• Circumcision

Circumcision

Public health officials are now arguing that circumcision of men should be a key weapon in the fight against infection with the human immunodeficiency virus (HIV) in Africa. Recent studies have shown that circumcision reduces infection rates by 50 to 60 percent among heterosexual African men. This article in the New England Journal of Medicine examines the past research and future obstacles associated with introducing circumcision as a preventative measure. The authors discuss the results from previous randomised trials which suggest that circumcision reduced the rate of HIV infection among heterosexual men by 60 percent. Researchers have also found that circumcision provides increased protection against the human papillomavirus, herpes simplex virus, syphilis, and chancroid.

The authors highlight how most people involved in scaling up adult male circumcision recognise that the surgery is a costly endeavour and a socially complex intervention that may compromise other public health priorities. Reaching women through other prevention methods is also important because there is no direct evidence to date that circumcision reduces the risk of transmission from men to women. The article concludes that although circumcision has increasing support from researchers, donors, and politicians, its status as a non–behaviour-based intervention may ultimately be its biggest obstacle. The scale up of circumcision will require strong political backing, adequate funding, and leaders to champion the cause to ensure that it is a safe, low-cost option available throughout Africa.

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