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.
KeywordsHIV/AIDS Circumcision Sexually transmitted infection Sub-Suharan Africa Epidemic
Medical male circumcision
Joint United Nations Program on HIV/AIDS
World Health Organization
Centers for Disease Control
Human Immunodeficiency Virus
Acquired Immune Disease Syndrome
Treatment as Prevention
Sexually Transmitted Infection
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Imani Jackson Rosario reported no potential conflicts of interest relevant to this article.
Dr. Khushabu Kasabwala reported no potential conflicts of interest relevant to this article.
Dr. Hossein Sadeghi-Nejad reported no potential conflicts of interest relevant to this article.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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