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Circumcision and HIV: Difference between revisions

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Insert new South Africa sub-section; Wikify Langerhans cells.
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  | publisher=
  | publisher=
  | work=
  | work=
  | date=February 2008
  | date=2008-02
  | accessdate=2011-06-01
  | accessdate=2011-06-01
}}</ref><ref>{{REFweb
}}</ref><ref>{{REFweb
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  | publisher=
  | work=
  | work=
  | date=March 2007
  | date=2007-03
  | accessdate=2011-06-01
  | accessdate=2011-06-01
}}</ref><ref>{{REFweb
}}</ref><ref>{{REFweb
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  | publisher=
  | publisher=
  | work=
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  | date=9/1/2011
  | date=2011-01-09
  | accessdate=2011-06-01
  | accessdate=2011-06-01
}}</ref>
}}</ref>
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  |pubmedCID=
  |pubmedCID=
  |DOI=10.1371/journal.pmed.0020298#r1326
  |DOI=10.1371/journal.pmed.0020298#r1326
  |date=October 2006
  |date=2006-10
  |accessdate=
  |accessdate=
}}</ref> In 1986, California urologist [[Aaron J. Fink| Aaron J. Fink]], (1926-1994) adopted this idea,<ref>{{REFbook
}}</ref> In 1986, California urologist [[Aaron J. Fink| Aaron J. Fink]], (1926-1994) adopted this idea,<ref>{{REFbook
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  |pubmedCID=
  |pubmedCID=
  |DOI=10.1097/00002030-200010200-00018
  |DOI=10.1097/00002030-200010200-00018
  |date=October 2000
  |date=2000-10
  |accessdate=
  |accessdate=
}}</ref> without any kind of proof whatsoever.
}}</ref> without any kind of proof whatsoever.
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  |publisher=USAID
  |publisher=USAID
  |format=PDF
  |format=PDF
  |date=January 2002
  |date=2002-01
  |accessdate=2019-09-29
  |accessdate=2019-09-29
}}</ref> By designing a trial to "detect" a minimum 50 percent reduction risk in HIV, these researchers might have artificially created the clinical setting to observe the effect they were looking to discover.
}}</ref> By designing a trial to "detect" a minimum 50 percent reduction risk in HIV, these researchers might have artificially created the clinical setting to observe the effect they were looking to discover.
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  |title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns
  |title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns
  |journal=J Law Med
  |journal=J Law Med
  |date=December 2011
  |date=2011-12
  |volume=19
  |volume=19
  |issue=2
  |issue=2
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== Real-world ==
== Real-world ==


An analysis of HIV prevalence compared to circumcision status in sub-Saharan Africa concluded that male circumcision is not associated with reduced HIV prevalence.<ref>Garenne M. Long-term population effects of male circumcision in generalized HIV epidemics in sub-Saharan Africa. Afr J AIDS Res 2008;7(1):1– 8.</ref> Another study on circumcision prevalence compared to HIV in the general South African population concluded: “Circumcision had no protective effect on HIV transmission.”<ref>Connolly C, Simbayi LC, Shanmugam R, Nqeketo A. Male circumcision and its relationship to HIV infection in South Africa: results of a national survey in 2002. S Afr Med J 2008;98:789 –94.</ref> When commercial sex worker patterns are controlled, male circumcision is not signifıcantly associated with lower HIV prevalence.<ref>Talbott JR. Size matters: the number of prostitutes and the global HIV/AIDS pandemic. PloS One 2007;2(6):e543. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0000543</ref> Mathematical impact modeling of circumcision, antiretroviral therapy (ART), and condom use for South Africa concluded: “Male circumcision was found to have considerably lower impact than condom use or anti-retroviral therapy on HIV infection rates and death rates.”<ref>Lima V, Anema A, Wood R, et al. The combined impact of male circumcision, condom use and HAART coverage on the HIV-1 epidemic in South Africa: a mathematical model. 5th IAS Conference on HIV Treatment, Pathogenesis and Prevention, Cape Town, abstract WECA105, 2009.</ref> Both the U.S. and sub-Saharan Africa have relatively high incidence rates of HIV infection, considering that about 75% of U.S. men and about 70% of sub-Saharan African men are circumcised—higher percentages than in most other regions or countries with lower prevalence of HIV.<ref>Green LW, Travis JW, McAllister RG, Peterson KW, Vardanyan AN, Craig A. Male circumcision and HIV prevention insufficient evidence and neglected external validity. Am J Prev Med. 2010 Nov;39(5):479-82. Department of Epidemiology and Biostatistics, University of California at San Francisco, USA. PMID: 20965388 </ref>
An analysis of HIV prevalence compared to circumcision status in sub-Saharan Africa concluded that male circumcision is not associated with reduced HIV prevalence.<ref>Garenne M. Long-term population effects of male circumcision in generalized HIV epidemics in sub-Saharan Africa. Afr J AIDS Res 2008;7(1):1– 8.</ref> Another study on circumcision prevalence compared to HIV in the general South African population concluded: “Circumcision had no protective effect on HIV transmission.”<ref>Connolly C, Simbayi LC, Shanmugam R, Nqeketo A. Male circumcision and its relationship to HIV infection in South Africa: results of a national survey in 2002. S Afr Med J 2008;98:789 –94.</ref> When commercial sex worker patterns are controlled, male circumcision is not signifıcantly associated with lower HIV prevalence.<ref>Talbott JR. Size matters: the number of prostitutes and the global HIV/AIDS pandemic. PloS One 2007;2(6):e543. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0000543</ref> Mathematical impact modeling of circumcision, antiretroviral therapy (ART), and condom use for South Africa concluded: “Male circumcision was found to have considerably lower impact than condom use or anti-retroviral therapy on HIV infection rates and death rates.”<ref>Lima V, Anema A, Wood R, et al. The combined impact of male circumcision, condom use and HAART coverage on the HIV-1 epidemic in South Africa: a mathematical model. 5th IAS Conference on HIV Treatment, Pathogenesis and Prevention, Cape Town, abstract WECA105, 2009.</ref> Both the U.S. and sub-Saharan Africa have relatively high incidence rates of HIV infection, considering that about 75% of U.S. men and about 70% of sub-Saharan African men are circumcised—higher percentages than in most other regions or countries with lower prevalence of HIV.<ref>{{REFjournal
|last=Green
|first=L.W.
|last2=Travis
|first2=J.W.
|last3=McAllister
|first3=R.G.
|author3-link=Ryan McAllister
|last4=Peterson
|first4=K.W.
|last5=Vardanyan
|first5=A.N.
|last6=Craig
|first6=A.
|title=Male circumcision and HIV prevention insufficient evidence and neglected external validity
|journal=Am J Prev Med
|date=2010-11
|volume=39
|issue=5
|pages=479-482
|location=Department of Epidemiology and Biostatistics, University of California at San Francisco, USA
|pubmedID=20965388
}}</ref>


There is no clear pattern of association between male circumcision and HIV prevalence. In 10 out of 18 countries, HIV prevalence is higher amongst circumcised men.<ref>{{REFdocument
There is no clear pattern of association between male circumcision and HIV prevalence. In 10 out of 18 countries, HIV prevalence is higher amongst circumcised men.<ref>{{REFdocument
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  |pubmedCID=
  |pubmedCID=
  |DOI=
  |DOI=
  |date=Annals of Epidemiology
  |note=Annals of Epidemiology
  |accessdate=2011-06-02
  |accessdate=2011-06-02
}}</ref>
}}</ref>
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