Male Circumcision Update (2)
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It is important to be clear on this issue by separating the two directions of transmission. Male circumcision has been known for twenty years to reduce the risk of female to male transmission. One clinical trial in South Africa has recently demonstrated a population level impact. The results of two further African trials are expected within a year.
But what is currently unknown is whether circumcision reduces the risk of male to female transmission. Or is a circumcised man living with the virus more or less likely to transmit the virus to his female partner than an uncircumcised one? There is one study being undertaken in Uganda but it will be well over a year before the results are available.
Until the risks of transmission in both directions are fully known it is premature to recommend infant or adult male circumcision as a public health measure to support other HIV prevention activities. But it may be that this prevention intervention will end up, as usual, "in the hands of men".
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Claudio Schuftan
mailto:claudio@hcmc.netnam.vn