Male circumcision for prevention of HIV transmission: What the new data mean for HIV prevention in the United States
2007

Male Circumcision and HIV Prevention in the US

publication Evidence: moderate

Author Information

Author(s): Patrick S. Sullivan, Peter H. Kilmarx, Thomas A. Peterman, Allan W. Taylor, Allyn K. Nakashima, Mary L. Kamb, Lee Warner, Timothy D. Mastro

Primary Institution: Centers for Disease Control and Prevention

Hypothesis

What are the implications of recent clinical trials in Africa that found male circumcision reduces the risk of acquiring HIV from heterosexual sex for HIV prevention in the United States?

Conclusion

Male circumcision can reduce the risk of HIV acquisition through penile-vaginal sex, but its implications for the US are complex due to different HIV epidemic patterns.

Supporting Evidence

  • Three clinical trials in Africa showed that circumcision reduced HIV infection risk by 51% to 60%.
  • Circumcision was associated with lower HIV prevalence among men with known infected female partners.
  • Most HIV transmission in the US occurs among men who have sex with men, complicating the applicability of circumcision findings.

Takeaway

Getting circumcised might help some men avoid getting HIV, but it's not a complete solution, especially in the US where the situation is different from Africa.

Methodology

The publication reviews findings from three randomized controlled trials in Africa and discusses their implications for the US context.

Potential Biases

Potential biases in observational studies regarding circumcision and HIV risk among MSM.

Limitations

The study highlights significant differences between HIV epidemics in Africa and the US, which complicates the direct application of findings.

Participant Demographics

The publication discusses demographics related to circumcision rates among different racial and ethnic groups in the US.

Statistical Information

Confidence Interval

95% CI 0.22–0.97

Digital Object Identifier (DOI)

10.1371/journal.pmed.0040223

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