Increasing Availability and Acceptability of Circumcision in Zambia

Increasing Availability and Acceptability of Circumcision in Zambia

This study proposes to balance supply and demand of male circumcision through a systematic scale-up of coordinated biomedical surgical and behavioral counseling services. The study will compare the combined biobehavioral sexual risk reduction intervention to the standard of care, which focuses exclusively on the provision of circumcision services alone, with the goal of optimizing both local and national HIV prevention efforts.

Inclusion Criteria:

• HIV negative
• Uncircumcised male
• 18+ years of age
• Able to understand and sign informed consent in English, Bemba, or Nyanja
• Have not requested male circumcision services at the time of or following VCT
• Female partners of enrolled males are invited to participate

Exclusion Criteria:

• Men seeking circumcision services are not eligible for this study
• Men with genital abnormalities requiring MC, e.g. balanitis (inflammation of the preputial skin), posthitis (inflammation of the glans penis; common in patients with diabetes), phimosis (scarring of the distal margins of the foreskin) resulting from chronic balanitis, paraphimosis (the inability to pull the retracted foreskin back over the glans) or diseases of the foreskin, including localized carcinoma are not eligible for this study
• Men with congenital or acquired penile abnormalities that require the preputial skin for generative repair, such as hypospadias (urethra exits from underside of penis) are not eligible to participate
• Participants unable to provide informed consent will not be eligible.