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Circumcision decreased HIV incidence in Africa

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The introduction of medical male circumcision significantly reduced HIV prevalence in South Africa, according to Bertran Auvert, MD, PhD, and colleagues, who suggest that the procedure may have the potential to decrease the spread of HIV in endemic communities — if successfully promoted.

The researchers conducted a cross-sectional survey in 2007 — before the Orange Farm project — and another in 2010, after the project was implemented. They assessed the effect the program had on the spread of HIV for 3 years among participants aged 15 to 49 years. HIV prevalence and incidence was compared among circumcised and uncircumcised men from the 2010 survey.

Compared with the baseline prevalence of medical male circumcision (15.6%), circumcision increased to 49.4% during the study period. Uncircumcised men had an HIV prevalence of 20% vs. 6.2% among circumcised men (P<.001).

The researchers hypothesized that HIV prevalence among men aged 15 to 49 years would have been 25.1% higher (95% CI, 13.1-39.1) and 61% higher among men aged 15 to 34 years (95% CI, 23-152) without the circumcision program.

“This study demonstrates that adult male circumcision works to reduce the spread of HIV in an African community highly affected by the epidemic,” Auvert, of the University of Versailles in France, said in a press release. “Reducing the number of new infections with adult male circumcision will save lives and reduce the need for antiretroviral therapy.”

For more information:

• Auvert B. #WELBC02. Presented at: The 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention; July 17-20, 2011; Rome.

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