Men should be circumcised to reduce the risk of heterosexually acquired HIV infection, the World Health Organization and UNAIDS have recommended.
Following an expert panel held in March in Montreaux, Switzerland, the two organizations are advising that circumcision be a part of a comprehensive HIV prevention package, which also includes testing and counseling, treatment, promotion of safe sex habits, and provision of condoms and instruction on their use.
In a March 28 statement, WHO and UNAIDS said they based their recommendation on three randomized, controlled trials conducted in Kenya, South Africa, and Uganda, which found that circumcision reduces the risk of heterosexually acquired HIV in men by about 60%. The trials followed observational studies in which lower HIV prevalence was found in African countries with higher circumcision rates.
“The recommendations represent a significant step forward in HIV prevention,” Dr Kevin M. De Cock, director of the WHO's HIV/AIDS department, said in a written statement. “Countries with high rates of heterosexual HIV infection and low rates of male circumcision now have an additional intervention which can reduce the risk of HIV infection in heterosexual men. Scaling up male circumcision in such countries will result in immediate benefit to individuals. However, it will be a number of years before we can expect to see an impact on the epidemic from such investment.”
UNAIDS officials caution, however, that circumcision does not provide complete protection against the virus.
“Men and women who consider male circumcision as an HIV preventive method must continue to use other forms of protection such as male and female condoms, delaying sexual debut and reducing the number of sexual partners,” Catherine Hankins, Associate Director in the department of policy, evidence, and partnerships at UNAIDS, said in the statement.
The organizations estimate that 30% of men worldwide are circumcised.