It is well known from a range of observational and epidemiological studies that the lifetime risk
of acquiring HIV among males can be significantly reduced via circumcision by 53%-60% [1-3].
Numerous papers on the topic have been published over the past two decades to elevate HIV
prevention awareness, especially in sub-Saharan countries.
Results from the Decision Makers’ Program Planning Tool (DMPPT) models supported by the
USAID Health Policy Initiative and UNAIDS, performed in 2011, suggest that scaling up adult
voluntary medical male circumcision (VMMC) to reach 80% coverage in the 13 countries by
2015 would entail performing 20.34 million circumcisions between 2011 and 2015 and additional
8.42 million between 2016 and 2025. Such a scale-up would result in averting 3.36 million new
HIV infections through 2025. In addition, while the model shows that this scale-up would cost a
total of US$2 billion between 2011 and 2025, it would result in net savings (due to averted
treatment and care costs) amounting to US$16.51 billion.
In Zimbabwe, the percentage of all circumcised men is estimated at about 10% of the male
population [4]. Zimbabwe started a phased implementation of the national male circumcision
(MC) Program using the forceps guided surgical method surgical procedure in 2009. The MOVE
(Models for Optimizing Volume and Efficiency) model was adopted to increase efficiency in
surgical circumcision programs by task sharing, setting up surgical suites, and making available
MC kits that include all the necessary components for the surgery [5]. About 50,000
circumcisions had done during the program until 2011 (MoHCW, TWG Report 2012). Ministry
of Health and Child Welfare (MoHCW) estimates that scaling up to reach 80% of men, aged 13 -
29 in Zimbabwe means that over 1.26 million circumcisions need to be performed by 2015
(National Strategic Plan 2010). To increase the feasibility of accomplishing this target and
scaling up MC, the MoHCW had shown interest in non-surgical circumcision devices for adult
and adolescent MC that might make the procedure quicker, simpler and less expensive and have
the potential to aid and accelerate scale up of MC.
Methods:
A comparative phase (RCT) assessed the performance of PrePex method compared to forceps
guided surgical method, registered in clinicaltrials.gov: NCT01956370. The main objective was
to examine the procedure time, the secondary objectives were comparing the rate of pain, healing
time, satisfaction rate, cosmetic results and cost of procedure. Here we elaborate on the cost
difference gathered during the study.