Male circumcision: calls for caution over potential to prevent HIV
In March UNAIDS and the WHO issued official recommendations on the basis of new evidence demonstrating that circumcised men are up to 60% less likely to get HIV than those who are not. Since then, experts have issued statements warning that this evidence should be greeted with caution. Although circumcision may reduce the transmission risk, it still cannot protect all parties or act as a replacement for condoms and other prevention methods.
According to experts, male circumcision can reduce the risk of HIV infection by removing the foreskin tissue which is particularly vulnerable to the virus. At a meeting of experts in Montreux, Switzerland, evidence was presented on trials carried out recently in Africa. In light of the results of these trials - which demonstrated the potential for circumcision to considerably reduce HIV transmission - UNAIDS and the WHO recommended that all heterosexual men be circumcised in those countries with the highest HIV prevalence rates.
However the potential of this approach is somewhat limited for a number of reasons. First of all, in Sub-Saharan Africa, the region of the world most severely affected by the pandemic, over 60% of all men are already circumcised. Furthermore it has been established that circumcision can only be effective in preventing transmission of the virus from HIV positive women to men. Even then, it is not 100% effective. There is also a danger that messages will be poorly conveyed and that circumcised men will presume that they no longer need to wear a condom. This may pose further difficulties to women who already have difficulties in persuading their partners to practice safe sex methods. In light of this, experts including staff of UNAIDS and the WHO have emphasised the importance of treating circumcision as an important prevention tool but not a complete one. For more information, please contact us at [email protected].
