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False alarm for women

Posted by plosmedicine on 30 Mar 2009 at 23:49 GMT

Author: Jake Waskett
Position: Independent researcher
Institution: n/a
Submitted Date: December 19, 2005
Published Date: January 5, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.


Sykes suggests that male circumcision results in increased risk for females,[1] basing this assertion on a 1994 observational study.[2] Other observational studies have in fact shown a decreased risk of HIV among women with circumcised partners.[3-5]

Unlike Auvert's impressive RCT,[6] such studies are susceptible to confounding and must be treated with some caution. Where they are to be considered at all, it is important to examine all the evidence.

Jake H Waskett

1. Sykes J. Male circumcision increases risk for females. PLoS Med eLetter, 24 Nov 2005

2. Chao A, et al. Risk factors associated with prevalent HIV-1 infection among pregnant women in Rwanda. Int J Epidemiol 1994; 23(2):371-80

3. Fonck K, et al. Pattern of sexually transmitted diseases and risk factors among women attending an STD referral clinic in Nairobi, Kenya. Sex Transm Dis. 2000 Aug;27(7):417-23

4. Hunter DJ, et al. Sexual behavior, sexually transmitted diseases, male circumcision and risk of HIV infection among women in Nairobi, Kenya. AIDS. 1994 Jan;8(1):93-9

5. Kapiga SH, et al. The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania. AIDS. 1998 Jan 1;12(1):75-84

6. Auvert B, et al. Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLoS Med 2005; 2(11): e298.

Competing interests declared: I declare that I have no competing interests.