Current Urology Reports

, Volume 14, Issue 4, pp 285–290

Circumcision as a Strategy to Minimize HIV Transmission

  • Imani Jackson Rosario
  • Khushabu Kasabwala
  • Hossein Sadeghi-Nejad
Men's Health (J Mulhall, Section Editor)

DOI: 10.1007/s11934-013-0343-8

Cite this article as:
Rosario, I.J., Kasabwala, K. & Sadeghi-Nejad, H. Curr Urol Rep (2013) 14: 285. doi:10.1007/s11934-013-0343-8

Abstract

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.

Keywords

HIV/AIDSCircumcisionSexually transmitted infectionSub-Suharan AfricaEpidemic

Abbreviations

MC

Male circumcision

MMC

Medical male circumcision

UNAIDS

Joint United Nations Program on HIV/AIDS

WHO

World Health Organization

CDC

Centers for Disease Control

HIV

Human Immunodeficiency Virus

AIDS

Acquired Immune Disease Syndrome

ART

Antiretroviral Therapy

TasP

Treatment as Prevention

STI

Sexually Transmitted Infection

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Imani Jackson Rosario
    • 1
  • Khushabu Kasabwala
    • 1
  • Hossein Sadeghi-Nejad
    • 1
    • 2
    • 3
  1. 1.Division of Urology, Department of SurgeryUniversity of Medicine and Dentistry of New JerseyNewarkUSA
  2. 2.Veteran Affairs Medical CenterEast OrangeUSA
  3. 3.Department of UrologyHackensack University Medical CenterHackensackUSA