Review: A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries


Morris, BJ; Bailey, RC; Klausner, JD; Leibowitz, A; Wamai, RG; Waskett, JH; Banerjee, J; Halperin, DT; Zoloth, L; Weiss, HA; Hankins, CA; (2012) Review: A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries. [Conference or Workshop Item]

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Abstract

: A potential impediment to evidence-based policy development on medical male circumcision (MC) for HIV prevention in all countries worldwide is the uncritical acceptance by some of arguments used by opponents of this procedure. Here we evaluate recent opinion-pieces of 13 individuals opposed to MC. We find that these statements misrepresent good studies, selectively cite references, some containing fallacious information, and draw erroneous conclusions. In marked contrast, the scientific evidence shows MC to be a simple, low-risk procedure with very little or no adverse long-term effect on sexual function, sensitivity, sensation during arousal or overall satisfaction. Unscientific arguments have been recently used to drive ballot measures aimed at banning MC of minors in the USA, eliminate insurance coverage for medical MC for low-income families, and threaten large fines and incarceration for health care providers. Medical MC is a preventative health measure akin to immunisation, given its protective effect against HIV infection, genital cancers and various other conditions. Protection afforded by neonatal MC against a diversity of common medical conditions starts in infancy with urinary tract infections and extends throughout life. Besides protection in adulthood against acquiring HIV, MC also reduces morbidity and mortality from multiple other sexually transmitted infections (STIs) and genital cancers in men and their female sexual partners. It is estimated that over their lifetime one-third of uncircumcised males will suffer at least one foreskin-related medical condition. The scientific evidence indicates that medical MC is safe and effective. Its favourable risk/benefit ratio and cost/benefit support the advantages of medical MC.<br/>

Item Type: Conference or Workshop Item
Keywords: circumcision, evidence-based evaluation, HIV, preventative medicine, public health policy, Australia, child death, clinical effectiveness, condom, cost benefit analysis, Denmark, developed country, evaluation, Finland, France, health care policy, health insurance, heterosexuality, human, Human immunodeficiency virus infection, infection risk, Israel, legal aspect, male genital tract cancer, medical ethics, medical information, morbidity, mortality, Nigeria, Norway, patient safety, priority journal, public opinion, review, risk benefit analysis, scientific literature, sexual arousal, sexual function, sexual satisfaction, sexually transmitted disease, systematic review (topic), United Kingdom, United States, Adult, Circumcision, Male, Developed Countries, Dissent and Disputes, Health Knowledge, Attitudes, Practice, Health Personnel, Health Policy, HIV Infections, Humans, Male, Public Health, Sexually Transmitted Diseases, Adult, Circumcision, Male, Developed Countries, Dissent and Disputes, HIV Infections, etiology, prevention & control, Health Knowledge, Attitudes, Practice, Health Personnel, Health Policy, Humans, Male, Public Health, Sexually Transmitted Diseases, prevention & control
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Tropical Epidemiology Group
PubMed ID: 22452415
Web of Science ID: 310484200013
URI: http://researchonline.lshtm.ac.uk/id/eprint/2064715

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