Advertisement

Circumcision Denialism Unfounded and Unscientific

      Although three RCTs
      • Auvert B.
      • Taljaard D.
      • Lagarde E.
      • Sobngwi-Tambekou J.
      • Sitta R.
      • Puren A.
      Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.
      • Bailey R.C.
      • Moses S.
      • Parker C.B.
      • et al.
      Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial.
      • Gray R.H.
      • Kigozi G.
      • Serwadda D.
      • et al.
      Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial.
      and dozens of observational studies have confirmed that medical male circumcision reduces the risk of HIV acquisition in men by at least 60%,
      • Klausner J.D.
      • Wamai R.G.
      • Bowa K.
      • Agot K.
      • Kagimba J.
      • Halperin D.
      Is male circumcision as good as the vaccine we've been waiting for?.
      Green et al.
      • Green L.W.
      • Travis J.W.
      • McAllister R.G.
      • Peterson K.W.
      • Vardanyan A.N.
      • Craig A.
      Male circumcision and HIV prevention insufficient evidence and neglected external validity.
      continue to question its effectiveness and would deny millions of men—and their female partners—a proven, permanent, and inexpensive method to reduce their lifetime risk of HIV infection. Such denialism in the face of the ongoing pandemic are unethical and immoral.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Auvert B.
        • Taljaard D.
        • Lagarde E.
        • Sobngwi-Tambekou J.
        • Sitta R.
        • Puren A.
        Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.
        PLoS Med. 2008; 2: E298
        • Bailey R.C.
        • Moses S.
        • Parker C.B.
        • et al.
        Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial.
        Lancet. 2007; 369: 643-656
        • Gray R.H.
        • Kigozi G.
        • Serwadda D.
        • et al.
        Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial.
        Lancet. 2007; 369: 657-666
        • Klausner J.D.
        • Wamai R.G.
        • Bowa K.
        • Agot K.
        • Kagimba J.
        • Halperin D.
        Is male circumcision as good as the vaccine we've been waiting for?.
        Future HIV Ther. 2008; 2: 1-7
        • Green L.W.
        • Travis J.W.
        • McAllister R.G.
        • Peterson K.W.
        • Vardanyan A.N.
        • Craig A.
        Male circumcision and HIV prevention insufficient evidence and neglected external validity.
        Am J Prev Med. 2010; 39: 479-482
      1. Bailey RC, Moses S, Parker CB, et al. The protective effect of adult male circumcision against HIV acquisition is sustained for at least 54 months: results from the Kisumu, Kenya trial. Presented at the XVIII International AIDS Conference; 2010 July 23; Vienna, Austria; Abstract #FRLBC101.

      2. Hallett TB, Alsallaq RA, Baeten JM, et al. Will circumcision provide even more protection from HIV to women and men? New estimates of the population impact of circumcision interventions. Sex Transm Infect 2010. Advance online article.

        • Agot K.E.
        • Kiarie J.N.
        • Nguyen H.Q.
        • et al.
        Male circumcision in Siaya and Bondo districts, Kenya: prospective cohort study to assess behavioral disinhibition following circumcision.
        J Acquir Immune Defic Syndr. 2007; 44: 66-70
        • Mattson C.L.
        • Campbell R.T.
        • Bailey R.C.
        • et al.
        Risk compensation is not associated with male circumcision in Kisumu, Kenya: a multi-faceted assessment of men enrolled in a randomized controlled trial.
        PLoS One. 2008; 3: e2443
        • Wamai R.G.
        • Weiss H.A.
        • Hankins C.
        • et al.
        Male circumcision is an efficacious, lasting and cost-effective strategy for combating HIV in high-prevalence AIDS epidemics.
        Future HIV Ther. 2008; 2: 399-405
        • Williams B.G.
        • Lloyd-Smith J.O.
        • Gouws E.
        • et al.
        The potential impact of male circumcision on HIV in sub-Saharan Africa.
        PLoS Med. 2006; 3: E262

      Linked Article

      • Male Circumcision and HIV Prevention: Insufficient Evidence and Neglected External Validity
        American Journal of Preventive MedicineVol. 39Issue 5
        • Preview
          Recent editorials have asked the global health community to scale up male circumcision for HIV prevention in regions with HIV epidemics following the publication of three randomized controlled clinical trials (RCCTs) in Africa (in South Africa, Uganda, and Kenya).1–5 One editorial concluded: “The proven efficacy of MC [male circumcision] and its high cost-effectiveness in the face of a persistent heterosexual HIV epidemic argues overwhelmingly for its immediate and rapid adoption.”6 This “Current Issue” review questions not the internal validity of the studies, but their external validity, an issue that has been discussed more generally in two commentaries,7,8 an editorial,9 and a systematic review of research on prevention trials10 in this journal.
        • Full-Text
        • PDF
      • Author Response
        American Journal of Preventive MedicineVol. 40Issue 3
        • Preview
          The authors of the preceding letter assert that the scientific questioning of male circumcision as a public health measure is immoral and unethical. Such a position untenably ignores the public health community's responsibility to encourage open discussion of the ethics and efficacy, as well as a thorough cost–benefit analysis of any public health intervention, especially a surgical one.
        • Full-Text
        • PDF