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Male Circumcision and HIV in Africa

We wish to congratulate Auvert et al. [1] on their work and wish them more success in their endeavors. Quite a number of studies have shown that circumcised males in heterosexual unions do have lower HIV rates [2–4]. It would be good to know to what extent circumcision affects the HIV rates in sub-Saharan African countries presently bearing the brunt of the disease.

Though ecological studies should be interpreted with caution, it would also be interesting to find out how this information helps us to better understand why some African countries with similar behavior have a much lower HIV rate than others [4–6]. West African countries, for example, have significantly higher circumcision rates than countries in the eastern and southern parts of Africa. HIV rates also appear to be generally lower in West Africa [7].

Also it would be interesting to find out if more African males who are not circumcised are ready to have this procedure done as a form of added protection, as there seem to be pockets of resistance to the procedure [8, 9].


  1. 1. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, et al. (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med 2: e298.
  2. 2. Agot KE, Ndinya-Achola JO, Kreiss JK, Weiss NS (2004) Risk of HIV-1 in rural Kenya: A comparison of circumcised men. Epidemiology 15: 157–163.
  3. 3. Siegfried N, Muller M, Deeks J, Volmink J, Egger M, et al. (2005) HIV and male circumcision—A systematic review with assessment of the quality of studies. Lancet Infect Dis 5: 167–173.
  4. 4. Kehinde AO, Lawoyin TO, Bakare RA (2004) Risk factors for HIV infection among special treatment clinic attendees in Ibadan Nigeria. Afr J Med Sci 33: 229–234.
  5. 5. Elharti E, Alami M, Khattabi H, Bennani A, Zidouh A, et al. (2002) Some characteristics of HIV epidemics in Morocco. East Mediterr Health J 8: 819–825.
  6. 6. Mattson CL, Bailey RC, Muga R, Poulussen R, Onyango T (2005) Acceptability of male circumcision and predictors of circumcision preference among men and women in Nyanza province Kenya. AIDS Care 17: 182–194.
  7. 7. Joint United Nations Programme on HIV/AIDS (2004) 2004 report on the global AIDS epidemic. Geneva: Joint United Nations Programme on HIV/AIDS. Available: Accessed 13 December 2005. .
  8. 8. [Anonymous] (2005) Male circumcision as a preventive method? Study was controversial from day one. AIDS Alert 20: 101–102.
  9. 9. Alanis MC, Lucidi RS (2004) Neonatal circumcision: A review of the world's oldest and most controversial operation. Obstet Gynecol Surv 59: 379–395.