Title |
Male circumcision for HIV prevention: current evidence and implementation in sub‐Saharan Africa
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Published in |
Journal of the International AIDS Society, October 2011
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DOI | 10.1186/1758-2652-14-49 |
Pubmed ID | |
Authors |
Richard G Wamai, Brian J Morris, Stefan A Bailis, David Sokal, Jeffrey D Klausner, Ross Appleton, Nelson Sewankambo, David A Cooper, John Bongaarts, Guy de Bruyn, Alex D Wodak, Joya Banerjee |
Abstract |
Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Norway | 1 | 33% |
South Africa | 1 | 33% |
Unknown | 1 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 2 | 67% |
Members of the public | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 1% |
Tanzania, United Republic of | 1 | <1% |
South Africa | 1 | <1% |
Ethiopia | 1 | <1% |
Japan | 1 | <1% |
United Kingdom | 1 | <1% |
Unknown | 168 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 39 | 22% |
Researcher | 28 | 16% |
Student > Bachelor | 22 | 13% |
Student > Ph. D. Student | 16 | 9% |
Student > Postgraduate | 13 | 7% |
Other | 23 | 13% |
Unknown | 34 | 19% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 58 | 33% |
Social Sciences | 19 | 11% |
Nursing and Health Professions | 15 | 9% |
Agricultural and Biological Sciences | 9 | 5% |
Psychology | 6 | 3% |
Other | 28 | 16% |
Unknown | 40 | 23% |