Male Circumcision and HIV Transmission Rates protects Men, not Women

The Bill and Melinda Gates foundation just recently allocated 50 million to male circumcision programs in Africa based on studies that showed it reduced the HIV AIDS transmission rates. This new information calls male circumcision partially into question.


Dr. Maria Wawer of Johns Hopkins and her Uganda colleagues stopped their most recent male circumcision trial because it proved ineffective at preventing the spread of HIV from men to their female partners.

Wawer's earlier studies of male circumcision in Uganda — like other studies in Kenya — showed unequivocally that male circumcision could reduce female-to-male transmission rates. As nearly 3 decades of dealing with HIV-AIDS as an international public health crisis has shown, simply educating people about barrier contraception and making contraception more readily and inexpensively available — both difficult endeavors in developing countries, for a variety of reasons — are simply not having the same effect in some countries on reducing HIV transmission rates that developed countries like the U.S. experienced (let alone that such efforts seem to plateau when the perception of immediate danger declines and rates go up again). It's entirely possible (and somewhat unsurprising) that education and contraception access simply don't trump human sexual urges, culture and tradition, which is why scientists think adult male circumcision programs could provide a necessary addition to the HIV-AIDS reduction arsenal.

Wawer and her team were hopeful that male circumcision could reduce male-to-female transmission rates as well, given that in many places, women don't have access to barrier contraception or the power in sexual relationships to demand its use even if their partner's HIV status is known. Unfortunately, their hypothesis was incorrect.

"However, the efficacy of male circumcision for prevention of HIV in uninfected men is clear, and reductions in male acquisition of HIV attributable to circumcision are likely to reduce women's exposure to HIV-infected men. Male circumcision programs are thus likely to confer an overall benefit to women," the researchers concluded.