Male Circumcision for Prevention of HIV
Male Circumcision for Prevention of HIV
Circumcision of the male may have ancient roots, but it is rarely practiced without controversy. Today the impassioned debate centers on, among other things, the potential value of male circumcision (MC) in making a significant dent in the incidence of HIV infection. The "abstinence, being faithful, using condoms" (ABC) prevention strategy, although promising in theory, has not proved to be effective in practice, and the HIV epidemic in some areas has grown to epic proportions. New, effective forms of prevention are desperately needed. Recent strong evidence suggests that MC is effective and should have a clear place in the array of evidence-based interventions for the prevention of HIV.
In 2011, 2 California cities gained national attention for efforts to outlaw MC for individuals younger than 18 years. In Santa Monica, the proposed petition was abandoned before making it onto the ballot. In San Francisco, the petition had enough signatures to be added to the ballot, but it was removed by a judge who cited that the state, rather than a city or county, had the responsibility for overseeing medical procedures. The state of California subsequently passed a law disallowing local bans on MC.
Many of those who support the prohibition on circumcising boys consider the procedure to be both unnecessary and a form of genital mutilation performed on a person who is unable to give consent. Opposing groups assert that restricting the procedure would infringe on the freedom of religion of Jewish and Muslim families, who traditionally circumcise boys for religious reasons. A third group is giving strong consideration to the growing body of literature suggesting that MC has medical benefits, particularly with respect to preventing HIV and other sexually transmitted infections in men.
Nonetheless, some individuals and groups have opposed the scale-up of MC (in any age group) for the purpose of HIV prevention, citing lack of generalizability of the scientific evidence, concerns about behavioral disinhibition, and lack of direct benefit to women. Others refute these criticisms, and this energetic debate continues in the medical literature and lay press.
Male Circumcision: A Highly Charged Controversy
Circumcision of the male may have ancient roots, but it is rarely practiced without controversy. Today the impassioned debate centers on, among other things, the potential value of male circumcision (MC) in making a significant dent in the incidence of HIV infection. The "abstinence, being faithful, using condoms" (ABC) prevention strategy, although promising in theory, has not proved to be effective in practice, and the HIV epidemic in some areas has grown to epic proportions. New, effective forms of prevention are desperately needed. Recent strong evidence suggests that MC is effective and should have a clear place in the array of evidence-based interventions for the prevention of HIV.
Support and Opposition for Male Circumcision
In 2011, 2 California cities gained national attention for efforts to outlaw MC for individuals younger than 18 years. In Santa Monica, the proposed petition was abandoned before making it onto the ballot. In San Francisco, the petition had enough signatures to be added to the ballot, but it was removed by a judge who cited that the state, rather than a city or county, had the responsibility for overseeing medical procedures. The state of California subsequently passed a law disallowing local bans on MC.
Many of those who support the prohibition on circumcising boys consider the procedure to be both unnecessary and a form of genital mutilation performed on a person who is unable to give consent. Opposing groups assert that restricting the procedure would infringe on the freedom of religion of Jewish and Muslim families, who traditionally circumcise boys for religious reasons. A third group is giving strong consideration to the growing body of literature suggesting that MC has medical benefits, particularly with respect to preventing HIV and other sexually transmitted infections in men.
Nonetheless, some individuals and groups have opposed the scale-up of MC (in any age group) for the purpose of HIV prevention, citing lack of generalizability of the scientific evidence, concerns about behavioral disinhibition, and lack of direct benefit to women. Others refute these criticisms, and this energetic debate continues in the medical literature and lay press.
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