Male Circumcision for HIV Prevention

Welcome to the Clearinghouse page on Male Circumcision for HIV Prevention, a comprehensive information source on male circumcision as an HIV prevention tool

Male circumcision is one of the most common surgical procedures in the world, with 20-25% of men worldwide undergoing circumcision either in infancy or adulthood. Reasons for male circumcision include both hygienic concerns as well as religious indications, and male circumcision ’s prevalence is geographically dependent on the cultural practices of local populations.

In the last decade, male circumcision has moved to the forefront of international HIV discussions and prevention research. As early as the late 1980s, observational and ecologic studies in the developing world suggested that higher rates of male circumcision were associated with lower rates of HIV transmission. Based on this observational data, investigators began to design experimental trials with the goal of establishing a causal link between these phenomena.

Several large-scale prospective trials have now been implemented to explore the question of whether male circumcision truly offers some level of protection against HIV infection.  With the HIV pandemic now affecting 40 million people worldwide, and condom use still limited in many areas of the globe, male circumcision has become an important area for prevention research.

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The male circumcision for HIV prevention page features current information including updates on the scientific findings, advocacy documents, and meeting reports.

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AVAC Resources
Check out AVAC's publications and advocacy efforts around male circumcision for HIV prevention

What's New

Check out the latest updates on male circumcision research

Basics
Get basic information on male circumcision as an HIV prevention tool

Trials Activity
Here you'll find a table of all ongoing trials of male circumcision and a history of male circumcision trials to date

Advocacy & Policy
Read letters, sign-on-statements, editorials, reports from consultations on male circumcision in response to community concerns, and other information prepared by groups working on issues related to male circumcision as a method of HIV prevention

In-depth
View and download scientific papers, meeting reports and news coverage about male circumcision and related issues

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AVAC Resources

• "A New Way to Protect Against HIV? Understanding the Results of Male Circumcision Studies for HIV Prevention"
  ***September 2007 - Updated version***
  Part of AVAC's "Anticipating and Understanding Results" series
• AVAC Calls for Strategic Leadership and Urgency in the
  Implementation of Male Circumcision for HIV Prevention - March 28, 2007
• AVAC Position on Research Priorities for Male Circumcision - March 28, 2007
• Civil Society Advocacy for Male Circumcision Rollout in Sub-Saharan Africa: Five Ways to Get Involved (March 2007)
• Making Sense of Male Circumcision for HIV Prevention: Q's, A's and Advocacy Points for US Civil Society (March 2007)

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What's New

• Israeli Surgeons Helping Swaziland in Drive to Curb HIV - Washington Post, October 21, 2007

• Rwanda To Launch Mass Male Circumcision Program To Reduce Spread of HIV/AIDS - Kaiser Daily HIV/AIDS Report, September 20, 2007

• Challenge for AIDS Fighters: Circumcising Africans Safely - Wall Street Journal, September 7, 2007

• HIV Loosens Tribe's Resistance to Circumcision; Many Kenyans See Survival at Stake - Washington Post, September 7, 2007

• Traditional circumcision shows protective effect against HIV in rural Kenyan men - aidsmap news, July 31, 2007

• IAS: Models predict costs and benefits of circumcision programmes - aidsmap news, July 25, 2007
• IAS: Lack of data on men with weak immune systems weakens study comparing safety of circumcision in HIV-positive and HIV-negative men - aidsmap news, July 25, 2007
• IAS: Circumcision may be acceptable to some gay men, but study says no value for HIV prevention, aidsmap news, July 25, 2007

• Male Circumcision for Prevention of HIV Transmission: What the New Data Mean for HIV Prevention in the United States - PLoS Medicine, July 24, 2007

• "Circumcision: a woman's view" - Mail & Guardian (SA), June 20, 2007
• "American Academy of Pediatrics reconsiders policy on circumcision" - Fresno Bee, June 18, 2007
• Is Male Circumcision the Key to Stopping the AIDS Epidemic?
  Read more on the Council on Foreign Relations roundtable discussion with Mark Dybul, U.S. Global AIDS Coordinator, Thomas Frieden, Commissioner, NYC Dept. of Health and Laurie Garrett Senior Fellow for Global Health, Council on Foreign Relations
• Lancet Publishes Opinion Pieces Responding to Studies Finding That Male Circumcision Reduces Men's HIV Infection Risk - May 14, 2007

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Basics

• Male Circumcision and Risk for HIV Transmission: Implications for the United States, from the US CDC - March 2007
• Male Circumcision and HIV/AIDS: Opportunities and Challenges, Sawires, Dworkin, Coates - December 2006
• Male circumcision - Technical Policies of the UNAIDS Programme
• "A New Way to Protect Against HIV? Understanding the Results of Male Circumcision Studies for HIV Prevention"
  ***September 2007 - Updated version***
• Does Male Circumcision Prevent HIV Infection?, Nandi Siegfried, PLoS - November 2005

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Trials Activity

• Male circumcision trial in Uganda Stopped Enrolling New Participants - Rakai Health Sciences, March 6, 2007
• Male circumcision trials table - March 2007
• AVAC's statement on the trial findings - December 13, 2006
• National Institute of Allergy and Infectious Diseases (NIAID) press release
• Q&A: NIAID-Sponsored Adult Male Circumcision Trials in Kenya and Uganda - December 13, 2006
• WHO/UNAIDS statement on trial findings - December 13, 2006

