title: Innovative Methods of Male Circumcision for HIV Prevention-Getting the Right Evidence.
abstract: World Health Organization recommends that countries with hyperendemic and generalized HIV epidemics implement voluntary medical male circumcision programs for HIV prevention. Innovative methods of male circumcision including devices have the potential to simplify the procedure, reduce time and cost, increase client acceptability, enhance safety, and expand the numbers of providers who may perform circumcision. We describe work led by World Health Organization and supported by global partners to define a pathway for the evaluation of efficacy and safety of male circumcision devices, to set priority criteria, and to establish a process to guide the use of devices in publicly funded voluntary medical male circumcision programs for HIV prevention. A device classification scheme, an expert Technical Advisory Group on Innovations in Male Circumcision, and a formal prequalification program have also guided considerations on safe use of devices. A rigorous approach was deemed appropriate given the intervention is for use among healthy men for public health purposes. The pathway and processes led to coordinated research, better standardization in research outcomes, and guidance that informed the research, introduction and implementation phases. The lessons learnt from this case study can inform evaluation and use of future public health innovations.
authors.affiliation: *Key Populations and Innovative Prevention Team, Department of HIV and AIDS, World Health Organization, Geneva, Switzerland; †Department of Clinical Sciences, Edinburgh University, Midlothian EH16 4TJ Scotland, United Kingdom; ‡Boston University School of Public Health, Boston, MA; and §Sigma3 Services SÀRL, Nyon, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Samuelson
authors.forename: Timothy
authors.initials: T
authors.lastname: Hargreave
authors.forename: Renee
authors.initials: R
authors.lastname: Ridzon
authors.forename: Tim
authors.initials: T
authors.lastname: Farley
mesh_terms: D002944:Circumcision, Male / Q000379:methods*; D019317:Evidence-Based Medicine; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male