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| Title: | Long-term population effect of male circumcision in generalised HIV epidemics in sub-Saharan Africa |
| Author: | Garenne, Michel |
| Year: | 2008 |
| Periodical: | African Journal of AIDS Research |
| Volume: | 7 |
| Issue: | 1 |
| Pages: | 1-8 |
| Language: | English |
| Geographic term: | Subsaharan Africa |
| Subjects: | AIDS circumcision morbidity |
| External link: | https://www.tandfonline.com/doi/abs/10.2989/AJAR.2008.7.1.1.429 |
| Abstract: | This paper examines the relationship between male circumcision and HIV prevalence and incidence in sub-Saharan African countries that have generalized HIV epidemics. In South Africa, the mean yearly HIV incidence and an estimate of the net reproduction rate of the epidemic were computed from antenatal clinic data for the period 1994-2004, and then compared, by province, to prevailing levels of male circumcision (high, medium and low). In South Africa, mean yearly HIV incidence and net reproduction rate of the epidemic were not lower in provinces with higher levels of male circumcision. For thirteen other countries where Demographic and Health Survey data were available, male HIV prevalence in circumcised and noncircumcised groups was compared. A meta-analysis of that data, contrasting male HIV seroprevalence according to circumcision status, showed no difference between the two groups. Individual case study analysis of eight of those countries showed no significant difference in seroprevalence in circumcised and uncircumcised groups, while two countries (Kenya and Uganda) showed lower HIV prevalence among circumcised groups, and three countries (Cameroon, Lesotho and Malawi) showed higher HIV prevalence among circumcised groups. In most countries with a complex ethnic fabric, the relationship between men's circumcision status and HIV seroprevalence was not straightforward, with the exception of the Luo in Kenya and a few groups in Uganda. These observations put into question the potential long-term effect of voluntary circumcision programmes in countries with generalized HIV epidemics. Bibliogr., sum. [Journal abstract, edited] |
