Feasibility of medical male circumcision in Nyanza Province, Kenya

Abstract

Background: Over forty observational studies have reported a protective effect of male circumcision against HIV-I acquisition, leading some to suggest that male circumcision be added to the limited armamentarium of HIV prevention strategies. Objectives: To evaluate the feasibility and requirements of implementing medical male circumcision in Nyanza Province of Kenya a quasi-experimental design was implemented to assess clinicians' knowledge of male circumcision and to assess the effectiveness of a one day educational intervention in one district. A cross sectional survey assessed the availability of necessary instruments and surgical supplies. Results: None of the participating ten health facilities had all the necessary instruments and supplies to safely perform male circumcisions. Though most clinicians reported training about circumcision, most lacked sufficient knowledge to perform the procedure, and few were familiar with the process of informed consent. We demonstrated that a didactic educational workshop significantly improved providers' knowledge of male circumcision. Conclusions: Since increasing numbers of young men and parents are requesting male circumcision services in many parts of sub-Saharan Africa, health providers must undergo further training in the performance of the procedure and the process of informed consent. Many health facilities will have to be provided with the instruments and supplies necessary to perform male circumcision safely.