A Pilot Study to Introduce Voluntary Medical Male Circumcision for HIV Prevention in Areas of High Prevalence of the Dominican Republic
Voluntary Medical Male Circumcision (VMMC) is an effective strategy to reduce the risk of HIV infection. Clinical trials conducted in Africa found that the procedure reduces the risk of HIV acquisition by approximately 60%. Studies conducted in the Dominican Republic (DR) suggest that acceptability of VMMC among men may be as high as 67% when information about the benefits is provided. The goal of this pilot study was to assess the acceptability, uptake, safety, for VMMC services in two areas of high HIV prevalence in the country.
Providers and study personnel received background information about the risks and benefits of VMMC. Physicians and nurses received theoretical and practical training on the surgical technique. Educational sessions were conducted in the community to inform men of the benefits and risks of VMMC. Each consenting participant completed a survey of demographics, sexual practices and knowledge about VMMC. One week after the surgery, participants returned for a postoperative visit for wound inspection. Descriptive statistics were generated and analyses were conducted to calculate rates and measures of central tendency.
454 men were circumcised using the Forceps Guided Method under local anesthesia. Median age of the cohort was 27 years. Fifty-seven subjects were excluded for medical or anatomical reasons. The rate of adverse events (AE) was 4.4% with no serious adverse events. All complications resolved promptly with treatment. Eighty seven percent of clients reported being very satisfied and 12.8% were somewhat satisfied with the outcome at the one-week postoperative visit.
Recruitment, uptake, and client satisfaction with VMMC in this pilot were high. The rate of AEs was low. Roll out of VMMC in targeted areas of the DR is feasible and should be considered. To our knowledge, this is the first time VMMC has been offered for HIV prevention to adult men outside of Africa.
S. Khosla, None
C. Volquez, None
E. Basora, None
R. Flete, None
F. Lantigua, None
R. Rosario, None
L. Rodriguez, None
M. Fernandez, None
Y. Donastorg, None
R. Bailey, None