Voluntary Medical Male Circumcision for HIV Prevention: a Global Overview. 2022

Chen Zhang, and Sten H Vermund
School of Nursing, University of Rochester, 265 Crittenden Blvd, Rochester, NY, 14620, USA. chen_zhang@urmc.rochester.edu.

With the promise of HIV prevention, there has been a scale-up of voluntary medical male circumcision (VMMC) in high HIV incidence/low circumcision prevalence nations worldwide. Nonetheless, debates over the implementation and the effectiveness and safety of the VMMC in real-world settings persist. We revisit the role of VMMC in HIV prevention to inform health professionals, policymakers, and advocates or opponents in this new era. There has been substantial progress on VMMC scale-up to date, but this has varied considerably by region. The evidence of solid and direct protection of VMMC is available for heterosexual men and older adolescent boys in sub-Saharan Africa. The protective effect in men who have sex with men is suggested by systematic reviews but is not confirmed by clinical trials. Sexual partners, including women, likely benefit indirectly from the increased VMMC coverage through a decreased risk of exposure to infected male partners. Fortunately, the preponderance of studies does not suggest higher sexual risk behaviors among circumcised men, so-called risk compensation. VMMC requires health systems strengthening and continued promulgation of other evidence-based HIV prevention strategies to be successful. Health authorities in high HIV incidence areas that have low circumcision coverage should implement VMMC within a context of complementary biomedical and behavioral prevention strategies.

UI MeSH Term Description Entries
D008297 Male Males
D002944 Circumcision, Male Excision of the prepuce of the penis (FORESKIN) or part of it. Male Circumcision,Circumcisions, Male,Male Circumcisions
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072339 Sexual and Gender Minorities Individuals including lesbian, gay, bisexual, transgender, queer, intersex, gender non-conforming people, and other populations whose sexual orientation or GENDER IDENTITY and reproductive development is considered outside cultural, societal, or physiological norms. Gays,Gender Diverse,LGBTQ,LGBTQIA,Bisexuals,GLBT Persons,Gender Minorities,Homosexuals,LBG Persons,LGBT Persons,LGBTQ Persons,Lesbians,Lesbigay Persons,Men Who Have Sex With Men,Non-Heterosexual Persons,Non-Heterosexuals,Queers,Sexual Dissidents,Sexual Minorities,Women Who Have Sex With Women,Bisexual,Dissident, Sexual,Dissidents, Sexual,Diverse, Gender,GLBT Person,Gay,Gender Minority,Homosexual,LBG Person,LGBT Person,LGBTQ Person,Lesbian,Lesbigay Person,Minorities, Gender,Minorities, Sexual,Minority, Gender,Minority, Sexual,Non Heterosexual Persons,Non Heterosexuals,Non-Heterosexual,Non-Heterosexual Person,Person, GLBT,Person, LBG,Person, LGBT,Person, LGBTQ,Person, Lesbigay,Person, Non-Heterosexual,Persons, GLBT,Persons, LBG,Persons, LGBT,Persons, LGBTQ,Persons, Lesbigay,Queer,Sexual Dissident,Sexual Minority
D000163 Acquired Immunodeficiency Syndrome An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive T-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. AIDS,Immunodeficiency Syndrome, Acquired,Immunologic Deficiency Syndrome, Acquired,Acquired Immune Deficiency Syndrome,Acquired Immuno-Deficiency Syndrome,Acquired Immuno Deficiency Syndrome,Acquired Immuno-Deficiency Syndromes,Acquired Immunodeficiency Syndromes,Immuno-Deficiency Syndrome, Acquired,Immuno-Deficiency Syndromes, Acquired,Immunodeficiency Syndromes, Acquired,Syndrome, Acquired Immuno-Deficiency,Syndrome, Acquired Immunodeficiency,Syndromes, Acquired Immuno-Deficiency,Syndromes, Acquired Immunodeficiency
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012725 Sexual Behavior Sexual activities of humans. Anal Sex,Oral Sex,Sexual Activity,Sexual Orientation,Premarital Sex Behavior,Sex Behavior,Sex Orientation,Sexual Activities,Activities, Sexual,Activity, Sexual,Behavior, Premarital Sex,Behavior, Sex,Behavior, Sexual,Orientation, Sexual,Sex, Anal,Sex, Oral
D015658 HIV Infections Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS). HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human
D018451 Homosexuality, Male Sexual attraction or relationship between males. Male Homosexuality

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