Prevention of HIV by male circumcision

doi:10.1136/bmj.39245.491169.BE

BMJ 2007;335:4-5 (7 July), doi:10.1136/bmj.39245.491169.BE

Editorials

Prevention of HIV by male circumcision

Is effective, but integration with existing sexual health servicesremains the biggest challenge

The first 150 words of the full text of this article appear below.

Three randomised controlled trials consistently show that medicallyperformed male circumcision can reduce the acquisition of HIVinfection in men by at least 50%.¹ ² ³ In east Africa and southernAfrica—where rates of new HIV infections are high andcircumcision rates are low—modelling studies estimatethat circumcision could reduce the incidence of HIV in men by50-60%.⁴ ⁵ Clearly, the size of this effect would be determinedby uptake. If uptake were 100%, an estimated 2 million new infectionsand 0.3 million deaths in sub-Saharan Africa would be avertedover 10 years, and up to 5.7 million new infections would beaverted over 20 years.⁶ In a setting like Orange Farm in SouthAfrica where one of the trials was performed,¹ a 50% uptakeof male circumcision could avert 32 000-53 000 new infectionsover 20 years. Conclusions about the effect of male circumcisionon the acquisition of HIV in women are . . . [Full text of this article]

Quarraisha Abdool Karim, associate scientific director

Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Congella 4013, South Africa

abdoolq2@ukzn.ac.za

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On the potential impacts of male circumcision on Africa�s HIV epidemics from modelling and simulation: Cyrille Delpierre, et al.
bmj.com, 20 Sep 2007 [Full text]