Reducing the Spread of HIV and Male Circumcision

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The first definitive proof that male circumcision (MC) may be an effective HIV prevention strategy was provided last year (Auvert et al., 2005). The study was conducted in the South African township of Orange Farm and involved 3,274 HIV-negative uncircumcised men between the ages of 18 and 24. Half of the men were randomly assigned to be circumcised and half served as controls and remained uncircumcised. The study was stopped early when an interim analysis reported that male circumcision reduced sexual transmission of HIV from women to men by 60%. Because the researchers reported that circumcision significantly reduced HIV transmission, they decided that it was unethical to proceed with the study and offered circumcision as an option to all enrolled males. This study served as the backdrop for the session on MC as an effective method for preventing or reducing the spread of HIV in developing countries that was held at the XVI International AIDS Conference. At this session, five papers addressed the efficacy of MC, potential impact on transmission and sexual behaviors, and cost-effectiveness. These papers are briefly described.