The Safe Non Surgical Male Circumcision (Prepex) campaign that the Ministry of Health in Rwanda has initiated to prevent or reduce the spread of HIV/AIDS is significantly being responded to in all parts of the country, recording about two million men for circumcision in two years time.
Health officials are optimistic of the positive results, saying the medical activity may contribute to reduction of HIV/AIDS infection by 50%. The non-surgical procedure that does not cause bleeding is said to be quick and safe which might be the reason why more men have positively responded to it.
The purpose of this new circumcision procedure is to make people (men) safer while practicing non protected sexual intercourses. Studies have shown that male circumcision reduces the risk of sexually acquired HIV infection in men by approximately 60%. Three randomized controlled trials have shown that male circumcision provided by well trained health professionals in properly equipped settings is safe.
The Rwandan ministry of health has put an emphasis on the sensitization of the prepex circumcision among the population in a bid to have almost every male circumcised.
The number of men circumcised through this new system is not yet published, but reports indicate that each hospital and health centre that practice Prepex treats at least 20 people per day. Dr Vincent Mutabazi, the lead investigator in the PrePex clinical trials in Rwanda said after clinical trials that this procedure is super compared to the surgical one.
“After three major clinical trials required by the World Health Organization technical advisory group that reviews innovations on male circumcision devices, we see strong and compelling evidence on the safety, superiority over surgical circumcision and simplicity in the hand of lower cadre health practitioners like nurses.”
At Kanombe Military Hospital, a 43 years old man known as John Rurangwa has said this new device is excellent because it’s painless, cheap and quick. “You go in the theatre and within less than five minutes you come out of the room smiling from ear to ear because there is no pain, no blood and you come out walking normally.
During the trials, PrePex circumcision device was found to be five times faster than surgical because it is bloodless, requires no anaesthesia, no sutures and no sterile settings as compared to the surgical procedure, he said.
There are some challenges in reaching all the people that need to be circumcised, especially in rural areas, as Mutabazi pointed out. “There are no sufficient health facilities and qualified personnel to handle mass circumcision programs. The PrePex device has the potential to facilitate rapid male circumcision scale-up programs for HIV prevention, an imminent need in Sub Saharan Africa.”
The targeted group for the nationwide voluntary medical male circumcision program is men between 15 and 49 years old. According to the Minister of health, there is a big number of men who need to be circumcised. With the efforts taking place, it seems the target will be hard to reach.
“Current male circumcision efforts have been a drop in the ocean compared to the masses required. Rwanda has a national goal to decrease its HIV incidence rate by 50% by launching a voluntary MC program to reach two million adults in two years as part of a comprehensive HIV prevention strategy”. Like the beneficiaries of this program, the Minister thinks it’s simple and quick status can make Rwanda achieve that goal.
“Rwanda has successfully completed the clinical evaluation of the PrePex and we are convinced that with this device, we will achieve our goal. The non-surgical procedure is quick, bloodless and safe.” Dr Agnes Binagwaho noted.