Male circumcision and HIV/AIDS: challenges and opportunities

The Kenya and Uganda trials replicated the landmark findings of the South African Orange Farm study, the first randomised controlled trial to report a greater than 50% protective benefit of male circumcision.3 Before the availability of data from these three African randomised controlled trials, multiple observational studies correlated male circumcision with reduced risk of HIV infection.4-9 Systematic reviews and meta-analysis of observational studies provide further evidence of the association of male circumcision with reduced risk of HIV infection10-12 and a plausible explanation for the biological mechanism for reduced risk of infection has been suggested.13 Recently released longitudinal evidence of the range of health benefits that male circumcision provides,14 modelling based on the South African trials,15 and cost-effectiveness data in both North America16 and Africa17 provide further evidence to support the health benefits of male circumcision.