Abstract
PrePex™ (Circ MedTech Ltd., Tortola, British Virgin Islands) devices are being evaluated in several countries for scale-up of medical male circumcision (MMC) as an HIV prevention intervention. Health care workers' perceptions should be considered prior to scale-up. A cross-sectional open-ended questionnaire was administered to health care workers from nine MMC programs in South Africa that provided either PrePex™ and surgical circumcision (mixed sites) or surgical circumcision only (surgery-only sites). A total of 77 health care workers (37 at mixed sites and 40 at surgery-only sites) with median ages of 29 years (interquartile range 27-37) and 34 years (interquartile range 29-42), respectively, were recruited into the study. The perceived benefits of PrePex™ MMC for health care workers were: device simplicity, convenience, bloodless, and ease of use. Identified challenges included limited public knowledge of device, pain, smell of necrotic skin, and delayed healing. Health care providers perceived the PrePex™ MMC device to be simple and adaptable for existing MMC programs.
Highlights
male circumcision (MMC) for health care workers were: device simplicity, convenience, bloodless, and ease of use
United Nations Program on HIV/AIDS have recommended the scale-up of medical male circumcision (MMC) for HIV prevention by using any of the three recommended surgical procedures: dorsal slit, sleeve resection, and forceps-guided methods (WHO, 2009)
Our study demonstrated that the PrePexTM MMC device was considered by health care workers to be easy, simple, quick, and convenient, and could be incorporated into existing MMC programs
Summary
MMC for health care workers were: device simplicity, convenience, bloodless, and ease of use. Health care providers perceived the PrePexTM MMC device to be simple and adaptable for existing MMC programs. South African legislation has required that surgical circumcision be performed by a trained physician even though there is evidence that nurses can provide surgical circumcision as safely as physicians (Curran et al, 2011; Frajzyngier, Odingo, Barone, Perchal, & Pavin, 2014; WHO, 2011), and there have been discussions on task shifting to allow trained nurses. Devices for MMC are being evaluated in several countries as they promise to make MMC quicker, safer, more cost effective, and will not require physician providers (South African Nursing Council, 2005; WHO, 2013a)
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