New Devices Seek to Advance Male Circumcision

by Chief K. Masimba Biriwasha | HIV/AIDS|Zimbabwe Charity, INC (HAZ)

Chief K. Masimba Biriwasha

Washington DC, US – Voluntary medical male circumcision (VMMC) has been a big topic at the XIX International AIDS Conference (AIDS 2012).  VMMC is a one-time procedure that provides a lifelong benefit by reducing the risk of female to male transmissions of HIV by 60 percent.

In spite of the scientific evidence, it is difficult to reach populations that may need circumcision services especially in resource poor countries. Finding a procedure that is safe, quicker and acceptable with males has potential to expand the reach of male circumcision.

Against this background, scientist and development experts are making significant advances on designing new tools and service delivery methods that will extend the reach of voluntary medical male circumcision to areas where the need in greatest.

“Just as with rapid HIV testing, technological innovation may dramatically expand our abilities to reach greater numbers of people more quickly with HIV prevention,” said Eric Goosby, the United States’ Global AIDS Coordinator.

Mathematical models indicate that scaling up circumcision services to 80 per cent coverage in five years could prevent nearly 3,6 million infections with 15 years. That translates to potential net savings

Several adult male circumcision devices have been developed recently and two, the Shang Ring and PrePex™, are currently being evaluated for safety, cost-effectiveness and acceptability.

The Shang Ring circumcision device, invented in China. The device serves to prevent bleeding with no need for sutures.

“A medical device for male circumcision that can be provided by nurses and without the need for needles and suturing may soon be a reality.  Furthermore, the device procedure takes about on third the time, or even less, of a typical circumcision surgery,” Goosby added.

The ShangRing circumcision device, which consists of two plastic rings with a silicon gasket in between, requires a sterile setting with surgical cleansing and local anaesthesia. The foreskin must be removed by a trained healthcare professional at the time of application. The device is then removed after seven days.

PrePex (manufactured in the USA) is the first known device to facilitate non-surgical medical adult MC that can claim all of the following: No injected anesthesia. No blood. No sutures. No sterile settings. (A- Placement Ring
B- Verification Thread
(wrapped around Elastic Ring)
C- Inner Ring
D- Elastic Ring)

The PrePex™, a non-surgical procedure, works through the removal of the foreskin, seven days after the time of application, when the tissue dries and hardens from the loss of blood circulation. The device can be applied in a short procedure without anaesthetic injection and with no cutting or bleeding at the time of application.

“Devices like the Shang Ring and PrePex™ have the potential to dramatically accelerate scale up by making the procedure faster, simpler and perfomable by non-physician providers,” said Dr. Karin Hatzold, Deputy Director for Sexual and Reproductive Health and TB at Population Services International (PSI Global).

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  1. When will the Prepex system be offered to the US?

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