September 5, 2013
A French research team reported that follow-up studies conducted in South Africa, Kenya, and Uganda have confirmed the effectiveness of male circumcision in preventing HIV transmission. In 2006, French researcher Bertran Auvert first published research indicating that foreskin removal could reduce HIV risk among men by approximately 50 percent. A subsequent male circumcision campaign ensued in sub-Saharan Africa, where 69 percent of the world's HIV infections have occurred, according to UNAIDS.
Auvert's team returned to South Africa's Orange Farm township, site of the original research, to conduct a follow-up study of more than 3,300 male volunteers. The study collected information about sexual behavior and asked the study participants to take an HIV test. Data collected for the study indicated that multiple partners and condom use were similar among men who were circumcised and those who were not, but circumcised men were 57-61 percent less likely to have HIV. The study estimated that without male circumcision, HIV prevalence would have been 19 percent higher in the community.
Experts theorized that HIV more easily penetrated the inner foreskin of uncircumcised men because it was rich in Langerhans cells, which the virus readily entered. Auvert's research did not address whether women would benefit indirectly from lower HIV incidence among men.
UNAIDS, the World Health Organization, the Gates Foundation, and other donors have endorsed the expansion of adult male circumcision programs, which could reduce HIV transmission in areas like sub-Saharan Africa where most men were not circumcised.
The full report, "Association of the ANRS-12126 Male Circumcision Project with HIV Levels Among Men in a South African Township: Evaluation of Effectiveness Using Cross-sectional Surveys," was published online in the journal PLoS Medicine (2013; doi:10.1371/journal.pmed.1001509).