Male circumcision and HIV prevention: Directions for future research

A growing body of scientific publications suggests that male circumcision is associated with reduced risk of HIV infection in sub-Saharan Africa. Thus, male circumcision is being considered as a potential intervention in the prevention of sexually transmitted HIV infection, even though this procedure has profound cultural implications and carries the risk of complications, and its benefits are realized only many years later. This report presents the findings of a meeting of international researchers, organized by the Horizons Project to explore the programmatic and research implications of the association between male circumcision and HIV prevention. Most studies on male circumcision and HIV infection have been done in Africa, and the discussion focuses largely on this continent. The conclusions and recommendations from the meeting, however, may be relevant for other parts of the world. Based on the discussion, participants determined that there is considerable evidence supporting a protective effect of male circumcision on HIV infection in men in sub-Saharan Africa. Participants also concluded that there are many unknowns.