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MMWR – Morbidity and Mortality Weekly Report

1. Progress of Voluntary Medical Male Circumcision Service Provision — Kenya, 2008–2011

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Kenya is progressing well towards its target of providing voluntary medical male circumcision (VMMC) for HIV prevention to 860,000 males aged 15-49 years by July 2013. From 2008-2011, 391,383 VMMCs were conducted by clinical staff in Kenya. Of these, 340,958 were performed in over 260 Ministry of Health service delivery sites supported by the U.S. Centers for Disease Control and Prevention (CDC) through funding from the President’s Emergency Plan for AIDS Relief (PEPFAR). VMMC service delivery has been focused on Nyanza Province, where the HIV prevalence is 14.9%, and the circumcision rate is only 48%. A total of 82% of all VMMCs done in Kenya have been conducted in Nyanza Province, achieving 52% of the province’s VMMC target set by the Ministry of Health. Kenya’s progress in VMMC scale-up from 2008-2011 has been a remarkable demonstration of translating research into public health programming.  In addition to improved VMMC uptake from 2008-2011, acceptance of provider-initiated HIV testing and counseling and the proportion of VMMCs performed by non-physician health care providers in various service delivery settings has increased.

2. HIV Infections Attributed to Male-to-Male Sexual Contact — Metropolitan Statistical Areas, United States and Puerto Rico, 2010

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An analysis of HIV diagnoses in 2010 by metropolitan statistical areas (MSAs) finds that adult and adolescent men who have sex with men (MSM) are the risk group most significantly affected by HIV in large metropolitan areas across the nation.  Researchers analyzed 2010 data on new diagnoses of HIV infection among adults and adolescents by transmission category and location in areas with longstanding, confidential name-based HIV reporting.  Persons infected through male-to-male sexual contact accounted for the largest percentage of new HIV diagnoses, comprising more than half of all diagnoses in MSAs (62 percent in areas with populations of at least 500,000), smaller metropolitan areas (56 percent in areas with populations of 50,000-499,999), and nonmetropolitan areas (54 percent).  Most diagnoses among MSM occurred in MSAs (82 percent of all diagnoses among MSM).  Additionally, MSM in some MSAs were more affected than in others—nearly half (49 percent) of all diagnoses among MSM occurred in men living in just seven MSAs, and the four MSAs with the greatest proportion of MSM diagnoses were all in California.  These data point to the critical need to reach all MSM, especially those in large metropolitan areas, with HIV prevention, care, and treatment services.

3. Take-Home Lead Exposure Among Children with Relatives Employed at a Battery Recycling Company — Puerto Rico, 2011

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The recycling of lead has increased during the last 20 years with more workers and their families being potentially exposed to lead from recycling facilities. Employees of lead recycling facilities and their families are at risk of lead exposure. CDC recommends blood lead tests for children and pregnant or lactating women who work or live with someone who works with lead. This information is especially critical for workers at the Battery Recycling Plant in Arecibo, Puerto Rico and their family members. Both surveillance for lead exposures and interventions that minimize the transport of lead dust out of lead processing facilities are needed.


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