News Release

Male circumcision appears to protect from HIV infection

Peer-Reviewed Publication

Population Council

Male circumcision appears to protect men at risk of HIV infection but cultural, medical, and ethical issues should be explored before the procedure is recommended as an intervention

NEW YORK (20 June 2000) - A growing body of scientific evidence supports the conclusion that circumcised men in sub-Saharan Africa are at reduced risk of HIV infection-possibly by as much as 50 percent.

Researchers involved in HIV prevention consider it premature, however, to recommend large-scale circumcision programs until important cultural, medical, programmatic, and ethical issues are resolved. These conclusions and recommendations from a recent international scientific conference may be relevant for any part of the world where the HIV epidemic continues to expand and where heterosexual transmission is a major issue.

A just-published report of a conference of experts convened by the Horizons Project, implemented by the Population Council, details both the scientific evidence of the benefits of male circumcision to those at risk of HIV infection and the many factors that must first be explored before circumcision is recommended. Horizons undertakes global HIV/AIDS/STI prevention and care research in sub-Saharan Africa, Asia, and Latin America.

"Research shows that uncircumcised men in certain parts of Africa are twice as likely as circumcised men to be HIV infected," says Dr. Johannes van Dam, deputy director of the Horizons Project, "but we still do not know the practicality, feasibility, acceptability, and cost-effectiveness of male circumcision as an HIV intervention."

"Other key issues that have not been resolved include the role that the anatomy of the foreskin and penile hygiene may play in HIV transmission," said van Dam. "We also do not know whether male circumcision affects risk behavior by men and women, such as the decision to use condoms, or whether it negatively affects women's ability to negotiate condom use. And we want to make sure that advocating male circumcision does not have negative repercussions on efforts in many communities to eliminate female genital cutting."

In addition, participants at the international conference made the following research recommendations:

  • Further examine the protective effect of circumcision against HIV, and the transmissibility of HIV infection to women by circumcised and uncircumcised men;
  • Analyze the role of possible confounding factors, such as religion;
  • Conduct randomized controlled trials of a male circumcision intervention to examine its efficacy in preventing HIV infection;
  • Conduct descriptive studies of attitudes and beliefs regarding male circumcision as an acceptable HIV intervention in currently non-circumcising populations;
  • Test mechanisms for implementing voluntary, safe, and effective male circumcision interventions, including the provision of training and supervision for traditional healers and allopathic health care providers; and
  • Develop and field test a rapid-assessment tool to evaluate the feasibility and cost of introducing male circumcision.

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The publication, "Male Circumcision and HIV Prevention," can be downloaded from the Council's Web site at http://www.popcouncil.org/horizons/reports/circumcision/default.html . Single copies can be ordered from pubinfo@popcouncil.org .

The Population Council is an international, nonprofit, nongovernmental institution that seeks to improve the wellbeing and reproductive health of current and future generations around the world and to help achieve a humane, equitable, and sustainable balance between people and resources. Established in 1952, the Council is governed by an international board of trustees. Its New York headquarters supports a global network of regional and country offices.

The Horizons Project was initiated under a cooperative agreement with the U.S. Agency for International Development to conduct global operations research to develop and identify best practices associated with the prevention and mitigation of HIV/AIDS. Horizons is implemented in Asia, Africa, and the Latin American/Caribbean region, in collaboration with five partners: International Center for Research on Women (ICRW), International HIV/AIDS Alliance, Program for Appropriate Technology in Health (PATH), Tulane University, and the University of Alabama at Birmingham.


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