Preventing Hiv Through Safe Voluntary Medical Male Circumcision For Adolescent Boys And Men In Generalized Hiv Epidemics

Since 2007 the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended voluntary medical male circumcision (VMMC) as an important strategy for the prevention of heterosexually acquired HIV in men in settings where the prevalence of heterosexually transmitted HIV is high. Over 25 million men and adolescent boys in East and Southern Africa have been reached with VMMC services. These new guidelines update earlier WHO recommendations to maximize the HIV prevention impact of safe VMMC services and aim to guide the transition to the sustained provision of interventions with a focus on the health and well-being of both adolescent boys and men.

Circumcision remains as one of the most controversial topics in current urological practice. The most important argument against circumcision is the permanent change of anatomy, histology and function of the penis, with potential complications, with rates reported to be low in developed countries, whereas it may be up to 85% when circumcision is carried out by traditional circumcisers, rather than by medically trained professionals in developing countries. In some studies, reporting the complications of circumcision, primary haemorrhage was the most common (52%), whereas infection, meatal stenosis, incomplete circumcision, penile oedema, glandular injury, penile adhesions, iatrogenic hypospadias and urethral injuries were also detected at different rates. At times minor complications after circumcision which cannot be avoided even when the procedure is undertaken by specialized pediatric surgeons or urologist, in a properly equipped centres; specially if the child or his penis is congenitally abnormal, the obvious examples are, circumcising a child with an excessive suprapubic fat or a child with webbed penis or microphallus . This title aims to minimize complications of MC and to compete against its serious impact on men’s’ health, it will educate and teach physicians about potential complications and how they could manage it early on and avoid further patient problems This title will shed some light over the common as well the uncommon complications, which usually raise a debate about its management. There are different sets to classify MC complications: Either early, or late, minor or major, local or systemic, rare or common. Both rare and common complications will be discussed with comprehensive photos and illustrations for each complication and its operative remedy.

A global economic analysis of HIV infection amongst sex workers, finding that evidence based and rights affirming interventions are not implemented to the level that their efficacy warrants, and that doing so at scale would be cost effective and deliver significant returns on investment.