Adult male circumcision reduces risk of HIV

A branch of the National Institutes of Health announced an early end to two clinical trials of adult male circumcision because an interim review of trial data revealed that medically performed circumcision significantly reduces a man’s risk of acquiring HIV through heterosexual intercourse. The trial in Kisumu, Kenya, of 2,784 HIV-negative men showed a 53% reduction of HIV acquisition in circumcised men compared with uncircumcised men, while a trial of 4,996 HIV-negative men in Rakai, Uganda, showed that HIV acquisition was reduced by 48% in circumcised men.

“These findings are of great interest to public health policy makers who are developing and implementing comprehensive HIV prevention programs,” said NIH Director Elias A. Zerhouni, MD. “Male circumcision performed safely in a medical environment complements other HIV prevention strategies and could lessen the burden of HIV/AIDS, especially in countries in sub-Saharan Africa where, according to the 2006 estimates from UNAIDS, 2.8 million new infections occurred in a single year.”

The findings from the African studies may have less impact on the epidemic in the United States because most men have been circumcised, there is a lower prevalence of HIV, and most infections among men in the United States are in men who have sex with men, for whom the amount of benefit provided by circumcision is unknown. Nonetheless, the overall findings of the African studies are likely to be broadly relevant regardless of geographic location because a man at sexual risk who is uncircumcised is more likely than a man who is circumcised to become infected with HIV, according to an NIH statement.