A practice for all seasons: male circumcision and the prevention of HIV transmission

Abstract

HIV/AIDS as a global epidemic has exerted its terrifying influence for quite some time now. Currently, a vaccine for its prevention appears to be near impossible. HIV has spread across the globe without deference to gender, race, religion, or socioeconomic status. Despite a growth in HIV awareness and interventions, there are perplexingly different prevelence rates in different countries with seemingly similar behavioral patterns. In this review we examined these variances in infection rates and found conclusive evidence that male circumcision makes a major difference. Removal of the foreskin of the penis (male circumcision, MC, C) is known to significantly reduce female-to-male HIV transmission through sex, which then decreases male-to-female transmission. Three recent randomized controlled studies from Africa have shown that circumcision offers a 60% to 70% protective effect against heterosexual acquisition of HIV. The protective effect of circumcision against HIV, known since the 1980s, has been confirmed by more than 30 studies before these three famous randomized controlled trials, which are the criterion standard of clinical research. The global epidemiology data clearly indicates a reduction of over 99.9% in HIV prevalence in countries where C rate is over 80%. As we show in this review, MC not only reduces HIV but also other sexually transmitted diseases (STDs). Circumcision’s decisive role in reducing the effect of HIV transmission has been so convincing that it has now been accepted officially by the WHO, UN, and NIH. Moreover, many nations have initiated adult circumcision as a public health measure.