PrePex: Difference between revisions
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[[File:Prepex-parts.jpg|thumb|Single-use PrePex Device.]] [[File:Prepex-sizing.jpg|thumb|Single-use Sizing Plate.]] | [[File:Prepex-parts.jpg|thumb|Single-use PrePex Device.]] [[File:Prepex-sizing.jpg|thumb|Single-use Sizing Plate.]] | ||
The '''PrePex''' is | The '''PrePex''' is an Israeli [[circumcision]] device which was marketed by Circ MedTech, Ltd., exploiting the [[WHO]]'s endorsement of harmful circumcision as an [[HIV]] prevention method.<ref>{{REFweb | ||
|last=Scientific American | |last=Scientific American | ||
|first= | |first= | ||
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|publisher=Nature America, Inc. | |publisher=Nature America, Inc. | ||
|accessdate=2011-08-30 | |accessdate=2011-08-30 | ||
}}</ref> It works by effecting ischemic necrosis, forcing the foreskin tissue to die and fall off. This is marketed as an "advantage" over other circumcision devices and techniques, because it makes circumcision "bloodless, simple," and the manufacturing of easily-mass-produced parts allows for "scalable male circumcision programs in resource limited settings."<ref>{{REFweb | }}</ref> It works by effecting ischemic [[necrosis]], forcing the [[foreskin]] tissue to die and fall off. This is marketed as an "advantage" over other circumcision devices and techniques, because it makes [[circumcision]] "bloodless, simple," and the manufacturing of easily-mass-produced parts allows for "scalable male circumcision programs in resource limited settings."<ref>{{REFweb | ||
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|publisher=PrePex | |publisher=PrePex | ||
|accessdate=2011-08-30 | |accessdate=2011-08-30 | ||
}}</ref> In actuality, the concept of cutting off circulation to the foreskin in order to effect ischemic necrosis is found in other devices, such as the [[Plastibell]], [[ | }}</ref> In actuality, the concept of cutting off circulation to the [[foreskin]] in order to effect ischemic [[necrosis]] is found in other devices, such as the [[Circumplast]], [[Plastibell]], [[TARA KLamp]] and [[Sunathrone]] devices. | ||
== Inventors == | == Inventors == | ||
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}}</ref> | }}</ref> | ||
Circ MedTech promotes the '''PrePex''' System as a means to "to dramatically reduce the HIV infection rate." Built in to the patent application is a statement touting male circumcision as an HIV prevention method.<ref>{{REFweb | Circ MedTech promotes the '''PrePex''' System as a means to "to dramatically reduce the [[HIV]] infection rate." Built in to the patent application is a statement touting male circumcision as an [[HIV]] prevention method.<ref>{{REFweb | ||
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== Use in Africa == | == Use in Africa == | ||
The PrePex device | The PrePex device has been tested in Africa starting 2013. The [[President's Emergency Plan for AIDS Relief]] poid for PrePex circumcisions for about 2,500 men in Lesotho, Malawi, South Africa, Tanzania and Uganda. The [[Bill & Melinda Gates Foundation]] will pay for similar studies in Kenya, Mozambique, South Africa, Zambia and Zimbabwe. <ref>{{REFweb | ||
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|publisher=The New York Times | |publisher=The New York Times | ||
|accessdate=2012-12-26 | |accessdate=2012-12-26 | ||
}}</ref> The [[Rakai Health Sciences Program]] is currently unveiling it and testing it in Uganda, presented by Godfrey Kigozi, program chief investigator, who stated that "it was invented in the United States of America. We have so far tested it on about 50 clients but we need 250 more to confirm its acceptability but so far it has worked properly with those who used it"<ref>{{REFweb | }}</ref> The [[Rakai Health Sciences Program]] is currently unveiling it and testing it in Uganda, presented by Godfrey Kigozi, program chief investigator, who stated that "it was invented in the [[United States of America]]. We have so far tested it on about 50 clients but we need 250 more to confirm its acceptability but so far it has worked properly with those who used it"<ref>{{REFweb | ||
|last= | |last= | ||
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|accessdate=2011-08-30 | |accessdate=2011-08-30 | ||
}}</ref>. | }}</ref>. | ||
==Video== | |||
<br> | |||
<youtube>v=ftYII-Ts5MM</youtube> | |||
== Project abandoned in 2019 == | == Project abandoned in 2019 == | ||
Kenya officially adopted the device [...] in 2016 to expand safe circumcision methods. However, the uptake has been sluggish. The manufacturer says it has abandoned the project and is now offloading it to interested buyers. <q>Circ Medtech, the PrePex manufacturer, was unable to remove unreasonable WHO-imposed restrictions which have materially disadvantaged the product as compared to other circumcision methods for several years now", company CEO Eddy Horowitz said.<ref>{{REFweb | Kenya officially adopted the device [...] in 2016 to expand safe circumcision methods. However, the uptake has been sluggish. The manufacturer says it has abandoned the project and is now offloading it to interested buyers. <q>Circ Medtech, the PrePex manufacturer, was unable to remove unreasonable [[WHO]]-imposed restrictions which have materially disadvantaged the product as compared to other circumcision methods for several years now", company CEO Eddy Horowitz said.<ref>{{REFweb | ||
|url=https://www.the-star.co.ke/news/2019-07-04-bloodless-painless-circumcision-device-abandoned/ | |url=https://www.the-star.co.ke/news/2019-07-04-bloodless-painless-circumcision-device-abandoned/ | ||
|title='Bloodless painless' circumcision device abandoned | |title='Bloodless painless' circumcision device abandoned | ||
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}}</ref> | }}</ref> | ||
The PrePex was withdrawn from the market in 2019. | |||
==Circumcision does not prevent HIV infection== | |||
=== Population-based studies === | |||
{{Population-based studies}} | |||
===Two African surveys=== | |||
The previously reported studies were from developed Western nations. Now we have information from Sub_Saharan Africa. | |||
French scientist [[Michel Garenne]], Ph.D. has published two reports in 2022 comparing the incidence of HIV infection in [[circumcised]] and [[intact]] men. | |||
In his first report, Garenne presented the findings from a study in Lesotho, the enclave in South Africa. He reported: | |||
<blockquote> | |||
In couple studies, the effect of circumcision and VMMC on HIV was not significant, with similar transmission from female to male and male to female. The study questions the amount of effort and money spent on VMMC in Lesotho.<ref name="garenne2022A">{{REFjournal | |||
|last=Garenne | |||
|first=Michel | |||
|init=M | |||
|author-link=Michel Garenne | |||
|title=Changing relationships between HIV prevalence and circumcision in Lesotho | |||
|url=https://pubmed.ncbi.nlm.nih.gov/35373731/ | |||
|date=2022-04-04 | |||
|journal=J Biosoc Sci | |||
|volume=online ahead of print | |||
|pages=1-16 | |||
|DOI=10.1017/S0021932022000153 | |||
|pubmedID=35373731 | |||
|accessdate=2022-11-05 | |||
}}</ref> | |||
</blockquote> | |||
In his second report, Garenne (2022) presented information from six Sub-Saharan African nations (Eswatini, Lesotho, Malawi, Namibia, Zambia, Zimbabwe). He reported: | |||
<blockquote> | |||
"Results matched earlier observations made in South Africa that [[circumcised]] and [[intact]] men had similar levels of HIV infection."<ref name="garenne2022B">{{REFjournal | |||
|last=Garenne | |||
|first=Michael | |||
|init=M | |||
|author-link= | |||
|etal=no | |||
|title=Age-incidence and prevalence of HIV among intact and circumcised men: an analysis of PHIA surveys in Southern Africa | |||
|trans-title= | |||
|language= | |||
|journal=J Biosoc Sci | |||
|location= | |||
|date=2022-10-26 | |||
|season= | |||
|volume= | |||
|issue= | |||
|article= | |||
|page= | |||
|pages=1-13 | |||
|url=https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/ageincidence-and-prevalence-of-hiv-among-intact-and-circumcised-men-an-analysis-of-phia-surveys-in-southern-africa/CAA7E7BD5A9844F41C6B7CC3573B9E50 | |||
|archived= | |||
|quote= | |||
|pubmedID=36286328 | |||
|pubmedCID= | |||
|DOI=10.1017/S0021932022000414 | |||
|accessdate=2022-11-05 | |||
}}</ref></blockquote> | |||
{{SEEALSO}} | |||
* [[Adolescent and adult circumcision]] | |||
* [[Circumcision]] | |||
* [[Israel]] | |||
{{LINKS}} | {{LINKS}} | ||
* [http://PrePex.com/ PrePex™ website] | * [http://PrePex.com/ PrePex™ website] | ||
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{{REF}} | {{REF}} | ||
[[Category:Circumcision | [[Category:Circumcision in Africa]] | ||
[[Category:Circumcision product]] | |||
[[Category:Financial gain]] | [[Category:Financial gain]] | ||
[[Category:Israel]] | |||
[[Category:From CircLeaks]] | [[Category:From CircLeaks]] | ||