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In July, AVAC and Internews in Kenya organized a journalists briefing on PrePex, a non-surgical device for voluntary medical male circumcision (VMMC) pre-qualified by the World Health Organization (WHO). (Click here for more on this process.) This was the first in a planned series of journalist “cafés” designed to spark conversation about VMMC and the role of non-surgical devices.
“Prequalification” is the process by which the WHO determines that a product meets required standards of quality, safety and efficacy for international use. This step paves the way for purchasing by international programs, such as PEPFAR and the Global Fund for AIDS, Tuberculosis and Malaria. PrePex is the first circumcision device pre-qualified by the WHO, and there are currently a range of evaluation studies underway to find out more about its acceptability, safety and feasibility.
Twelve journalists attended the conversation in Kenya—and they had a number of questions. “How will PrePex complement conventional VMMC surgery?” asked Thomas Bwire, an editor with Pamoja FM, a community radio based in the Kibera section of Nairobi. This is an essential question—and one that the evaluation studies described above are designed to address. As countries look at the information from these studies and decide if and how to introduce non-surgical devices alongside surgery, we will get a better picture of how these two options are viewed and sought by men as well as women, who play a key role as parents, partners and allies of men seeking circumcision.
Journalists also asked about the price of PrePex. The currently quoted cost is approximately US$20. There are ongoing negotiations that could bring the price down through bulk-purchasing agreements, but so far no new price has been set.
The journalists also emphasized the need to better communicate the partial protection message to men and their communities. Circumcision does not afford complete protection against HIV transmission and that must be made absolutely clear. VMMC is just part of combination HIV prevention—behavioral interventions, HIV testing, STI treatment, immediate initiation of ART, couples counseling and testing and condoms among others, as the local context dictates.
AVAC is collaborating with partners in South Africa, Uganda and Zambia to organize similar cafés in the coming months. Please contact us if you would like to be involved.