Voluntary medical male circumcision protects against HIV infection by safely removing the foreskin, which is susceptible to infection, from the penis. Male circumcision significantly reduces the risk of sexually transmitting HIV from a woman living with HIV to a man, and is now recommended by the World Health Organization. NIAID-funded research played a major role in the discovery that male circumcision is an effective HIV prevention strategy.
In 2006, two large NIAID-supported clinical trials in Kenya and Uganda found that medical, voluntary circumcision of adult African men who had sex with women significantly reduced their risk of getting HIV. Men in the studies either received circumcision at the start of the study, or waited two years to receive a circumcision. The studies were stopped in 2006, when an early review of the data showed that the men circumcised at the start had less than half of the number of HIV infections as those who were not circumcised.
These findings, along with results from an earlier clinical trial in South Africa, prompted the World Health Organization in 2007 to recommend the use of medically supervised adult male circumcision as an important part of HIV prevention programs. Male circumcision is now widely recognized a key HIV prevention tool, and several African countries, including Kenya, Botswana, and Tanzania, have included it in their national HIV strategies.
Male circumcision does not protect during sex between men, nor does it reduce the risk of infection for a women if the man has HIV. While male circumcision is proven to be effective to reduce a man’s risk during sex with a woman, it is not protective all the time and should be combined with other prevention techniques such as condoms, being tested for HIV and knowing the HIV status of sexual partners, and use of pre-exposure prophylaxis (PrEP) as prescribed by a doctor.
NIAID continues to support research on ways to increase the safety and accessibility of male circumcision around the world. This research concentrates on what level of health care personnel can be trained to perform the surgery, at what age can surgery most safely and effectively be performed, and if there are devices to make the procedure safer and simpler.