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A typology of penile cutting in Papua New Guinea: results of a modified Delphi study among sexual health specialists

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Male circumcision (MC) significantly reduces the risk of HIV acquisition in men. The geographical, linguistic and cultural diversity of Papua New Guinea (PNG) makes issues of acceptability and implementation complex, and culturally appropriate HIV and Sexually Transmissible Infection (STI) prevention strategies are crucial in this setting. A modified Delphi approach was conducted with sexual health specialists to document and classify variants of penile cutting as part of a programme of research being carried out to investigate the acceptability and potential epidemiological impact of MC for HIV prevention in PNG, and options for future roll-out. Three broad categories were identified: circumcision, longitudinal incisions (including dorsal slit procedures) and incisions that did not alter the profile of penis or foreskin. The typology provides a universal language for health practitioners and policy makers that will inform future sexual health deliberations. The popularity of dorsal slit procedures in PNG has significant implications due to its procedural simplicity and limited resource requirements, making it an attractive provider option compared to medical circumcision. Further research is urgently required to examine the effectiveness of dorsal slit procedures for HIV prevention in PNG, the prevalence of various forms of penile cutting and the extent to which health staff are currently engaged in dorsal slit procedures.

Keywords: HIV; Papua New Guinea; male circumcision; modified Delphi

Document Type: Research Article

DOI: http://dx.doi.org/10.1080/09540121.2011.592812

Affiliations: 1: Australian Centre for International and Tropical Health, School of Population Health,The University of Queensland, Brisbane, Australia 2: Sexual Health and Disease Control Branch, National Department of Health, Port Moresby, Papua New Guinea 3: HIV/AIDS Prevention and Control in Rural Development Enclaves Project, Department of Health, Port Moresby, Papua New Guinea 4: 9 Mile Clinic, Hope WorldwidePort Moresby, Papua New Guinea 5: Papua New Guinea Institute of Medical Research (PNG IMR), Eastern Highlands Province (EHP)Goroka, Papua New Guinea 6: National Centre in HIV Epidemiology and Clinical Research,The University of New South Wales, Sydney, Australia

Publication date: January 1, 2012

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