男性学と婦人科: 現在の研究

The Role of Adult Male Circumcision in the Prevention of HIV/AIDS- Does the Technique Make a Difference?

Norman D Goldstuck

The Role of Adult Male Circumcision in the Prevention of HIV/AIDS- Does the Technique Make a Difference?

The co-evolution of the Human Immunodeficiency virus (HIV) and the human male foreskin have in part enabled the spread of HIV. This is due to the affinity of the HIV virus for the Langerhans cells of the inner foreskin. Voluntary Medical Male Circumcision (VMMC) is a means of breaking this link. The techniques available include standard surgical techniques or one of the many types of necrotising rings and clamps or by removal of the foreskin with a Gomcolike disposable device. The best device to use will be one which is most amenable to VMMC programmes so that it must be safe, easy to learn, to use and to teach, disposable and non-re-usable, affordable, and easy to store. Only the Gomco Clamp or a Gomcolike disposable device allowing healing by primary intention, which when used with tissue adhesive, avoid the necessity for routine follow-up visits as with other methods and may make VMMC more cost effective and well suited for up-scaling circumcision. A clinical comparison of the Gomco devices with surgical methods and rings and clamps is needed.