title: How do you circumcise a nation? The Rwandan case study.
abstract: Voluntary medical male circumcision has been conclusively demonstrated to reduce the lifetime risk of male acquisition of HIV. The strategy has been adopted as a component of a comprehensive strategy towards achieving an AIDS-free generation. A number of countries in which prevalence of HIV is high and circumcision is low have been identified as a priority, where innovative approaches to scale-up are currently being explored. Rwanda, as one of the priority countries, has faced a number of challenges to successful scale-up. We discuss here how simplifications in the procedure, addressing a lack of healthcare infrastructure and mobilizing resources, and engaging communities of both men and women have permitted Rwanda to move forward with more optimism in its scale-up tactics. Examples from Rwanda are used to highlight how these barriers can and should be addressed.
authors.affiliation: Ministry of Health, Republic of Rwanda, Rwanda Biomedical Centre-Medical Research Centre, PO Box 2717, Kigali, Rwanda. mutabazivincent@gmail.com.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mutabazi
authors.affiliation: Global Evaluative Sciences, Calgary, Canada. jforrest@geshealth.com.
authors.forename: Jamie I
authors.initials: JI
authors.lastname: Forrest
authors.affiliation: Department of HIV/AIDS, World Health Organization, Geneva, Switzerland. nford@who.int.
authors.forename: Nathan
authors.initials: N
authors.lastname: Ford
authors.affiliation: Global Evaluative Sciences, Calgary, Canada. dr.edward.j.mills@gmail.com.|Stanford Prevention Research Center, Stanford University, Stanford, USA. dr.edward.j.mills@gmail.com.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mills
mesh_terms: D000328:Adult; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology