{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:05:50Z","timestamp":1785434750822,"version":"3.56.0"},"reference-count":8,"publisher":"AOSIS","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PHCFM"],"abstract":"<jats:p>Voluntary medical male circumcision (VMMC) is a priority human immunodeficiency virus (HIV) preventive intervention. Challenges in funding national VMMC programmes mandate us to adopt new methods to provide circumcisions in a primary care setting. This study aims to test the practicality of instrument-assisted circumcision in primary care in pre-school-age boys. The study setting was one primary care centre in Western Cape, South Africa. The methodology adopted is prospective case series of minimally invasive voluntary circumcision using the Unicirc instrument in boys less than 6 years of age. We circumcised 221 healthy boys using the Unicirc instrument, using a combination of topical anaesthetic, subcutaneous local anaesthetic and intramuscular ketamine. There were 5 (2.3%) mild complications and 48 (21.7%) had mucosal swelling as a result of lysis of physiological phimosis. All boys were fully healed at 2 weeks and all caregivers were highly satisfied. Using a circumcision instrument in primary care simplifies circumcision in pre-school-age boys and has a low rate of adverse events. This study demonstrates that a new model of circumcision in primary care may enhance national VMMC programmes.<\/jats:p>","DOI":"10.4102\/phcfm.v17i1.5039","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:07:57Z","timestamp":1762160877000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Voluntary male medical circumcision of pre-school-aged boys in primary care"],"prefix":"10.4102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6695-032X","authenticated-orcid":false,"given":"Norman D.","family":"Goldstuck","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-3356","authenticated-orcid":false,"given":"Peter S.","family":"Millard","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02n2ava60","id-type":"ROR","asserted-by":"publisher"}],"name":"University of New England"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref0","unstructured":"World Health Organization. Voluntary medical male circumcision for HIV prevention [homepage on the Internet]. 2025 [cited 2025 Jan 22]. Available from: https:\/\/www.who.int\/teams\/global-hiv-hepatitis-and-stis-programmes\/hiv\/prevention\/voluntary-medical-male-circumcision"},{"key":"ref1","unstructured":"Global HIV Prevention Coalition. Global HIV Prevention Coalition Newsletter January 2025 [homepage on the Internet]. Geneva: UNAIDS; 2025 [cited 2025 Jan 22]. Available from: https:\/\/hivpreventioncoalition.unaids.org\/en\/news\/global-hiv-prevention-coalition-newsletter-january-2025"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"El Bcheraoui C, Zhang X, Cooper CS, et al. Rates of adverse events associated with male circumcision in U.S. medical settings, 2001 to 2010. JAMA Pediatr. 2014;168(7):625\u2013634. https:\/\/doi.org\/10.1001\/jamapediatrics.2013.5414","DOI":"10.1001\/jamapediatrics.2013.5414"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Millard PS, Goldstuck ND. No needle, single-visit adult male circumcision with Unicirc: A multi-centre field trial. PLoS One. 2015;10(3):e0121686. https:\/\/doi.org\/10.1371\/journal.pone.0121686","DOI":"10.1371\/journal.pone.0121686"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Shenje J, Millard PS. Sutureless adult voluntary male circumcision with topical anesthetic: A randomized field trial of Unicirc, a single-use surgical instrument. PLoS One. 2016;11(6):e0157065. https:\/\/doi.org\/10.1371\/journal.pone.0157065","DOI":"10.1371\/journal.pone.0157065"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Millard PS, Goldstuck ND. Minimally invasive, sutureless, adolescent male circumcision with topical anesthetic: A field trial of Unicirc, a single-use surgical instrument. Transl Androl Urol. 2020;9(2):516\u2013522. https:\/\/doi.org\/10.21037\/tau.2019.12.16","DOI":"10.21037\/tau.2019.12.16"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Millard PS. Circumcision \u2013 What\u2019s wrong with plastic rings? S Afr Med J. 2012;102(3):126\u2013129. https:\/\/doi.org\/10.7196\/SAMJ.5419","DOI":"10.7196\/SAMJ.5419"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Goldstuck ND. Male medical circumcision for the control of human immunodeficiency virus by nurses using the Unicirc assist device. J Biotech Biomed. 2023;6:579\u2013584. https:\/\/doi.org\/10.26502\/jbb.2642-91280120","DOI":"10.26502\/jbb.2642-91280120"}],"container-title":["African Journal of Primary Health Care &amp; Family Medicine"],"original-title":[],"link":[{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/5039\/8784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:08:01Z","timestamp":1762160881000},"score":1,"resource":{"primary":{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/5039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":8,"URL":"https:\/\/doi.org\/10.4102\/phcfm.v17i1.5039","relation":{},"ISSN":["2071-2928","2071-2936"],"issn-type":[{"value":"2071-2928","type":"print"},{"value":"2071-2936","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"article-number":"a5039"}}