Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) Preventing HIV infection and reducing risk behaviour • A person may be exposed to HIV once or many times before he or she becomes infected. The more often exposure occurs, the more likely a person is to become infected. Most people do not know their HIV status or whether they have been infected, and may continue to behave in a way that puts them at risk of infection or risks giving HIV to others. • HIV infection can be avoided by avoiding penetrative sexual intercourse, by having only one partner, who is HIV-negative and faithful, by using condoms the right way every time you have sex, and by using only clean needles for injections. • Correct and consistent condom use prevents not only HIV, but also other sexually transmitted infections (thereby protecting future fertility) and unwanted pregnancy. When used correctly every time, condoms are an excellent method of family planning and help prevent the spread of HIV and other STIs. Reducing the risk of getting infected with HIV • Do you know of ways in which people can reduce their risk of getting infected with HIV (Add to participants’ suggestions: not having sex with high-risk partners, talking to a partner about testing, talking about HIV concerns with a partner or friend, decreasing alcohol or drug use, increasing condom use, avoiding places where you often have high risk behaviour, abstaining from sex, avoiding penetrative sex, correctly using condoms every time until you and your partner have been tested, etc.) • Try to think of some ways in which you personally could decrease your risk of getting infected with HIV. • When you think of some ways that you can reduce your risk of getting infected with HIV, share them with someone you trust, such as a close friend. • Now I will show you the proper use of a condom. (Include a condom demonstration here if appropriate. Use models and ask participants to do some demonstrations themselves.) HIV testing • Our health facility offers HIV testing and counselling. Each person has the right to choose whether or not to be tested for HIV. • Before you make a decision about HIV testing, you will have the chance to talk with a counsellor about your specific situation with regard to STI and HIV infection, and about ways to reduce your risk of getting infected. • The test result shows your HIV status as of 3 months earlier. If you became infected in the 3 months before your test, it may not be detected. For this reason, some people will need to be retested. Educating and Counselling Clients and Obtaining Informed Consent Chapter 3-16
Male circumcision under local anaesthesia Version 3.1 (Dec09) For example, if you had unprotected sex in May and were tested in June, you may want to be tested again in August. • A positive HIV test means you have been infected with HIV. It does not mean you have AIDS, and it does not tell us when you were infected or when you will get sick. • A negative HIV test means you have not been infected with HIV or were infected too recently for the test to detect your infection. (Share information on how to remain HIV-negative). • If you are ill with signs and symptoms of HIV infection, medical staff will recommend an HIV test in order to determine the best way of treating and helping you. • [Only relevant if the country has adopted a national policy of provider-initiated testing and counselling at all contacts with health-care services]: It is the policy of our country to routinely offer an HIV test for all people who come to health care services, even if it is for reasons not linked to HIV infection. This policy has been adopted to encourage more and more people to know their HIV status. Those who are infected with HIV will then be able to take better care of themselves, their partners and their family members For those who are not infected, a negative test will be a strong motivation to remain free from HIV infection and can reinforce good practices that reduce the risk of infection. • Here is how the testing works at our facility. (Describe the testing process at your clinic. Emphasize the confidentiality of test results). Medicines • In this facility, medicines are available to slow down the progression of HIV infection to AIDS and therefore prolong life. The medicines are safe to take. Discuss the medicines that are available in your country for people who test positive and how to get them. Contraception for men • Two methods of male contraception are available in this clinic: a temporary method (male condoms) and a permanent method (male sterilization or vasectomy). • The male condom is suitable for those wanting to space pregnancies, to protect themselves against STIs and HIV, and to preserve their future fertility. In fact, the condom is the only method that both prevents pregnancy and provides protection against HIV and other sexually transmitted infections. • Vasectomy is a surgical procedure, in which the tubes (vas deferens) that transport sperm cells from the testes to the penis are cut and tied off (show drawing of male reproductive system to illustrate vasectomy). Vasectomy is a permanent method of contraception, and should be used only by men who are very sure that they do not want to have more children. You will still need to Educating and Counselling Clients and Obtaining Informed Consent Chapter 3-17
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Manual for Male Circumcision under Local Anaesthesia

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