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Study Shows Male Circumcision in Sub-Saharan Africa May Help Prevent Spread of HIV

According to an analysis published on July 10, 2006 in the Public Library of Science Medicine Journal , routine male circumcisions across sub-Saharan Africa could prevent two million new HIV infections and 300,000 AIDS-related deaths in the next ten years. An additional 3.7 million new HIV infections and 2.7 million deaths could be avoided in the next 20 years.1

The study took place in the South African province of Gauteng , which is home to about nine million people. More than 3,000 uncircumcised, HIV-negative males between the ages of 18-24 were randomly chosen to participate in the clinically controlled experiment. Half the men were randomly assigned to the group of men to be circumcised, while the other half were assigned to the control group and were not circumcised. The study found that, for every ten uncircumcised men who contracted HIV, only three circumcised men contracted the virus. This means that there was about a 60% reduction in the contraction of HIV in men who were circumcised as part of the study.2

The results were considered to be so substantial that the researchers decided that proceeding with the study would be unethical if they did not offer the control group a chance to be circumcised as well.

As a result of the study, researchers believe that the reason for the decreased transmission rate of HIV in circumcised men may have to do with the fact that the cells of the foreskin of the penis are easily infected with HIV. In addition, the virus may survive better in a warm, wet environment, such as under the foreskin. Researchers also noted that the effects of fewer men being infected with HIV would, in turn, reduce the number of women infected with the virus as well.3 In the report, the researchers cautioned that, “male circumcision alone cannot bring the HIV/AIDS epidemic in Africa under control. Even circumcised men can become infected, though their risk of doing so is much lower.”4

Follow-up studies are being conducted in Kenya and Uganda . If the results are as promising as those in the South African study, advocates may call for an immediate change in HIV-prevention strategies.5

The study's success raises the issue of how to actually implement widespread male circumcision. In one survey, Dr. Robert Bailey of the University of Chicago interviewed adult Luo men and women from non-urban areas of the Nyanza province of Kenya concerning the acceptability of male circumcision. This is an area where the vast majority of men are uncircumcised. Given a choice, 60% of men said they would prefer to be circumcised, and 74% of men and 88% of women say they would have their son circumcised. While these results are encouraging, interviews with clinical practitioners in the area revealed that there was little to no knowledge on how to perform a circumcision or the benefits and risks involved in such a procedure. There was also little or no knowledge about the principle of informed consent which involves making sure that the patients understand the risks and benefits involved in such a procedure.6 These issues raise obvious concerns about how to implement mass circumcisions safely and effectively.

Opponents of circumcision, calling it genital mutilation, say that safe implementation is only one concern and that the practice inherently violates human rights, especially when practiced on infants. According to the National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM), an anti-circumcision group, “ genital cutting of healthy unconsenting individuals fundamentally violates individual autonomy.” They believe this to be the case because, “ circumcision is surgery, which results in the permanent loss of a healthy, functional body part and has long-term physical, sexual and psychological consequences that have yet to be studied.”7


  1. Brian Williams et. al, “The Potential Impact of Male Circumcision on HIV in Sub-Saharan Africa,” Public Library of Science Medicine Journal, 11 July 2006, accessed 25 July 2006, <
  2. Ibid.
  3. Maggie Fox, “Circumcisions May Stop Millions of HIV Deaths-Study,” Reuters , 11 July 2006, accessed 12 July 2006, <
  4. Ibid.
  5. Brian Williams et. al.
  6. “Male Circumcision: Cutting the Risk?” (New York : AmfAR, August 2000), accessed 17 July 2006, <>.
  7. “Frequently Asked Questions about NOHARMM and Circumcision,” National Organization to Halt the Abuse and Routine Mutilation of Males, 6 September 2005, accessed 17 July 2006, <>.

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