Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum.
In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of HealthlNational AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting.
Kirby Institute, University of New South Wales, Sydney, Australia. avallely@kirby.unsw.edu.au
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Vallely
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Coo University, Cairns, Queensland, Australia.
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MacLaren
Papua New Guinea National AIDS Council Secretariat, Port Moresby.
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Kaleva
Papua New Guinea Sexual Health Society, Waigani, National Capital District 131, Papua New Guinea.
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Millan
Pacific Adventist University, Boroko, Papua New Guinea.
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Tommbe
Divine Word University, Madang, Papua New Guinea.
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Marape
Divine Word University, Madang, Papua New Guinea.
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Manineng
National Research Institute, Port Moresby, Papua New Guinea.
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Buchanan
National Research Institute, Port Moresby, Papua New Guinea.
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Amos
National Research Institute, Port Moresby, Papua New Guinea.
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Frank
Papua New Guinea Institute of Medical Research, Goroka, James Cook University, Cairns, Australia.
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Kelly
Papua New Guinea Institute of Medical Research, Goroka, James Cook University, Cairns, Australia.
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Kupul
Papua New Guinea Institute of Medical Research, Goroka, James Cook University, Cairns, Australia.
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Aeno
East Sepik Provincial AIDS Committee, Wewak, Papua New Guinea.
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Trowalle
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Coo University, Cairns, Queensland, Australia.
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John
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Coo University, Cairns, Queensland, Australia.
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Redman-Maclaren
Papua New Guinea Institute of Medical Research, Goroka, James Cook University, Cairns, Australia.
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Ryan
National Department of Health and Asian Development Bank HIV Prevention Project, Waigani, Papua New Guinea.
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Browne
School of Population Health, University of Queensland, Herston, Australia.
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Tynan
School of Population Health, University of Queensland, Herston, Australia.
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Hill
Kirby Institute, University of New South Wales, Sydney, Australia.
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Gray
Kirby Institute, University of New South Wales, Sydney, Australia.
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Murray
Kirby Institute, University of New South Wales, Sydney, Australia.
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Wilson
Disease Control Branch, National Department of Health, Waigani, Papua New Guinea.
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Law
Papua New Guinea Institute of Medical Research, Goroka, James Cook University, Cairns, Australia.
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Siba
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Coo University, Cairns, Queensland, Australia.
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McBride
Sigma 3 Services, Nyon, Switzerland.
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Farley
Kirby Institute, University of New South Wales, Sydney, Australia.
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Kaldor
D000328:Adult; D002944:Circumcision, Male / Q000379:methods / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006287:Health Planning Guidelines; D006291:Health Policy; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D010219:Papua New Guinea; D011050:Policy Making; D011159:Population Surveillance / Q000379:methods; D011314:Preventive Health Services / Q000458:organization & administration*; D011634:Public Health; D014944:World Health Organization