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Open Access Highly Accessed Research article

Determinants of circumcision and willingness to be circumcised by Rwandan men, 2010

Rwego A Gasasira*, Malabika Sarker, Landry Tsague, Sabin Nsanzimana, Aimée Gwiza, Jennifer Mbabazi, Corine Karema, Anita Asiimwe and Placidie Mugwaneza

  • * Corresponding author: Rwego A Gasasira rwegoa@gmail.com

  • † Equal contributors

BMC Public Health 2012, 12:134  doi:10.1186/1471-2458-12-134

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Rwandan men are *more* likely to have HIV if theyve been circumcised

Mark Lyndon   (2012-02-29 12:17)  n/a

2.1% of intact Rwandan men have HIV
3.5% of circumcised Rwandan men have HIV

Why then would anyone be promoting male circumcision in Rwanda to prevent HIV?

http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf (table 15.11)

From the USAID report LEVELS AND SPREAD OF HIV SEROPREVALENCE AND ASSOCIATED FACTORS: EVIDENCE FROM NATIONAL HOUSEHOLD SURVEYS

There appears no clear pattern of association between male circumcision and HIV prevalence��in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups believe that circumcised men do not need to use condoms.

http://www.info.gov.za/issues/hiv/survey_2009.htm

From the committee of the South African Medical Association Human Rights, Law and Ethics Committee :

the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission.

The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract

ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems more likely to cost African lives rather than save them.

Competing interests

None declared

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