Scaling Safe Circumcisions in Communities

Shazia Moosa, L. Samad
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Abstract

Male circumcision (MC), although a common and simple procedure, is not available to a majority of the population as a safe, sterile intervention. The con-vincing evidence of the protective role of circumcision towards the spread of STDs (particularly HIV) led to the establishment of voluntary, adult male circumcision programmes in high-HIV-burden countries. In low- and middle-income Muslim countries, where the need for circumcision is high, there is an evident gap in access to, and delivery of, this procedure. Large-scale programmes aimed at circumcising male babies in settings where circumcision is a religious requirement, as opposed to a medical indication, have not been established. This chapter would draw upon current guidelines and literature, review existing programmes that have attempted to establish community-based safe circumcision initiatives and discuss strategies for sustainable scale-up to meet this huge public health need. We believe it is important to translate existing clinical knowledge into a population-based healthcare intervention.
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在社区推广安全包皮环切术
男性包皮环切术(MC)虽然是一种常见而简单的手术,但并不是大多数人都能获得的一种安全、无菌的干预措施。包皮环切对性传播疾病(特别是艾滋病毒)传播具有保护作用的令人信服的证据导致在艾滋病毒高负担国家建立自愿的成年男性包皮环切规划。在低收入和中等收入穆斯林国家,包皮环切手术的需求很高,但在获得和实施这一手术方面存在明显差距。在将包皮环切作为一项宗教要求而非医学指示的环境中,尚未建立旨在对男婴进行包皮环切的大规模方案。本章将借鉴目前的准则和文献,审查试图建立基于社区的安全包皮环切倡议的现有规划,并讨论可持续扩大规模的战略,以满足这一巨大的公共卫生需求。我们认为将现有的临床知识转化为基于人群的医疗保健干预是很重要的。
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