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Female circumcision

Jessica B McGillen, Sarah-Jane Anderson, Timothy B Hallett
INTRODUCTION: The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape...
2016: Journal of the International AIDS Society
Waleed M Sweileh
BACKGROUND: Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. METHODS: Scopus database was used to retrieve data on FGM/C...
October 10, 2016: Reproductive Health
Sarah Rudrum, John L Oliffe, Cecilia Benoit
This paper analyses discourses of masculinity, femininity and sexuality in Stand Proud, Get Circumcised, a public health campaign promoting circumcision as an HIV-prevention strategy in Uganda. The campaign includes posters highlighting the positive reactions of women to circumcised men, and is intended to support the national rollout of voluntary medical male circumcision. We offer a critical discourse analysis of representations of masculinity, femininity and sexuality in relation to HIV prevention. The campaign materials have a playful feel and, in contrast to ABC (Abstain, Be faithful, Use condoms) campaigns, acknowledge the potential for pre-marital and extra-marital sex...
August 11, 2016: Culture, Health & Sexuality
Jong Kwan Park, Yu Seob Shin
To our knowledge, this is the first study that focuses on risk factor of urethral condyloma (UC). The subjects of our study included genital warts patients who had been diagnosed as having condyloma acuminatum of penile skin (CAPS) with/without UC. Relationship with UC of number of life time female partners, co-infection with urethritis, circumcision status, number of CAPS and wart diameter were studied by use of multivariate analysis. Co-infection with urethritis, circumcision status were risk factors of UC in heterosexual young male patients with CAPS...
September 2016: Infection & Chemotherapy
Matthew Westercamp, Walter Jaoko, Supriya Mehta, Pauline Abuor, Perez Siambe, Robert C Bailey
BACKGROUND: Three randomized controlled trials (RCT) showed that voluntary medical male circumcision (VMMC) reduces the risk of female to male HIV transmission by approximately 60%. However, data from communities where VMMC programs have been implemented are needed to assess changes in circumcision prevalence and whether men and women compensate for perceived reductions in risk by increasing their HIV risk behaviors. METHODS: Scale-up of free VMMC began in Kisumu, Kenya in 2008...
September 13, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Annick Bórquez, Anne Cori, Erica L Pufall, Jingo Kasule, Emma Slaymaker, Alison Price, Jocelyn Elmes, Basia Zaba, Amelia C Crampin, Joseph Kagaayi, Tom Lutalo, Mark Urassa, Simon Gregson, Timothy B Hallett
BACKGROUND: Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates. METHODS AND FINDINGS: We developed a predictive model, the Incidence Patterns Model (IPM), representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, "key populations" based on risk behaviours (sex work, injecting drug use, and male-to-male sex), HIV and ART status within married or cohabiting unions, and circumcision status...
September 2016: PLoS Medicine
G Pialoux, C Delaugerre, L Cotte, F Raffi, E Cua, J-M Molina
The aim of preventive measures against human immunodeficiency virus (HIV) is to reduce the incidence of HIV infection in the general population and in high-risk groups, such as men having sex with men (MSM), and to reduce the risk that a given individual will contract or spread the virus. Male and female condoms, post-exposure prophylaxis and circumcision are preventive methods currently recognized or promoted worldwide. Although modest success has been reported in a phase-III vaccine trial, other methods are being evaluated, such as vaginal and rectal microbicides, and pre-exposure prophylaxis (PrEP)...
September 2016: Clinical Microbiology and Infection
Brian J Morris, John N Krieger, Jeffrey D Klausner
We evaluate recent claims opposing infant male circumcision, a procedure now supported by the evidence-based policy of the American Academy of Pediatrics. We find those criticisms depend on speculative claims about the foreskin and obfuscation of the strong scientific evidence supporting pediatric policy development. An argument that circumcision should be delayed to allow a boy to make up his own mind as an adult fails to appreciate the psychological, scheduling and financial burdens later circumcision entails, so reducing the likelihood that it will occur...
