Male circumcision: Africa and beyond?

Kim, Howard H^a; Li, Philip S^b; Goldstein, Marc^b,c

^aCedars-Sinai Medical Center, Los Angeles, California, USA

^bNew York-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, USA

^cThe Population Council, Center for Biomedical Research, New York, New York, USA

Correspondence to Marc Goldstein, MD, Department of Urology, Weill Cornell Medical College, 525 E. 68th Street, New York, NY 10065, USA Tel: +1 212 746 5470; fax: +1 212 746 0977; e-mail:[email protected]

Current Opinion in Urology20(6):p 515-519, November 2010. |DOI:10.1097/MOU.0b013e32833f1b21

Abstract

Purpose of review

Male circumcision has become an important component of HIV prevention strategies in Africa. Results of recent trials have renewed interest in this ancient procedure and its potential application in the reduction of sexually transmitted infections (STIs). With renewed interest comes controversy, which has always been a close companion to circumcision.

Recent findings

Following the three randomized trials in Africa demonstrating the protective effects of male circumcision on HIV infection, studies have reported other benefits of circumcision including protection from certain STIs, including human papillomavirus and herpes simplex virus 2. With data accumulating on the public health benefits of circumcision and the endorsement of circumcision from WHO, investigators have begun to evaluate the feasibility, safety and cost of implementation of large-scale circumcision programs. Limitations of circumcision have also been explored.

Summary

Male circumcision will likely play an important role in HIV/STI prevention programs in Africa; the inclusion of circumcision in the health policy of developed countries will require further investigation.