Schenker Inon
Jerusalem AIDS Project, Israel.
AIDS Educ Prev. 2018 Jun;30(3):232-242. doi: 10.1521/aeap.2018.30.3.232.
Male circumcision is a minor surgery performed for religious and medical reasons. Three randomized clinical trials demonstrated it could reduce heterosexual HIV transmission from infected females to males by over 60%, paving the way in 2006 for multinational efforts to circumcise 27 million men in sub-Saharan Africa by 2021. It is estimated that by 2030 male circumcision will avert at least 500,000 HIV infections in Africa, saving lives and budgets. Voluntary medical male circumcision (VMMC) of adults and adolescents has challenged policy makers, implementers, funders, and civil society in bringing surgery to the frontline of HIV prevention. Five key challenges are discussed: policy, clinical, demand, supply, and scaling up. A unique Israel-Senegal-South Africa collaboration, which enhanced high-volume (100 VMMCs per day) and high-quality (less than 2% minor adverse events) procedures, is described, highlighting VMMC as one of the most impressive public health collaborative interventions in HIV/AIDS prevention globally.
男性包皮环切术是出于宗教和医学原因而进行的小型手术。三项随机临床试验表明，该手术可将异性恋中艾滋病毒从受感染女性传播给男性的几率降低60%以上，这为2006年至2021年在撒哈拉以南非洲为2700万男性实施包皮环切术的跨国行动铺平了道路。据估计，到2030年，男性包皮环切术将在非洲避免至少50万例艾滋病毒感染，从而挽救生命并节省预算。成人和青少年的自愿医疗男性包皮环切术（VMMC）给政策制定者、实施者、资助者和民间社会带来了挑战，促使他们将该手术推到艾滋病毒预防的前沿。文中讨论了五个关键挑战：政策、临床、需求、供应和扩大规模。还介绍了以色列、塞内加尔和南非之间独特的合作，这种合作提高了手术量（每天100例VMMC）和手术质量（轻微不良事件发生率低于2%），突出了VMMC是全球艾滋病毒/艾滋病预防领域最令人瞩目的公共卫生合作干预措施之一。
