Unique Identifier
21799805
Status
MEDLINE
Authors
Mugwanya KK. Whalen C. Celum C. Nakku-Joloba E. Katabira E. Baeten JM.
Institution
Department of Epidemiology and Biostatistics, School of Medicine, Case
Western Reserve University, Cleveland, Ohio, United States of America. kmugwanya@gmail.com
Title
Circumcision of male children for reduction of future risk for HIV:  acceptability among HIV serodiscordant couples in Kampala, Uganda.
Source
PLoS ONE [Electronic Resource]. 6(7):e22254, 2011.
OBJECTIVE:  To conduct a critical review of recent proposals that widespread circumcision of male infants be introduced in Australia as a means of combating heterosexually transmitted HIV infection.  APPROACH:  These arguments are evaluated in terms of their logic, coherence and fidelity to the principles of evidence-based medicine; the extent to which they take account of the evidence for circumcision having a protective effect against HIV and the practicality of circumcision as an HIV control strategy; the extent of its applicability to the specifics of Australia's HIV epidemic; the benefits, harms and risks of circumcision; and the associated human rights, bioethical and legal issues.  CONCLUSION:  Our conclusion is that such proposals ignore doubts about the robustness of the evidence from the African random-controlled trials as to the protective effect of circumcision and the practical value of circumcision as a means of HIV control; misrepresent the nature of Australia's HIV epidemic and exaggerate the relevance of the African random-controlled trials findings to it; underestimate the risks and harm of circumcision; and ignore questions of medical ethics and human rights. The notion of circumcision as a 'surgical vaccine' is criticised as polemical and unscientific.  IMPLICATIONS:  Circumcision of infants or other minors has no place among HIV control measures in the Australian and New Zealand context; proposals such as these should be rejected.© 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.
Publication Type
Journal Article.  Research Support, N.I.H., Extramural.  Research Support, Non-U.S. Gov't.