VMMC Devices—Introducing a New Innovation to a Public Health Intervention

Ridzon, Renée; Reed, Jason; Sgaier, Sema K.; Hankins, Catherine

doi:10.1097/qai.0000000000000967

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…The 18.6 million VMMCs had already averted an estimated 230,000 new HIV infections by 2017 and this number is projected to grow to 1.1 million by 2030 [ 2 ]. An important innovation in the delivery of VMMC has been the introduction of medical devices for adolescent and adult male circumcision (MC) [ 3 ]. To date, two devices, PrePex and ShangRing, have been prequalified by World Health Organization (WHO) and can be used in VMMC programs supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund for AIDS, Tuberculosis and Malaria [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Medical devices for MC have the potential to accelerate VMMC roll-out by making the procedure easier, quicker and more widely accessible [ 5 , 6 ]. Additionally, choice is an important factor in enhancing acceptability and uptake of health services [ 3 ]. VMMC devices provide an alternative for males who are hesitant to undergo conventional surgery.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is the PrePex device an alternative for surgical male circumcision in adolescents ages 13–17 years? Findings from routine service delivery during active surveillance in Zimbabwe

Mavhu

Hatzold²,

Madidi³

et al. 2019

PLoS ONE

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BackgroundMale circumcision devices have the potential to accelerate adolescent voluntary medical male circumcision roll-out. Here, we present findings on safety, acceptability and satisfaction from active surveillance of PrePex implementation among 618 adolescent males (13–17 years) circumcised in Zimbabwe.MethodsThe first 618 adolescents consecutively circumcised from October 2015 to October 2016 using PrePex during routine service delivery were actively followed up. Outcome measures included PrePex uptake, attendance for post-circumcision visits and adverse events (AEs). A survey was conducted amongst 500 consecutive active surveillance clients to assess acceptability and satisfaction with PrePex.ResultsA total of 1,811 adolescent males were circumcised across the three PrePex active surveillance sites. Of these, 870 (48%) opted for PrePex but only 618/870 (71%) were eligible. Among the 618, two (0.3%) self-removals requiring surgery (severe AEs), were observed. Four (0.6%) removals by providers (moderate AEs) did not require surgery. Another 6 (1%) mild AEs were due to: bleeding (n = 2), swelling (n = 2), and infection (n = 2). All AEs resolved without sequelae. Adherence to follow-up appointments was high (97.7% attended 7 day visit). A high proportion (71.6%) of survey respondents said they heard about PrePex from a mobilizer; 49.8% said they chose PrePex because they wanted to avoid the pain associated with the surgical procedure/surgery on their penis. Acceptability and satisfaction with PrePex was high; 95.4% indicated willingness to recommend PrePex to peers. A majority (92%) reported experiencing pain when PrePex was being removed.ConclusionsActive surveillance of the first 618 adolescent males circumcised using PrePex suggests that the device is both safe and acceptable when used in routine service delivery among 13–17 year-olds. There is need to intensify specific demand generation activities for PrePex male circumcision among this group of males.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is the PrePex device an alternative for surgical male circumcision in adolescents ages 13–17 years? Findings from routine service delivery during active surveillance in Zimbabwe

Mavhu

Hatzold²,

Madidi³

et al. 2019

PLoS ONE

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“…Device‐based circumcision procedures compared to standard surgical techniques are consistently reported to be significantly quicker to conduct and easier to learn and execute, thus, minimising surgical skills and requirements such as injected anaesthesia and suturing. This allows for task‐shifting to other mid‐level cadres of staff (nurses and medical officers) and has the potential for rapid scale‐up of VMMC programmes for HIV prevention in resource‐constrained settings [ 12 , 44 ]. Still, this does not eliminate the need for surgical VMMC services, as some patients may not be eligible for a device or would prefer a standard surgical circumcision.…”

Section: Discussionmentioning

confidence: 99%

“…This technique is supposedly safer and easier to replicate than the standard dissection techniques [ 7 ]. Device‐based techniques also allow for task‐shifting, as nurses and other non‐physician healthcare providers may safely perform them, thus allowing for rapid scale‐up of VMMC for HIV prevention in resource‐constrained settings [ 12 , 13 ]. It is important to note that device‐based techniques are precluded in men with penile anatomical abnormalities, chronic paraphimosis, and active genital infection [ 11 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Circumcision devices versus standard surgical techniques in adolescent and adult male circumcisions: a Cochrane review

et al. 2021

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“…[3] This will further impede acceptance and utilisation of an innovation that has shown neither safety, efficiencies, or costeffectiveness. [4] The great hope is 'demand creation. ' Funding agencies (primarily the Bill and Melinda Gates Foundation) are squarely behind marketing circumcision to men, and demand creation now plays a central role in the Clearinghouse on Male Circumcision (http://www.…”

mentioning

confidence: 99%