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Male circumcision as a preventive measure against HIV and other sexually transmitted diseases

Weiss, Helen A

Current Opinion in Infectious Diseases:
doi: 10.1097/QCO.0b013e328011ab73
Sexually transmitted diseases and urinary tract infections
Abstract

Purpose of review: In 2005, 4.1 million people were infected with HIV. There is an urgent need to intensify and expand HIV prevention methods. Male circumcision is one of several potential approaches. This review summarizes recent evidence for the potential of male circumcision to prevent HIV and other sexually transmitted infections.

Recent findings: The first randomized controlled trial of adult male circumcision found a highly significant 60% reduction in HIV incidence among men in the intervention arm. Modelling this effect predicts that widespread implementation of male circumcision could avert 2 million HIV infections over the next decade in sub-Saharan Africa. The biological rationale is that the foreskin increases risk of HIV infection due to the high density of HIV target cells and lack of keratinization of the inner mucosal surface.

Summary: There is strong evidence that male circumcision reduces risk of HIV, syphilis and chancroid. If results are confirmed by two ongoing trials in sub-Saharan Africa, provision of safe male circumcision could be added to HIV prevention packages in high-incidence settings. This would also provide an opportunity for HIV-prevention education and counselling to young men at high risk of infection.

Author Information

Infectious Disease Epidemiology Unit, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK

Correspondence to Helen A. Weiss, Medical Research Council Tropical Epidemiology Group, Infectious Disease Epidemiology Unit, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK Tel: +44 207 612 7872; fax: +44 207 636 8739; e-mail: helen.weiss@lshtm.ac.uk

© 2007 Lippincott Williams & Wilkins, Inc.