Original Research

Exposé of fallacious claims that male circumcision will increase HIV infections in Africa

Brian J. Morris, Jake H. Waskett, Ronald H. Gray, Daniel T. Halperin, Richard Wamai, Bertran Auvert, Jeffrey D. Klausner
Journal of Public Health in Africa | Vol 2, No 2 | a1127 | DOI: https://doi.org/10.4081/jphia.2011.e28 | © 2024 Brian J. Morris, Jake H. Waskett, Ronald H. Gray, Daniel T. Halperin, Richard Wamai, Bertran Auvert, Jeffrey D. Klausner | This work is licensed under CC Attribution 4.0
Submitted: 29 November 2024 | Published: 05 September 2011

About the author(s)

Brian J. Morris, School of Medical Sciences, University of Sydney, Sydney, Australia
Jake H. Waskett, Circumcision Independent Reference and Commentary Service, Radcliffe, Manchester, United Kingdom
Ronald H. Gray, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
Daniel T. Halperin, Department of Global Health and Population, Harvard School of Public Health, United States
Richard Wamai, Department of African-American Studies, Northeastern University, Boston, United States
Bertran Auvert, INSERM-UVSQ U1018, Villejuif, France
Jeffrey D. Klausner, Divisions of AIDS and Infectious Diseases, University of California, San Francisco, United States

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Abstract

Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We also evaluate the statistics used and show that when these data are properly analyzed the results lead to a contrary conclusion affirming the major role of male circumcision in protecting against HIV infection in Africa. Researchers, policy makers and the wider community should rely on balanced scholarship when assessing scientific evidence. We trust that our assessment may help refute the claims by Van Howe and Storms, and provide reassurance on the importance of circumcision for HIV prevention.

Keywords

circumcision; HIV; epidemiology; evidence-based medicine

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Crossref Citations

1. Male circumcision to prevent syphilis in 1855 and HIV in 1986 is supported by the accumulated scientific evidence to 2015: Response to Darby
Brian J. Morris, Richard G. Wamai, John N. Krieger, Joya Banerjee, Jeffrey D. Klausner
Global Public Health  vol: 12  issue: 10  first page: 1315  year: 2017  
doi: 10.1080/17441692.2015.1104371

2. Ethics of pursuing targets in public health: the case of voluntary medical male circumcision for HIV-prevention programs in Kenya
Stuart Rennie, Adam Gilbertson, Denise Hallfors, Winnie K Luseno
Journal of Medical Ethics  vol: 47  issue: 12  first page: e51  year: 2021  
doi: 10.1136/medethics-2020-106293

3. Expertise or ideology? A response to Morris et al. 2016, ‘Circumcision is a primary preventive against HIV infection: Critique of a contrary meta-regression analysis by Van Howe’
Robert S. Van Howe
Global Public Health  vol: 13  issue: 12  first page: 1900  year: 2018  
doi: 10.1080/17441692.2016.1272939

4. Circumcision is a primary preventive against HIV infection: Critique of a contrary meta-regression analysis by Van Howe
Brian J. Morris, Gia Barboza, Richard G. Wamai, John N. Krieger
Global Public Health  vol: 13  issue: 12  first page: 1889  year: 2018  
doi: 10.1080/17441692.2016.1164737

5. Critical evaluation of arguments opposing male circumcision: A systematic review
Brian J Morris, Stephen Moreton, John N Krieger
Journal of Evidence-Based Medicine  vol: 12  issue: 4  first page: 263  year: 2019  
doi: 10.1111/jebm.12361

6. Male circumcision for protection against HIV infection in sub-Saharan Africa: The evidence in favour justifies the implementation now in progress
Richard G. Wamai, Brian J. Morris, Robert C. Bailey, Jeffrey D. Klausner, Mackenzie N. Boedicker
Global Public Health  vol: 10  issue: 5-6  first page: 639  year: 2015  
doi: 10.1080/17441692.2014.989532

7. BOYLE AND HILL'S CIRCUMCISION ‘PHALLUSIES’
Brian J. Morris
BJU International  vol: 110  issue: 3  year: 2012  
doi: 10.1111/j.1464-410X.2012.10674_2.x

8. Expertise and Ideology in Statistical Evaluation of Circumcision for Protection against HIV Infection
Brian J. Morris, Gia Barboza, Richard G. Wamai, John N. Krieger
World Journal of AIDS  vol: 07  issue: 03  first page: 179  year: 2017  
doi: 10.4236/wja.2017.73015