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Advocacy & Policy

• The New Evidence on Male Circumcision: An Indian Perspective, Nomita Chandhiok, RR Gangakhedkar - 2007
• Delivery of Male Circumcision Services: ‘‘Festina lente’’, Anne Buve, Therese Delvaux, Bart Criel - 2007
• Male Circumcision and HIV Prevention: Is There Really Enough of the Right Kind of Evidence?, Gary Dowsett and Murray Couch - 2007
• ‘‘Just a Snip’’?: A Social History of Male Circumcision, Peter Aggleton - 2007
• How did circumcision prevent HIV in clinical trials in Africa… and what does it mean for the United States? An educational briefing paper for US AIDS communities by the Community HIV/AIDS Mobilization Project (CHAMP) - March 2007
• WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention - March 28, 2007
• Civil Society Advocacy for Male Circumcision Rollout in Sub-Saharan Africa: Five Ways to Get Involved (March 2007)
• Making Sense of Male Circumcision for HIV Prevention: Q's, A's and Advocacy Points for US Civil Society (March 2007)
• Click here to download notes (draft) from civil society call on male circumcision held December 14, 2006
• The First Randomized Trial of Male Circumcision for Preventing HIV: What Were the Ethical Issues?, Peter Cleaton-Jones - PLoS Medicine November 2005

- Editorials

• "Beyond ABC in AIDS" - Boston Globe editorial - August 22, 2006
• "Male Circumcision Programs Should Receive PEPFAR, G8 Funding To Reduce Spread of HIV/AIDS" - Los Angeles Times editorial - February 10, 2006
• A Landmark Paper in HIV Research? PLoS Medicine Editors' letter - November 2005

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In-depth

- Journal articles

• Cost-Effectiveness of Male Circumcision for HIV Prevention in a South African Setting, Kahn et. al. - December 2006
• Male Circumcision in Siaya and Bondo Districts, Kenya: Prospective Cohort Study to Assess Behavioral Disinhibition Following Circumcision, Agot et. al. in JAIDS, January 1, 2007
  - aidsmap review of findings
• Male circumcision reduces the risk of HIV infection - the Lancet, February 24, 2007
• Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial, Auvert et. al. in PLoS Medicine - November 2005
• The Potential Impact of Male Circumcision on HIV in Sub-Saharan Africa, Williams et. al. in PLoS Medicine - July 2006

- Meeting reports and presentations

• IAS Conference on HIV Pathogenesis, Treatment and Prevention - Sydney, July 22-25, 2007
  - Male Circumcision: The Cutting Edge of HIV Prevention - click for more information and video and podcast of the session
  - Scaling up circumcision Programmes: The Road from Evidence to Practice (plenary presentation) - click for video and slides from the presentation

• The Perinatal HIV Research Unit held a colloquium on circumcision in South Africa on June 6, 2006
  Download Guy de Bruyn's presentation,
  "Male circumcision for HIV prevention: overview and status leading up to RCT evidence"
  Click here for more information from the colloquium

• Download Bertran Auvert's presentation on male circumcision from the 2005 IAS Conference on HIV Pathogenesis and Treatment -
  "The impact of male circumcision on the female-to-male transmission of HIV : Results of the intervention trial : ANRS 1265"

- In the News

• "Circumcision’s Anti-AIDS Effect Found Greater Than First Thought" - New York Times, February 23, 2007

• "Healing: A Caveat on Circumcision as AIDS Prevention" - New York Times, March 13, 2007
• "In Africa, a problem with circumcision and AIDS" - International Herald Tribune, February 27, 2007
• "Circumcision’s Anti-AIDS Effect Found Greater Than First Thought" - New York Times, February 23, 2007
• "Circumcision fever begins to sweep Swaziland" - Mail and Guardian (SA) - February 2, 2007
• "Male circumcision, HIV prevention, and communication challenges" - International HIV/AIDS Alliance News
• INTERVIEW - "Circumcision not yet right for China AIDS fight" - Reuters UK - January 19, 2007
• "Circumcisions not leading to increase in risky sex in Kenya" - aidsmap news - January 15, 2007
• "Africa: Male Circumcision Should Never Pre-Empt Other HIV Prevention Measures, UN Warns" - UN News Service - December 14, 2006
• "Circumcision Halves H.I.V. Risk, U.S. Agency Finds" - New York Times - December 14, 2006
• "Circumcision Shown to Slow Spread of HIV in Africa" - Washington Post - December 14, 2006
• "Circumcision cuts risk of HIV by half, studies find in Kenya and Uganda" - San Francisco Chronicle - December 14, 2006
• "Update on HIV Prevention: The Role of Male Circumcision" - American College of Preventive Medicine - November 15, 2006
• "Swaziland to endorse male circumcision" - The Star (SA) - November 14, 2006
• "Routine circumcision could reduce STD rate" - USA Today - November 6, 2006
• "SADC moots massive male circumcision drive" - Xinhua News - October 29, 2006
• "U.S. to End Funding of Anti-AIDS Program in Swaziland" - Washington Post - October 13, 2006
• "What if circumcision saves lives?" - Business Day (SA) - August 3, 2006
• "South Africa Slow to Encourage Circumcision to Curb HIV" - Washington Post - July 16, 2006
• "Circumcision may slow African AIDS, trials hint" - The Globe and Mail - July 11, 2006
• "Circumcision 'could cut HIV risk'" - BBC News - July 10, 2006
• "Africa to incorporate male circumcision in HIV/Aids" - The Guardian - June 15, 2006
• "Five African Countries Look at Male Circumcision to Curb AIDS" - Agence France Presse - June 2, 2006
• "Male circumcision protects women from AIDS: study" - Reuters - February 8, 2006
• "No longer routine - Circumcision rates decline nationally, albeit more slowly in Midwest" - the Columbus Dispatch - January 15, 2006
• "In Swaziland, Science Revives an Old Rite" - Washington Post - December 26, 2005

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