Circumcision as a Strategy to Minimize HIV Transmission
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The newest data related to the Human Immunodeficiency Virus (HIV) / Acquired Immune Disease Syndrome (AIDS) epidemic is primarily positive, but many areas of the world, especially Sub-Saharan Africa, remain disproportionately affected. Between 2005 and 2007, three large randomized trials evaluating circumcision for prevention of HIV acquisition in heterosexual African males showed a reduction in the rate of acquisition of HIV by up to 66 % over 24 months. Since the results of these studies were published, global health organizations have ramped up efforts to help target countries to provide male circumcision delivery services in sub-Saharan Africa. Male circumcision (MC) is cost-effective and efficacious, especially when used in combination with other prevention strategies. Available data shows good acceptability amongst target populations. Neonatal circumcision is well tolerated and more cost effective than adult male circumcision and should be included as part of MC initiatives in the future. Behavioral disinhibition and risk compensation are important factors that may mitigate the rate of risk reduction conferred by male circumcision and should be further investigated. As delivery of male circumcision services is expanded, the issues affecting the female sexual partners of the target population must be outlined and addressed. Whether or not the results of the African trials can be extrapolated to warrant expansion of MC programs to other populations is a critical area for further study.
- UNAIDS. Political declaration on HIV and AIDS: Intensifying our efforts to eliminate HIV and AIDS. 2011.
- UNAIDS. Global AIDS response progress reporting 2012: Guidelines—construction of core indicators for monitoring the 2011 political declaration on HIV/AIDS. 2012.
- •• UNAIDS. UNAIDS report on the global AIDS epidemic—2012. 2012. Annual UNAIDS report on the status of the AIDS epidemic and update on global initiatives to control it.
- UNAIDS. UNAIDS report on the global AIDS epidemic—2010. 2010.
- Centers for Disease Control. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. Dependent areas—2010. HIV surveillance supplemental report 2012;17(no. 3, part a). 2012.
- Centers for Disease Control. Estimated HIV incidence in the United States, 2007–2010. HIV surveillance supplemental report 2012;17(no. 4). 2012.
- Templeton DJ. Male circumcision to reduce sexual transmission of HIV. Curr Opin HIV AIDS. 2010;5:344–9. CrossRef
- •• Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial. PLoS Med. 2005;2:e298. One of the three landmark trials demonstrating the protective effect of male circumcision against HIV infection in sub-Saharan Africa.
- •• Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56. One of the three landmark trials demonstrating the protective effect of male circumcision against HIV infection in sub-Saharan Africa.
- •• Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369:657–66. One of the three landmark trials demonstrating the protective effect of male circumcision against HIV infection in sub-Saharan Africa.
- Siegfried N, Muller M, Deeks JJ, Volmink J. Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane Database Syst Rev. 2009:CD003362.
- Njeuhmeli E, Forsythe S, Reed J, Opuni M, Bollinger L, Heard N, et al. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa. PLoS Med. 2011;8:e1001132. CrossRef
- Circumcision policy statement. Pediatrics. 2012;130:585-586.
- Mavhu W, Hatzold K, Laver SM, Sherman J, Tengende BR, Mangenah C, et al. Acceptability of early infant male circumcision as an HIV prevention intervention in zimbabwe: a qualitative perspective. PLoS One. 2012;7:e32475. CrossRef
- Abbott SA, Haberland NA, Mulenga DM, Hewett PC. Female sex workers, male circumcision and HIV: a qualitative study of their understanding, experience, and HIV risk in Zambia. PLoS One. 2013;8:e53809. CrossRef
- Grund JM, Hennink MM. A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland. AIDS Care. 2012;24:245–51.
- Sadeghi-Nejad H, Wasserman M, Weidner W, Richardson D, Goldmeier D. Sexually transmitted diseases and sexual function. J Sex Med. 2010;7:389–413. CrossRef
- Weiss HA, Hankins CA, Dickson K. Male circumcision and risk of HIV infection in women: a systematic review and meta-analysis. Lancet Infect Dis. 2009;9:669–77. CrossRef
- Wawer MJ, Makumbi F, Kigozi G, Serwadda D, Watya S, Nalugoda F, et al. Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trial. Lancet. 2009;374:229–37. CrossRef
- Andersson N, Cockcroft A. Male circumcision, attitudes to HIV prevention and HIV status: a cross-sectional study in Botswana, Namibia and Swaziland. AIDS Care. 2012;24:301–9. CrossRef
- •• Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505. Landmark study showing that early antiretroviral therapy prevents transmission of HIV in serodiscordant couples. CrossRef
- • Barnighausen T, Bloom DE, Humair S. Economics of antiretroviral treatment vs. Circumcision for HIV prevention. Proc Natl Acad Sci U S A. 2012;109:21271–6. Discusses the relative cost-effectiveness of treatment strategies for HIV. Shows that MC combined with ART is the most cost effective option. CrossRef
- Alsallaq RA, Baeten JM, Celum CL, Hughes JP, Abu-Raddad LJ, Barnabas RV, et al. Understanding the potential impact of a combination HIV prevention intervention in a hyper-endemic community. PLoS One. 2013;8:e54575. CrossRef
- Westercamp M, Agot KE, Ndinya-Achola J, Bailey RC. Circumcision preference among women and uncircumcised men prior to scale-up of male circumcision for HIV prevention in Kisumu, Kenya. AIDS Care. 2012;24:157–66.
- Centers for Disease Control. Estimated lifetime risk for diagnosis of HIV infection among Hispanics/Latinos—37 states and Puerto Rico, 2007. 2010.
- Circumcision as a Strategy to Minimize HIV Transmission
Current Urology Reports
Volume 14, Issue 4 , pp 285-290
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Sexually transmitted infection
- Sub-Suharan Africa
- Industry Sectors
- Author Affiliations
- 1. Division of Urology, Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
- 2. Veteran Affairs Medical Center, East Orange, NJ, USA
- 3. Department of Urology, Hackensack University Medical Center, Hackensack, NJ, USA