Panel A shows the percentage of survey respondents who were sexually active in the previous year. Panel B shows the percentage of survey respondents who were in a spousal or other intimate relationship. Panel C shows the percentage of respondents who were sexually active in the previous year among those with a spousal or other intimate relationship. Blue symbols denote men, red symbols women, plus signs respondents who reported being in excellent or very good health, triangles respondents who reported being in good health, and circles respondents who reported being in fair or poor health.
In April 2009 a Cochrane review was published assessing theeffectiveness of male circumcision in preventing acquisition of HIV. Itconcluded that there was strong evidence that male circumcision,performed in a medical setting, reduces the acquisition of HIV by menengaging in heterosexual sex. Yet, importantly, the review noted thatfurther research was required to assess the feasibility, desirabilityand cost-effectiveness of implementation within local contexts. Thispaper endorses the need for such research and suggests that, in itsabsence, it is premature to promote circumcision as a reliable strategyfor combating HIV. Since articles in leading medical journals as wellas the popular press continue to do so, scientific researchers shouldthink carefully about how their conclusions may be translated both topolicy makers and to a more general audience. The importance ofaddressing ethico-legal concerns that such trials may raise ishighlighted. The understandable haste to find a solution to the HIVpandemic means that the promise offered by preliminary and specificresearch studies may be overstated. This may mean that ethical concernsare marginalised. Such haste may also obscure the need to be attentiveto local cultural sensitivities, which vary from one African region toanother, in formulating policy concerning circumcision.
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CIRCUMCISION offers the same level of protectionagainstHIVinfection in heterosexual men as a highly effective vaccine, accordingto a landmark study. In the first randomised controlled trial of itskind, researchers found circumcision provided protection against the virus, confirming the results of a large body ofobservational studies.
These concerns are not unfounded
The study objective was to describe malecircumcision trendsamong men attending the San Francisco municipal STD clinic, and tocorrelate the findings with HIV, syphilis and sexual orientation.
Methods and Findings. A cross sectionalstudy was performed by reviewing all electronicrecords of males attending the San Francisco municipal STD clinicbetween 1996 and 2005. The prevalence of circumcision overtime and by subpopulation such as race/ethnicity and sexual orientationwere measured. The findings were further correlatedwith the presence of syphilis and HIV infection. Circumcision statuswas determined by physical examination and diseasestatus by clinical evaluation with laboratory confirmation.
The overall aim of the Australian Longitudinal Study of Health and ..
For several years, researchers have been debatingtherelationshipbetween male circumcision and HIV. Several studies have indicatedthat circumcised men are less likely to become infected with HIV thanuncircumcised men. However, because circumcision is usually linked toculture or religion, it has been argued that the apparent protectiveeffect of the procedure is likely to be related not to removal of theforeskin but to the behaviours prevalent in the ethnic or religiousgroups in which male circumcision is practised. In addition, someresearchers have assumed that any association between circumcisionand HIV must be complicated by the presence of other sexuallytransmitted infections, which have been found to be more common amonguncircumcised men.
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DESIGN/METHODS:: Data collected as part of aprospectivestudy among African HIV-1-serodiscordant couples were analyzed for therelationship between circumcision status of HIV-1-seropositive men andrisk of HIV-1 acquisition among their female partners. Circumcisionstatuswas determined by physical examination. Cox proportional hazardsanalysiswas used.