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Article Review
The primary research article chosen for this assignment shows that voluntary medical male circumcision (VMMC) can reduce HIV infections. A standardized questionnaire was pilot-tested before the commencement of the actual study. A total of 233 males aging between 18-40 underwent VMMC for purposive HIV prevention (Mukudu et al., 2019). The study was conducted at a hospital in Soweto, South Africa between November 2012 and July 2014. The male participants underwent surgical circumcision, and a follow-up was scheduled 12 months after the VMMC. Several VMMC-trained clinicians conducted all the study procedures. A structured questionnaire was administered to the participants before the circumcision and during the post-circumcision study visit to ascertain HIV-risk behavior. Risk behavior was determined through condom use at the last sexual act and concurrent multiple sexual partners. The minor variables were vaginal sexual intercourse within the last one year, a history of the treatment of sexually transmitted infections (STIs) within the last one year, knowledge of sexual partners’ HIV status at the last sex act and having taken alcohol at the time of last sexual act.
The study did not consider the evidence for risk compensation after VMMC. Risk compensation was defined as engaging in sex without condoms and having multiple sexual partners due to the knowledge that VMMC can reduce the risk of HIV infection. The study results showed an increase of 56% in the males aged between 18-24 years who reported using condoms in their last sex act. Additionally, there was an increase of 34% in the participants who knew the HIV status of their partners (Mukudu et al., 2019). Another observation was that the number of participants who engaged in sexual intercourse in the past twelve months after the VMMC also increased by 79% (Mukudu et al., 2019). Generally, the study results showed a 70% general increase in the perception of the risk of contracting HIV after circumcision.
From the study results, the researchers concluded that males were more likely to use a condom during their last sexual act after undergoing VMMC. The study also concluded that more males are more likely to know their partners’ HIV statuses after VMMC. Another finding from the study was that VMMC made males more aware of their risk of contracting HIV. Generally, the researchers concluded that VMMC has potential benefits in a program set up as a behavioral and biomedical intervention for possible prevention of HIV transmission. The study shows that VMMC is one of the best one-time bio-medical and behavioral HIV prevention approaches, especially among populations with a high prevalence of HIV. The researchers’ conclusion resonates with the WHO and UNAIDS’ recommendation for implementing VMMC programs among the general population in the countries with a high prevalence of HIV. The robust evidence from the clinical trial in this article proves that VMMC
is cost-effective and adequate in HIV prevention.
References
Mukudu, H., Dietrich, J., Otwombe, K., Manentsa, M., Hlongwane, K., Haas-Kogan, M., ... & Martinson, N. (2019). Voluntary medical male circumcision (VMMC) for prevention of heterosexual transmission of HIV and risk compensation in adult males in Soweto: Findings from a programmatic setting. PloS One, 14(3), e0213571. https://doi.org/10.1371/journal.pone.0213571