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. 2008 May;10(3):243-51.
doi: 10.1007/s11908-008-0040-9.

Update on male circumcision: prevention success and challenges ahead

Kristine E Johnson  1 , Thomas C Quinn
Affiliations

Update on male circumcision: prevention success and challenges ahead

Kristine E Johnson et al. Curr Infect Dis Rep. 2008 May.

Abstract

This article reviews the findings of three trials of male circumcision for HIV prevention, with emphasis on the public health impact, cultural and safety concerns, implications for women, and the challenges of roll out. Three randomized trials in Africa demonstrated that adult male circumcision reduces HIV acquisition by 50% to 60%. As circumcision provides only partial protection, higher risk behaviors could nullify circumcision's effect. Additionally, circumcision among HIV-infected men does not directly reduce male-to-female HIV transmission among discordant couples, according to the results of a recent Ugandan study. The roll-out or full-scale implementation requires committed expansion into existing HIV prevention programs. Efforts should include attention to safety, implications for women, and risk compensation. Rapid, careful establishment of circumcision services is essential to optimize HIV prevention in countries with the highest prevalence.

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Conflict of interest statement

Disclosures

The authors have reported no potential conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
Population-level incidence with an increase in number of sexual partners and varying degrees of circumcision efficacy for HIV prevention, assuming 75% program coverage. (From Gray et al. [30], with permission.)
See this image and copyright information in PMC

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