The impact of male circumcision on HIV transmission.

PURPOSE: Adult male circumcision is currently being implemented as an HIV prevention strategy worldwide. We reviewed the literature on adult male circumcision in the prevention of HIV.

MATERIALS AND METHODS: A MEDLINE search was used to identify current literature addressing HIV and male circumcision. The data from that literature were reviewed and summarized.

RESULTS: Three randomized, controlled trials demonstrate that circumcising adult males reduces the incidence of HIV by 50% to 60%. Adult male circumcision does not seem to have an adverse impact on sexual function. Epidemiological and economic modeling suggests that adult male circumcision can potentially be a highly cost-effective strategy for HIV prevention.

CONCLUSIONS: Safe, high quality, low cost adult male circumcision services should be made available to regions with a high HIV incidence as part of a comprehensive HIV prevention package.