Male circumcision as a public health measure for the prevention of HIV transmission

Abstract

Although male circumcision is regarded as an efficacious and cost-effective public health strategy for combating human immunodificiency virus (HIV) in heterosexual men in high-prevalence areas, some experts suggest a more cautious approach to the implementation of circumcision for HIV prevention because of practical difficulties. This review addresses the practicality and ethics of implementing circumcision as a preventative strategy in under-resourced settings. A literature survey was carried out using the key terms "male circumcision" and "HIV prevention" in a number of databases. There is generally high acceptability of circumcision as a preventative strategy for HIV. Some experts, albeit a minority, raise questions regarding costs, timing, and integration of religious and cultural forms of circumcision in the fight against the spread of HIV. Geographical, cultural, religious and socio-economic factors should be considered prior to instituting circumcision as public health measure for the prevention of female-to-male HIV transmission.