Review Article

How the circumcision solution in Africa will increase HIV infections

Robert S. van Howe, Michelle R. Storms
Journal of Public Health in Africa | Vol 2, No 1 | a1103 | DOI: https://doi.org/10.4081/jphia.2011.e4 | © 2024 Robert S. van Howe, Michelle R. Storms | This work is licensed under CC Attribution 4.0
Submitted: 28 November 2024 | Published: 01 March 2011

About the author(s)

Robert S. van Howe, Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Marquette, United States
Michelle R. Storms, Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Marquette, United States

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Abstract

The World Health Organization and UNAIDS have supported circumcision as a preventive for HIV infections in regions with high rates of heterosexually transmitted HIV; however, the circumcision solution has several fundamental flaws that undermine its potential for success. This article explores, in detail, the data on which this recommendation is based, the difficulty in translating results from high risk adults in a research setting to the general public, the impact of risk compensation, and how circumcision compares to existing alternatives. Based on our analysis it is concluded that the circumcision solution is a wasteful distraction that takes resources away from more effective, less expensive, less invasive alternatives. By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections.

Keywords

circumcision; HIV infection; risk compensation

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