Marcos, Nhaguiombe Herminio, Shihepo Ella K, Zemburuka Brigitte L T, Mutandi Gram, Yoboka Emmanuel, Mbayiha André H, Maringa Hilda, Bere Alfred, Lawrence J Joseph, Lija Gissenge J I, Simbeye Daimon, Kazaura Kokuhumbya, Mwiru Ramadhani S, Talisuna Stella Alamo, Lubwama Joseph, Kabuye Geoffrey, Zulu James Exnobert, Chituwo Omega, Mumba Maybin, Xaba Sinokuthemba, Mandisarisa John, Baack Brittney N, Hinkle Lawrence, Grund Jonathan M, Davis Stephanie M, Toledo Carlos
MMWR Morb Mortal Wkly Rep. 2017 Dec 1;66(47):1285-1290. doi: 10.15585/mmwr.mm6647a2.
Countries in Southern and Eastern Africa have the highest prevalence of human immunodeficiency virus (HIV) infection in the world; in 2015, 52% (approximately 19 million) of all persons living with HIV infection resided in these two regions.* Voluntary medical male circumcision (VMMC) reduces the risk for heterosexually acquired HIV infection among males by approximately 60% (1). As such, it is an essential component of the Joint United Nations Programme on HIV/AIDS (UNAIDS) strategy for ending acquired immunodeficiency syndrome (AIDS) by 2030 (2). Substantial progress toward achieving VMMC targets has been made in the 10 years since the World Health Organization (WHO) and UNAIDS recommended scale-up of VMMC for HIV prevention in 14 Southern and Eastern African countries with generalized HIV epidemics and low male circumcision prevalence (3). This has been enabled in part by nearly $2 billion in cumulative funding through the President's Emergency Plan for AIDS Relief (PEPFAR), administered through multiple U.S. governmental agencies, including CDC, which has supported nearly half of all PEPFAR-supported VMMCs to date. Approximately 14.5 million VMMCs were performed globally during 2008-2016, which represented 70% of the original target of 20.8 million VMMCs in males aged 15-49 years through 2016 (4). Despite falling short of the target, these VMMCs are projected to avert 500,000 HIV infections by the end of 2030 (4). However, UNAIDS has estimated an additional 27 million VMMCs need to be performed by 2021 to meet the Fast Track targets (2). This report updates a previous report covering the period 2010-2012, when VMMC implementing partners supported by CDC performed approximately 1 million VMMCs in nine countries (5). During 2013-2016, these implementing partners performed nearly 5 million VMMCs in 12 countries. Meeting the global target will require redoubling current efforts and introducing novel strategies that increase demand among subgroups of males who have historically been reluctant to undergo VMMC.
撒哈拉以南非洲和东非国家的人类免疫缺陷病毒（HIV）感染率居世界之首；2015年，所有HIV感染者中有52%（约1900万）居住在这两个地区。* 男性自愿医学包皮环切术（VMMC）可使男性通过异性性行为感染HIV的风险降低约60%（1）。因此，它是联合国艾滋病规划署（UNAIDS）到2030年终结获得性免疫缺陷综合征（AIDS）战略的重要组成部分（2）。自世界卫生组织（WHO）和UNAIDS建议在14个HIV广泛流行且男性包皮环切率较低的撒哈拉以南非洲和东非国家扩大VMMC以预防HIV以来的10年里，在实现VMMC目标方面已取得了重大进展（3）。这在一定程度上得益于通过美国总统艾滋病紧急救援计划（PEPFAR）累计提供的近20亿美元资金，该计划由包括美国疾病控制与预防中心（CDC）在内的多个美国政府机构管理，CDC迄今已支持了所有由PEPFAR资助的VMMC中的近一半。2008 - 2016年期间，全球共实施了约1450万例VMMC，占截至2016年在15 - 49岁男性中实施2080万例VMMC这一最初目标的70%（4）。尽管未达到目标，但预计这些VMMC到2030年底将避免50万例HIV感染（4）。然而，UNAIDS估计，到2021年还需要额外实施2700万例VMMC才能实现快车道目标（2）。本报告更新了之前一份涵盖2010 - 2012年期间的报告，当时由CDC支持的VMMC实施伙伴在9个国家实施了约100万例VMMC（5）。2013 - 2016年期间，这些实施伙伴在12个国家实施了近500万例VMMC。要实现全球目标，需要加倍努力并引入新策略，以提高历来不愿接受VMMC的男性亚群体的需求。
