WHO recommends adult circumcision as HIV prevention measure

The United Nations Programme on AIDS (UNAIDS) announced this week in a joint press release with the World Health Organization the results of three clinical trials conducted in Africa which indicate that circumsized men are 50-60% less likely to contract HIV through heterosexual sex. The results were so striking that the trials were stopped and all participants offered the circumcision procedure.

This is very exciting news for HIV/AIDS prevention efforts in Africa, but as usual, the sticking point is money.

"Money is going to be the key. If additional resources brought to bear, we can have very substantial effects on the AIDS epidemic in East and Central Africa," Ronald Gray, MD [professor of reproductive epidemiology at Johns Hopkins University] says. "These are not cheap resources. There are the costs of training, the costs of equipment and supplies, the costs of all the complexities of providing surgeries and providing postsurgical care and managing any problems that arise."

If money is not forthcoming, the recommendations may do more harm than good. Men in areas with high HIV prevalence are very much aware of the news that circumcision lowers HIV risk.

"There is a lot of anecdotal evidence that men already are lining up asking for circumcision," Gray says. "And if we do not provide safe services, they will seek unsafe services."

Further trials are being conducted to see whether circumcision has a preventive effct on HIV transmission to women and the impact on men who have sex with men.