August 8, 2016: World Journal of Clinical Pediatrics
Paul C Hewett, Mutinta Nalubamba, Fiammetta Bozzani, Jean Digitale, Lung Vu, Eileen Yam, Mary Nambao
BACKGROUND: Provision of HIV prevention and sexual and reproductive health services in Zambia is largely characterized by discrete service provision with weak client referral and linkage. The literature reveals gaps in the continuity of care for HIV and sexual and reproductive health. This study assessed whether improved service delivery models increased the uptake and cost-effectiveness of HIV and sexual and reproductive health services. METHODS: Adult clients 18+ years of age accessing family planning (females), HIV testing and counseling (females and males), and male circumcision services (males) were recruited, enrolled and individually randomized to one of three study arms: 1) the standard model of service provision at the entry point (N = 1319); 2) an enhanced counseling and referral to add-on service with follow-up (N = 1323); and 3) the components of study arm two, with the additional offer of an escort (N = 1321)...
2016: BMC Public Health
Virginia Senkomago, Danielle M Backes, Michael G Hudgens, Charles Poole, Steven R Meshnick, Kawango Agot, Stephen Moses, Peter Jf Snijders, Chris Jlm Meijer, Albertus T Hesselink, Nicolas F Schlecht, Robert C Bailey, Jennifer S Smith
BACKGROUND: Whether higher penile human papillomavirus (HPV) viral load is associated with a lower rate of HPV clearance remains unknown. OBJECTIVES: We examined the association between penile HPV16 and HPV18 viral load and subsequent HPV clearance in uncircumcised Kenyan men. STUDY DESIGN: Participants were human immunodeficiency virus (HIV)-seronegative, sexually active, 18- to 24-year-old men randomized to the control arm of a male circumcision trial in Kisumu, Kenya...
September 2016: Sexually Transmitted Diseases
Abiodun S Adeniran, Munirdeen A Ijaiya, Adegboyega A Fawole, Olayinka R Balogun, Kikelomo T Adesina, Abdul Waheed O Olatinwo, Adebunmi O Olarinoye, Peace I Adeniran
BACKGROUND: The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C). OBJECTIVE: To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it. METHODS: A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents...
August 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
B Friedman, J Khoury, N Petersiel, T Yahalomi, M Paul, A Neuberger
Based on three large randomized controlled trials (RCTs) conducted in Africa, it can clearly be stated that circumcision lowers the risk of infection with the human immunodeficiency virus (HIV) and some sexually transmitted infections (STIs) among males in settings of high HIV and STI endemicity. Similar effects on STI risk may exist for females, although this may result from an indirect effect of decreasing risk of infection among male partners. It is unknown whether circumcision prevents HIV acquisition in men who have sex with men (MSM), although there might be a protective effect for men who engage mainly in insertive anal intercourse...
September 2016: Clinical Microbiology and Infection
Nayi Zongo, Nina Korsaga-Somé, Amandine Banata Gang-Ny, Edgar Ouangré, Maurice Zida, Aimé Sosthène Ouédraogo, Aboubacar Hirrhum Bambara, Augustin Tozoula Bambara, Si Simon Traore, Pascal Niamba, Adama Traoré, Ahmadou Dem
BACKGROUND: Vulvar cancer is a rare gynaecological cancer. In Burkina Faso, the diagnosis of vulvar cancers is delayed and the prognosis is poor. However, no specific study on vulvar cancers has been conducted at the moment. This work aimed to study the characteristics of these cancers. METHODS: This is a prospective study on histologically confirmed primary cancers of the vulva diagnosed between 1st January 2013 and 30th June 2015. The demographic and clinical aspects were studied at the Yalgado Ouedraogo University Hospital of Ouagadougou (CHU-YO)...
2016: Infectious Agents and Cancer
Brian D Earp
The spectrum of practices termed "Female Genital Mutilation" (or FGM) by the World Health Organization is sometimes held up as a counterexample to moral relativism. Those who advance this line of thought suggest the practices are so harmful in terms of their physical and emotional consequences, as well as so problematic in terms of their sexist or oppressive implications, that they provide sufficient, rational grounds for the assertion of a universal moral claim--namely, that all forms of FGM are wrong, regardless of the cultural context...
