In the second of a special three-part series on the issue of male circumcision and its links. In the second of a special three-part series on the issue of male circumcision and its links to the reduction of HIV acquisition, unaids. Male circumcision and its links to HIV is one of the most talked about issues within the AIDS response over the last years, with latest research findings driving potential change in the way male circumcision is practiced and implemented for the future in relation to HIV prevention.
Male circumcision reduces the risk of HIV transmission from women to men. A meta-analysis of data from fifteen observational studies of men who have sex with men found "insufficient evidence that male circumcision protects against HIV infection or other STIs". Circumcised men can still become infected with the virus and, if HIV-positive, can infect their sexual partners.
Studies in Africa claim that adult male circumcision significantly reduces the risk of men acquiring HIV. Many professionals question the reliability and validity of these studies. However, some others take the leap of recommending adult male circumcision as an HIV prevention strategy in Africa for up to 38 million men.
Three randomized, controlled clinical trials in South Africa, Kenya, and Uganda were recently unblinded early because interim analyses concluded that circumcision of HIV-negative adult males reduced their risk for acquiring HIV infection through penile—vaginal sex [ 1—3 ]. In each trial, men who had been randomly assigned to an intervention group receiving circumcision had a lower incidence of HIV infection in up to two years of follow up, compared to men who were assigned to a control group not receiving circumcision. It is now clear that male circumcision can be efficacious for men in reducing their risk of HIV acquisition through sex with women [ 4 ]. Some experts predict that the impact of male circumcision as a biomedical intervention for HIV prevention in Africa could be large [ 56 ], and preparatory work has been done to establish male circumcision programs in Africa.
Three randomized controlled trials have shown that male circumcision provided by well trained health professionals in properly equipped settings is safe. Male circumcision provides only partial protection, and therefore should be only one element of a comprehensive HIV prevention package which includes: the provision of HIV testing and counseling services; treatment for sexually transmitted infections; the promotion of safer sex practices; the provision of male and female condoms and promotion of their correct and consistent use. Voluntary medical male circumcision for HIV prevention in 14 priority countries in eastern and southern Africa.
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AIDS and Behavior. Program data suggests uptake of VMMC below age 15 is lower than expected, given the age distribution of the eligible population. This analysis uses the Decision Makers Program Planning Tool to understand the impact of age prioritization on circumcision in Namibia.
Male circumcision as strategy for HIV prevention and sexually transmitted diseases. The potential role of traditional birth attendants in neonatal male circumcision. La circoncisione maschile come strategia di prevenzione dell'HIV e delle malattie sessualmente trasmissibili.
Male circumcision is surgical removal of the foreskin - the retractable fold of tissue that covers the head of the penis. The inner aspect of the foreskin is highly susceptible to HIV infections. Trained health professionals can safely remove the foreskin of infants, adolescents and adults medical male circumcision.