HIV/AIDS and circumcision: lost in translation

Marie Fox, Michael Thomson

School of Law, Keele University,
Staffordshire, UK
Correspondence to
Marie Fox, School of Law, Keele
University, Staffordshire ST5
5BG, UK;
Received 30 June 2010
Accepted 13 August 2010

In April 2009 a Cochrane review was published
assessing the effectiveness of male circumcision in
preventing acquisition of HIV. It concluded that there
was strong evidence that male circumcision, performed
in a medical setting, reduces the acquisition of HIV by
men engaging in heterosexual sex. Yet, importantly, the
review noted that further research was required to
assess the feasibility, desirability and cost-effectiveness
of implementation within local contexts. This paper
endorses the need for such research and suggests that,
in its absence, it is premature to promote circumcision
as a reliable strategy for combating HIV. Since articles in
leading medical journals as well as the popular press
continue to do so, scientific researchers should think
carefully about how their conclusions may be translated
both to policy makers and to a more general audience.
The importance of addressing ethico-legal concerns that
such trials may raise is highlighted. The understandable
haste to find a solution to the HIV pandemic means that
the promise offered by preliminary and specific research
studies may be overstated. This may mean that ethical
concerns are marginalised. Such haste may also obscure
the need to be attentive to local cultural sensitivities,
which vary from one African region to another,in
formulating policy concerning circumcision.
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