Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1(Dec09)
Contents
Preface
Acknowledgements
Photo credits
Financial support
Abbreviations and acronyms used in this manual
vii
ix
x
x
xi
1. Benefits and risks of male circumcision
Summary 1-1
Introduction 1-1
What is male circumcision 1-1
How circumcision is performed 1-1
Benefits and risks 1-1
Benefits 1-2
Risks 1-2
Male circumcision and HIV infection 1-3
The evidence linking male circumcision and HIV 1-3
Male circumcision and regional differences in HIV prevalence 1-3
Randomized controlled trials to assess the efficacy of male circumcision in
reducing risk of HIV infection 1-5
Possible biological explanations for the protective effect of male circumcision 1-5
Protection for women 1-6
Other health benefits of circumcision 1-6
Acceptability of circumcision among African men 1-6
References 1-7
2. Linking male circumcision to other male sexual and reproductive health services
Summary 2-1
Men’s sexual and reproductive health needs and services 2-2
Counselling and testing for HIV infection 2-3
Barriers to male sexual and reproductive health services 2-4
Meeting the sexual and reproductive health needs of men 2-4
Men’s roles in women’s and children’s health 2-5
Who should provide sexual and reproductive health services and information to
boys and men 2-6
Detection and treatment of selected male sexual and reproductive health problems 2-7
Sexually transmitted infections 2-7
Balanitis 2-8
Phimosis 2-9
Paraphimosis 2-10
Urinary tract infections 2-11
Infertility 2-11
References 2-12
3. Educating and counselling clients, and obtaining informed consent
Summary 3-1
Education about sexual and reproductive health and male circumcision 3-1
Group education script 3-2
Counselling 3-5
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