Adult Male Circumcision Reduces HIV Acquisition Risk
Medical circumcision of adult men continues to reduce the risk of acquiring HIV through heterosexual intercourse for at least 3.5 years. This finding recently emerged from an analysis of long-term follow-up data on Kenyan men who have participated in a large clinical trial assessing the protective value of adult male circumcision against HIV infection.
Among the 2,784 Kenyan men who have participated in the study, some for as long as 3.5 years, 62, or 7.45 percent, have acquired HIV while uncircumcised and only 27, or 2.6 percent, have acquired HIV after circumcision. Nearly 1,830 of the study participants are now circumcised. It is estimated from the study data that circumcision reduces a man’s risk of acquiring HIV by 64 percent. The investigators will present these data on August 7 at the XVII International AIDS Conference in Mexico City.
The Kenyan study is a follow-up component of one of two clinical trials sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), that were stopped in December 2006—before their scheduled completion—because of the overwhelming evidence that medically supervised circumcision can reduce a man’s risk of acquiring HIV through heterosexual intercourse. The trial in Kisumu, Kenya, of 2,784 HIV-negative men showed a 53 percent reduction in HIV acquisition among circumcised men compared to uncircumcised men, while a study of 4,996 HIV-negative men in Rakai, Uganda, demonstrated a 48 percent reduction in HIV acquisition among circumcised men. NIAID is co-sponsoring the follow-up Kenyan study in connection with the Canadian Institutes of Health Research.
In response to the results of these studies and an earlier randomized trial conducted in Orange Farm, South Africa, the World Health Organization recommended in 2007 that male circumcision be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men.