Dr Ntlotleng Mabena, of the Centre for HIV and Prevention Studies, shows the PrePex circumcision device. Picture: Puri Devjee
Dr Ntlotleng Mabena, of the Centre for HIV and Prevention Studies, shows the PrePex circumcision device. Picture: Puri Devjee

Circumcision ring to the fore in SA

By Mpume Madlala Time of article published Jun 20, 2013

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Durban - A new circumcision device will be piloted in the country in the next sixth months after success in other African countries.

The non-surgical PrePex device was officially pre-approved by the World Health Organisation (WHO) in May.

A media briefing on the device was held as the Sixth SA Aids 2013 Conference began in Durban on Tuesday.

The conference, at the Inkosi Chief Albert Luthuli International Convention Centre (ICC) and attended by more than 3 000 delegates, is believed to be the second-largest Aids conference in the world.

Speaking about the device, said to be safe and easy to use, Dr Ntlotleng Mabena, of the Centre for HIV and Prevention Studies, said they had conducted pilot projects on the PrePex in several African countries, including Rwanda and Zimbabwe, and were impressed with the results.

Mabena said with the PrePex, a patient did not have to be put under local anaesthetic, but anaesthetic cream was applied for comfort.

She said the PrePex used a ring to create pressure on the the foreskin and took less than five minutes, compared with a forcep-guided method, which required between 10 and 15 minutes.

“Once the ring is on, the man will have it on him for seven days, during which time it gradually stops the blood supply. The foreskin then dries up and it is then carefully cut off and the man is circumcised,” she said. The benefits of using the PrePex were that there was no bleeding, there were no stitches, and patients were not at risk of infection after being circumcised as the skin healed during the time that the ring was on, Mabena said.

“Men also take less time off work because they heal quickly, as opposed to surgical circumcision.

“It is a device that is easy to use as long as the person fitting it was properly trained,” she said. “There are obviously the traditional methods and there are issues of safety when it comes to traditional circumcision. Sometimes people who have undergone traditional circumcision have to redo it in order to remove the foreskin that has been left behind.”

Mabena said each PrePex device cost about R200 and was intended for men aged 18 and older. One of the risks associated with the device was that men could forget that they had the ring on and engage in sex.

“The ring will then move and if that happens, medical circumcision will then be required. Our other fear is that if the device is not socially accepted, it cannot be introduced properly,” she said.

Mabena’s PrePex pilot project would be run in Orange Farm, North West, or Mpumalanga. She said when they conducted their study on medical male circumcision in Orange Farm, HIV incidence decreased by 76 percent.

“We now have to train staff on how to fit the PrePex. We need to make it acceptable to communities,” she said.

The chief director for HIV, Aids and sexually transmitted infections in the national Department of Health, Dr Thobile Mbengashe, said they would watch the PrePex pilot programme with interest.

Mbengashe said they hoped to circumcise at least 4.3 million men by 2016. “We have managed to have 1 million males circumcised, but we still have a lot to do. The PrePex has, however, addressed a lot of questions done by surgical procedures.

“Circumcision can prevent new infections by 60 percent. If we have many males who are circumcised, we are also reducing the number of infections,” he said.

Mbengashe said their goal was to reduce the number of infections by 50 percent.

“We cannot afford new infections. We spend R11-billion every year to treat people.” - Daily News

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