Patient observed sterile treatment for male circumcision
Whether men should get circumcised is a controversial issue in Africa. From 2008, a massive pro-circumcision effort has been been fueled by foreign money and justified by badly-reported (incompletely-reported) research. Other pages on this website discuss the ongoing controversy.
Leaving aside controversies, if you want to be circumcised, don’t get HIV from the procedure:
|POST for male circumcision
|1. Avoid skin-piercing procedures
||You can choose not to be circumcised. Circumcision involves a lot of possible blood exposures through instruments and injections. In addition, the procedure – removing the foreskin – has other risks and consequences (see below). Circumcision may reduce your risk to get HIV during sex, but to be safe you will still need to use a condom.
|2. Use new disposable instruments
||(a) Before the event, find out what instruments will be used. As far as possible, arrange that the instruments will be new disposables – razor, surgical blade, etc. This applies to both traditional circumcisions outside medical settings and circumcisions in clinics. (b) Make sure the provider uses new disposable gloves. If you are circumcised with other men, make sure the provider puts on new gloves for you. (c) For circumcision in medical settings, the provider will inject local anaesthetic. Insist that the provider uses a new syringe and needle and takes the anaesthetic from a single-dose vial, or from a new multi-dose vial opened for you (see Injection section).
|3. You sterilize the instruments
||If you are circumcised at home, and the provider uses a special instrument, you can boil this before the event to be sure it is sterile.
|4. Ask providers how they sterilize instruments
||If you are circumcised in a medical setting, the provider may reuse some specialized instruments. Ask the provider if he/she has autoclaved all such instruments before reusing them to circumcise you.
Risk to get HIV from a circumcision
If your provider reuses a syringe and/or needle from an HIV-positive person without any effort to clean, and takes local anaesthetic from an opened multi-dose vial, your risk to get HIV from an injection of local anaesthetic may be estimated at 3%-10% (see Injection section; see also Table in Blood-borne Risks section). If the provider reuses other instruments from an HIV-positive man without any effort to clean, your risk to get HIV from a circumcision could exceed 10%.
If the provider uses a new syringe and needle, takes local anaesthetic from a single-dose vial, uses new gloves, and sterilizes all reused instruments, you have no risk to get HIV from a circumcision.
Evidence that men have gotten HIV during circumcision
Several papers report evidence that boys and men have gotten HIV and other blood-borne infections while getting circumcised in medical clinics or from traditional procedures.