June 2016: Kennedy Institute of Ethics Journal
Larry W Chang, Mary K Grabowski, Robert Ssekubugu, Fred Nalugoda, Godfrey Kigozi, Betty Nantume, Justin Lessler, Sean M Moore, Thomas C Quinn, Steven J Reynolds, Ronald H Gray, David Serwadda, Maria J Wawer
BACKGROUND: Understanding the extent to which HIV burden differs across communities and the drivers of local disparities is crucial for an effective and targeted HIV response. We assessed community-level variations in HIV prevalence, risk factors, and treatment and prevention service uptake in Rakai, Uganda. METHODS: The Rakai Community Cohort Study (RCCS) is an open, population-based cohort of people aged 15-49 years in 40 communities. Participants are HIV tested and interviewed to obtain sociodemographic, behavioural, and health information...
August 2016: Lancet HIV
B M Gbadebo, R F Afolabi, A S Adebowale
BACKGROUND: Female Circumcision (FC) is a harmful traditional practice and remains a public health problem particularly in the era of HIV/AIDS. Aside its numerous health implications, it can cause infertility, complications in childbirth and increased risk of newborn deaths. FC is widely practised in Nigeria. OBJECTIVE: The study assessed the level of FC, daughters' circumcision and attitude towards discontinuation of the practice among women of reproductive age...
December 2015: African Journal of Medicine and Medical Sciences
Olayide Ogunsiji
Female genital mutilation (FGM) or female circumcision is a global health issue with increasing international migration of affected women and girls to countries unfamiliar with the practice. Western health care providers are unfamiliar with FGM, and managing obstetric care presents challenges to midwives who are in the forefront of care provision for the women. The participants in this Heideggerian qualitative interpretive study elucidated the strategies they used in overcoming the particular physical, emotional, and gynecological health issues with which mutilated women present...
October 2016: Health Care for Women International
Mulugeta Gajaa, Negash Wakgari, Yigzaw Kebede, Lemma Derseh
BACKGROUND: Female genital mutilation is currently a public health problem which needs investigation and immediate action. Ethiopia is the second-ranked African country in terms of having higher numbers of circumcised girls. This study aimed to determine prevalence and associated factors of circumcision among daughters of reproductive aged women. METHODS: A community based cross-sectional study was conducted on 610 mothers. The total sample was allocated proportionally in three randomly selected kebeles based on the number of reproductive age mothers with at least one daughter under 15 years old...
2016: BMC Women's Health
Rachel T Esra, Abraham J Olivier, Jo-Ann S Passmore, Heather B Jaspan, Rushil Harryparsad, Clive M Gray
In many parts of the World, medical male circumcision (MMC) is used as standard prevention of care against HIV infection. This is based on seminal reports made over 10 years ago that removal of the foreskin provides up to 60% protection against HIV infection in males and seems currently the best antiretroviral-free prevention strategy yet against the global epidemic. We explore the potential mechanisms by which MMC protects against HIV-1 acquisition and that one of the oldest, albeit re-invented, rituals of removing a foreskin underscores the exploitative nature of HIV on the anatomy and tissue of the uncircumcised penis...
2016: Frontiers in Immunology
Xiangrong Kong, Godfrey Kigozi, Joseph Ssekasanvu, Fred Nalugoda, Gertrude Nakigozi, Anthony Ndyanabo, Tom Lutalo, Steven J Reynolds, Robert Ssekubugu, Joseph Kagaayi, Eva Bugos, Larry W Chang, Pilgrim Nanlesta, Grabowski Mary, Amanda Berman, Thomas C Quinn, David Serwadda, Maria J Wawer, Ronald H Gray
IMPORTANCE: Medical male circumcision (MMC) and antiretroviral therapy (ART) are proven HIV prevention interventions, but there are limited data on the population-level effect of scale-up of these interventions in sub-Saharan Africa. Such evaluation is important for planning and resource allocation. OBJECTIVE: To examine whether increasing community MMC and ART coverage was associated with reduced community HIV incidence in Rakai District, Uganda. DESIGN, SETTING, AND PARTICIPANTS: Using person-level data from population-based surveys conducted from 1999 through 2013 in 45 rural Rakai communities, community-level ART and MMC coverage, sociodemographics, sexual behaviors, and HIV prevalence and incidence were estimated in 3 periods: prior to the availability of ART and MMC (1999-2004), during early availability of ART and MMC (2004-2007), and during mature program scale-up (2007-2013)...
July 12, 2016: JAMA: the Journal of the American Medical Association
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