Medical circumcision efforts gained ground against new HIV infections, but not enough

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Focused efforts to protect men and boys from HIV led to more than 14.5 million medical circumcision procedures globally between 2008 and 2016, enough to avert an estimated half million infections by 2030, according to a report released today.

That progress, however, falls at least 30 percent short of the nearly 21 million procedures originally aimed for by the end of 2016 to meet goals toward epidemic control, according to the update in the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. Those goals call for an additional 27 million medical circumcisions worldwide within the next four years. But, with many of the procedures performed so far serving populations that were relatively easy to reach, the numbers of circumcisions are dropping, the report says.

The report updates data from 12 countries in southern and eastern Africa, regions that together are home to more than half of all people living with HIV worldwide, where access to the procedure is considered critical to ending the public health, development and economic impacts of the pandemic in the next 13 years.

Factors hindering uptake of medical circumcision include the recognition of tetanus as a rare, but serious potential complication from the procedure, particularly in the targeted regions where immunization coverage against the bacteria is sparse. The need to train health workers in the safest circumcision technique also has slowed rollout of the procedure, the report says.

Increased resources and new strategies to speed medical circumcision access will be essential to reaching goals and controlling the epidemic, according to the report.

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