Can devices for adult male circumcision help bridge the implementation gap for HIV prevention services?

Medical male circumcision could prevent more than 5 million new HIV infections in men in Africa over 20 years and should be a central part of any combination prevention public health strategy. Surgical methods, with systems designed for high volume services, have been used in circumcision scale-up programs in several African countries, but remain limited by the need for high-level health workers, skilled in the surgical techniques, and appropriate facilities. New male circumcision devices such as the Shang Ring and the PrePex device have shown promise in initial trials and may provide innovative ways to improve access to medical male circumcision in the future. The rapid introduction of new and promising biomedical strategies for HIV prevention, including antiretrovirals for HIV prevention, will require early consideration of delivery systems and service design.