Model for roll-out of comprehensive adult male circumcision services in South Africa

In research published this week in PLoS Medicine. Bertran Auvert (INSERM) and colleagues describe the large-scale roll-out of adult male circumcision (AMC) in Orange Farm, South Africa.

The researchers studied the ''Bophelo Pele'' (Health First) project. The project, which follows the WHO/UNAIDS guidelines for AMC, aims to offer free, safe adult male circumcision services to all men aged 15 years or older living in the Orange Farm township in South Africa as part of a community-based intervention against HIV. Orange Farm is in a low-income region of South Africa where adult HIV prevalence is 15.2% and AMC prevalence is about 25%.

Their findings suggest that the rapid AMC roll-out has been successful in the Orange Farm township but that challenges were present. For example, only a quarter of the participants agreed to voluntary HIV counseling and testing.

Despite the challenges, the authors say that these findings and those from similar intervention programs in Kenya and Uganda indicate that AMC scale-up should be feasible, at least in the short term, as an HIV prevention strategy in low-income communities where there is a high HIV prevalence and a low AMC rate.