Translation of research data into programmes and practice: UN Work Plan on Male Circumcision Translation of research data into programmes and practice:

Translation of research data into Translation of research data into programmes and practice:programmes and practice:

UN Work Plan on Male Circumcision UN Work Plan on Male Circumcision Catherine Hankins

Associate Director and Chief Scientific Adviser to UNAIDS

New perspectives in prevention on HIV sexual transmission

International AIDS Conference ANRS Satellite, Toronto, August 15, 2006

New perspectives in prevention on HIV sexual transmissionANRS satellite at the International AIDS Conference Toronto August 15,

2006

UN Work Plan on Male Circumcision


2006


Focus: • Improving safety of current practices• Supporting anticipatory activities by countries

Funding support: (US$ 1,040,000):Bill and Melinda Gates FoundationUNAIDS SecretariatUSA National Institutes of Health (NIH)Agence nationale de recherches sur le sida (ANRS)

Programme support: UNAIDS: HQ and regional support teams, country officesWHO: HQ and regionalUNICEF: HQ and regionalUNFPA: HQ and regionalCollaborations: World Bank (regional), USAID, PEPFAR


2006


briefing packs (key publications, fact sheets, maps, Q&A, reference lists and slides) for policy-makers, programme managers and partners

technical guidance on clinical and programmatic approaches to male circumcision, in an appropriate human rights framework pre-circumcision assessment, including the role of HIV testing and

counselling informed consent/adolescent assent/parental consent clinical/surgical procedures to ensure safety,

minimize and manage complications, and prevent risk compensation

simple programmatic tools for countries where uptake of services is increasing: supervision,

standard setting, certification, accreditation, monitoring and evaluation


2006

UN Work Plan on Male Circumcision anticipate potential impact and resource needs:

model impact of male circumcision at population level under different post-circumcision sexual risk and behavioural scenarios

estimate resources needed for male circumcision services under various scenarios, assess cost-effectiveness

develop and field test a rapid assessment tool for use at country level to document male circumcision practices, identify key providers, and assess social-cultural determinants of circumcision

develop an operations research plan, research agenda and tools.

support country stakeholder meetings in 5 sub-Saharan Africa countries bring countries together to review emerging information

and document experiences provide programming and technical support to

countries wanting to increase the supervision and safety of current circumcision practices through

training, regulatory and licensing improvements


2006

Next steps: watch this space……

NIH Data Safety Monitoring Board (DSMB) of the Kisumu, Kenya and Rakai, Uganda MC trials (female to male transmission) will review results of interim analyses in early 2007

Outcomes: Both trials continue to intended end: Uganda (July, 2007), Kenya

(September, 2007) One trial is stopped for observed effect size Both trials are stopped for observed effect size

If one or more trials are stopped, the UN will rapidly convene a meeting to examine randomised controlled

trial data (including the Gates funded Rakai trial of male to female transmission if data available), results

of impact modelling and implications for policy and programming


2006

Male circumcision for HIV prevention:

If effective, safe male circumcision would increase HIV prevention choices, create

synergies with correct and consistent male and female condom use for increased

protection…. provide a golden opportunity to invest in

male sexual and reproductive health

Documents

Translation of research data into programmes and practice: UN Work Plan on Male Circumcision Translation of research data into programmes and practice: