Male medical circumcision reduces the risk of heterosexual men contracting HIV. It is highly likely that the widespread introduction and encouragement of voluntary male medical circumcision (VMMC) in countries with generalised heterosexual epidemics will reduce HIV incidence substantially. There is also evidence that VMMC reduces the risk of men contracting HPV, the virus that causes cervical cancer. Therefore, there is likely a lower risk of circumcised men passing on HPV to their female partners.
Yet a number of commentators have raised objections to the introduction of VMMC.
An article by Halperin et al. titled Male circumcision is an efficacious, lasting and cost-effective strategy for combating HIV in high-prevalence AIDS epidemics has been published in Future HIV Therapy (September 2008, Vol. 2, No. 5, Pages 399-405, doi:10.2217/17469600.2.5.399). It answers the objections raised to VMMC. Its authors include many distinguished scientists, clinicians and activists, including members of the TAC.
There are few proven options available for reducing heterosexual transmission of HIV. The TAC’s position is that VMMC is an important part of HIV prevention. It is not a “magic bullet”; it should be part of a comprehensive set of prevention interventions. The high uptake rates of circumcision in some pilot projects indicate that this is also a way of encouraging men to take greater responsibility for their health. TAC endorses the World Health Organisation recommendations on VMMC, particularly that “male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men.”
TAC calls on the South African National AIDS Council (SANAC) to ensure that a national policy on VMMC is finalised before the end of the year.