Technical Meeting on Male Circumcision - Global

The first day of the meeting consisted in plenary and break-out sessions that presented data from recent and proposed studies. Discussion then followed about concerns and caveats related to safety and complication rates, age of circumcision, bioethics, informed choice/consent, potential for behavioural "disinhibition," cost-benefit analysis, introduction within existing reproductive health service programmes, and potential coordination with anti-female-genital-cutting advocacy programmes. Also at issue was MC policy and implementation issues: when and how it may be appropriate to initiate MC programmes?

Day two explored in greater detail the feasibility of next steps for further activities, including research, dissemination of existing data on risks and benefits of circumcision, and possible introduction of pilot clinical services.

As materials from the meeting indicate, the group concluded that data on the protective effect of MC on HIV infection are compelling. However, information on safety, particularly when MC is done outside the clinical setting, is limited. Steps need to be taken even before controlled trials, which are expected to continue to show that MC is safe, are completed. These steps include initiating international and country-specific dialogues on policy issues, strengthening the safety and standardisation of the procedure, and conducting operational research to evaluate feasibility and acceptance in various settings.

To access papers from the meeting, visit the Reproductive Health Outlook (RHO) site.

HIV/AIDS, Health, Gender.

Meeting organisers note that a synthesis of 38 studies shows that circumcised men are more than half as likely to be infected by HIV. Among African studies, there was a 69% reduction in HIV/AIDS prevalence among higher-risk men. Based on this and other data, MC is an emerging issue of importance to epidemiologists and, increasingly, programme staff in some regions of Africa and elsewhere.