When I was eight years old, my aunt gave birth to a baby boy perfect in every way, except for a six boneless finger on his left hand. When I met my new cousin a week later, he had a string tied around his now shriveled six digit. The string, my aunt explained, would painlessly starve the troublesome finger of blood until it fell off on its own.
A medical worker clamps the device around the foreskin of a man's penis. The lack of blood supply kills the foreskin within a few hours. A week later the man returns to the clinic to have the device removed. Altogether the application and removal time totals about three minutes. The discomfort of removing the PrePex (and the now detached foreskin) has been likened to that of taking off a bandaid.
Why the need for such a quick low-impact circumcision method for adult men? Studies in African countries with high levels of HIV have found that circumcision reduces a man's risk of contracting the virus by up to 60%. That explains PrePex's target demographic, Sub-Saharan Africa.
Here's where PrePex has a built-in market. The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President's Emergency Plan for AIDS Relief plans to fund the circumcision of 80% of men ages 15 to 49 in high-risk African countries by 2015.
As the first non-surgical male circumcision device that involves no injected anesthesia, bleeding, sutures, or sterile settings, PrePex is an attractive product choice for helping to meet that goal. Since its debut in 2009, the device is already well on its way to broad usage, Ariel Schwartz of Co.Exist reports:
Last month, [the World Health Organization] WHO gave Rwanda its approval to scale up the use of PrePex, which has already successfully circumcised 1,200 men in the country. In Zimbabwe, a large PrePex trial funded by the Bill and Melinda Gates Foundation and the [United Nations Population Fund] UNFPA has already seen 500 circumcisions performed. People have been literally lining up to participate in PrePex studies.
PrePex has the certifications to enter the U.S. and E.U. markets, but the company has no plans to do so any time soon.
"We are laser focused on an imminent burning need," PrePex's parent company's CEO told Co.Exist regarding their focus on the Sub Sahara. “Every 16 seconds someone dies of AIDS. We have a rare opportunity to make a monumental impact in the battle against this life threatening disease."
As a recent commenter on my post on HIV vaccines pointed out, debate still exists in the U.S. over the merits of circumcision. A 2008 review of circumcision and HIV studies by Scientific American's Barbara Juncosa came to this conclusion:
Circumcision protects heterosexual men from HIV acquisition via sexual intercourse with the greatest benefits accruing in developing nations that are hardest hit by the epidemic.
But, Juncosa notes, the HIV-preventing benefits of circumcision for homosexual men are less certain.
While male circumcision rates in Sub Saharan Africa continue to rise, male infant circumcision rates have dropped dramatically in the U.S. over the last few years. And while studies show circumcision lowers a man's chance of contracting HIV from a female partner, the question remains whether it also affects his chances of passing the virus on to her.