Accepted Abstract presented in IAS 2013 Conference; Kuala Lampur, Malaysia
- HIV Prevention: Using the SurgiPex technique for Adult Male Circumcision (Rwanda). Previous studies showed that 8% of men are not suitable for the standard PrePex method due to very narrow foreskin, preventing insertion of the PrePex Inner Ring. The Main objective was to test the safety of PrePex with incision and injected anesthesia, on subjects with narrow foreskin, as an alternative to surgical procedure. 2 techniques were tested: (1) A full removal of the foreskin after device placement including anesthesia injection in a ring block technique, and a foreskin incision of 1cm-2cm in order to inset the Inner Ring. On day 7, the foreskin and device were removed. (2) The technique included no removal of the foreskin after device placement, including local anesthesia injection at the intended incision area, then a minimal incision of the foreskin to allow insertion of the Inner Ring. On day 7, the foreskin and device were removed. The PrePex with Incision procedure was found to be safe, effective and feasible when using technique #2. This procedure can become an accepted solution for men who are not suitable for standard non surgical PrePex MC due to Narrow Foreskin.
- Cost Analysis of the PrePex Procedure Compared to Surgical Procedure (Rwanda). The objective of this cost-analysis study was to provide an average unit cost and cost-analysis information related to performing male circumcision using either a surgical method or PrePex, and to determine how the use of PrePex might enhance the delivery of Rwanda national VMMC targets. A Prospective, randomized controlled trial was conducted in Rwanda in which the PrePex device was used for nonsurgical MC and the dorsal-slit method for surgical MC (ratio: 2:1) and evaluated the cost elements that may differ between the 2 methods, per each MC arm, by gathering data during the study course on the following cost elements: tools and materials, required infrastructure, clinical human resource, costs related to treating adverse events and the cost of training. The total circumcision cost per person, for surgical MC was found to be $40US/person, while the PrePex MC was found to be $27US/person assuming the current cost of $20 per device, providing an overall cost saving of more than 33% ($13). Moreover PrePex MC was found to be 5 times faster than the surgical procedure, conducted in a non-sterile facility.