Project Duration: Dec 1, 2008 to January 31, 2009

This award supported a fact finding visit to Rwanda, Ethiopia and Kenya to gather information about male circumcision as a means of HIV prevention. Activities in Rwanda included surgical exchange and demonstration of male circumcision (MC) methods, and meetings with staff and leadership. Several themes emerged: there is some awareness and uptake of MC for HIV prevention thanks to media and community coverage; cost in excess of 3000 francs ($6 CDN) was seen as an obstacle; “risk compensation” is a concern so that education is required to reinforce condom use, limitation of partner exchange and safe post-operative behaviour; pre-operative counseling of attached young men undergoing the procedure should involve the partner; logistics dictate that non-medical personnel must be trained to provide most procedures; and the Rwandese Ministry of Health has costed neonatal circumcision for the country. In Gambella, a pocket of Ethiopia with high HIV prevalence and low uptake of MC, local authorities are interested in developing a Ministry of Health-sanctioned plan to increase training and availability of MC. In Rwanda, the Ministry of Health will encourage MC in adolescents and young men.

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