Over 15 years ago, studies published in leading medical journals on AIDS in Africa, found that uncircumcised men were about 3 times as likely as were circumcised men to be infected with the human immunodeficiency virus (HIV). These findings have been confirmed in more than 40 separate studies. Currently almost 40 million people worldwide are infected with HIV, mostly in sub-Saharan Africa and 22 million have died of AIDS. The AIDS epidemic is rapidly spreading in Asia and Eastern Europe. Professor Malcolm Potts (Lancet. 2000) of the University of California estimated that if all HIV-exposed men in Sub-Saharan Africa and Asia had been circumcised there would have been 8 million fewer deaths from AIDS; 6 million fewer in Africa and 2 million fewer in Asia. In a review article in a leading British journal (Halperin, Lancet. 1999) alluded to the lack of response of the international community to the knowledge of the effect of circumcision on preventing HIV infection in spite of these convincing figures. Public knowledge in Africa of the protective effect of circumcision against HIV infection, has resulted in private store-front clinics offering adult circumcision under suboptimal conditions. Governmental involvement is required in order to assure that these circumcisions are properly performed by qualified personnel. It should also be emphasized that circumcision itself is most effective when used in association with condoms.
In the U.S. there has been some official recognition of the protective effect of circumcision against HIV. Dr. Anthony Fauci, head of the HIV Research Division of the NIH, stated that “the link between male circumcision and lower HIV infection rates is now absolute fact.” In March 2002 a group of internationally reknowned scientists concluded that affordable, safe, voluntary circumcision should be developed to help fight the AIDS epidemic and that “such efforts must commence now, lest the opportunity for a potentially important prevention measure be further delayed.” Randomized controlled trials are now under way in Africa, supported by the NIH, the Canadian and the French governments, on the effectiveness of adult medical circumcision in preventing HIV transmission.