Circumcision and HIV
Male
Efficacy
Heterosexual men
As of 2020[update], past research has shown that circumcision reduces the risk of HIV infection in heterosexual men, although these studies have had limitations.[6]
The WHO Expert Group on Models To Inform Fast Tracking Voluntary Medical Male Circumcision In HIV Combination Prevention in 2016 found "large benefits" of circumcision in settings with high HIV prevalence and low circumcision prevalence. The Group estimated male circumcision is cost-saving in almost all high priority countries. Furthermore, WHO stated that: "While circumcision reduces a man’s individual lifetime HIV risk, the indirect effect of preventing further HIV transmissions to women, their babies (vertical transmission) and from women to other men has an even greater impact on the population incidence, particularly for circumcisions performed at younger ages (under age 25 years)."[7]
Newly circumcised HIV infected men who are not taking
Men who have sex with men
The
Regional differences
Whether circumcision is beneficial to developed countries for HIV prevention purposes is undetermined.[3][5] It is not known whether the effect of male circumcision differs by HIV-1 variant. The predominant subtype of HIV-1 in the United States is subtype B, and in Africa, the predominant subtypes are A, C, and D.[9]
Recommendations
The most recent WHO review of the evidence reiterates prior estimates of the impact of male circumcision on HIV incidence rates. In 2020, WHO again concluded that male circumcision is an efficacious intervention for HIV prevention and that the promotion of male circumcision is an essential strategy, in addition to other preventive measures, for the prevention of heterosexually acquired HIV infection in men. Eastern and southern Africa had a particularly low prevalence of circumcised males. This region has a disproportionately high HIV infection rate, with a significant number of those infections stemming from heterosexual transmission. The WHO has made voluntary medical male circumcision (VMMC) a priority intervention in that region since their 2007 recommendations.[3]
Although these results confirm that male circumcision reduces the risk of men becoming infected with HIV, the UN agencies emphasize that it does not provide complete protection against HIV infection. Circumcised men can still become infected with the virus and, if HIV-positive, can infect their sexual partners. Male circumcision should never replace other known effective prevention methods and should always be considered as part of a comprehensive prevention package, which includes correct and consistent use of male or female condoms, reduction in the number of sexual partners, delaying the onset of sexual relations, and HIV testing, counseling, and treatment.
— World Health Organization, Joint WHO/UNAIDS Statement made in 2007.[10]
In the United States, the
Because the evidence that circumcision prevents HIV mainly comes from studies conducted in Africa, the Royal Dutch Medical Association (KNMG) questioned the applicability of those studies to developed countries. Circumcision has not been included in their HIV prevention recommendations. The KNMG circumcision policy statement was endorsed by several Dutch medical associations. The policy statement was initially released in 2010, but was reviewed again and accepted in 2022.[12]
Mechanism of action
While the biological mechanism of action is not known, a 2020 meta-analysis stated "the consistent protective effect suggests that the reasons for the heterogeneity lie in concomitant individual social and medical factors, such as presence of STIs, rather than a different biological impact of circumcision."[6]
The inner foreskin harbours an increased density of CD4 T-cells and releases increased levels of pro-inflammatory cytokines. Hence the sub-preputial space displays a pro-inflammatory environment, conducive to HIV infection.[13]
Langerhans cells (part of the human immune system) under the foreskin may be a source of entry for HIV.[14] Excising the foreskin removes what is thought to be a main entry point for the HIV virus.[15]
Advocacy campaigns
Sociologist Sarah Rudrum and colleagues have written that the communication of VMMC in Uganda is unethical and contradicts medical evidence. In their analysis of “Stand Proud, Get Circumcised”, a public health campaign promoting circumcision as an HIV-prevention strategy in Uganda, Rudrum et al. “exploit male anxieties about appearance and performance, drawing on hegemonic masculinity to promote circumcision as an idealized body aesthetic”.[16] In their work combining a transnational history of medicalised male circumcision and an analysis of International Organisations documents promoting VMMC, Alejandro and Feldman show that medicalised male circumcision “is represented as an enhancer of virility, sexual pleasure and sexual performance”.[17]
History

Valiere Alcena, in a 1986 letter to the New York State Journal of Medicine, noted that low rates of circumcision in parts of Africa had been linked to the
Experimental evidence was needed to establish a causal relationship, so three
Society and culture

The WHO recommends VMMC, as opposed to traditional circumcision. There is some evidence that traditionally circumcised men (i.e. who have been circumcised by a person who is not medically trained) use condoms less often and have higher numbers of sexual partners, increasing their risk of contracting HIV.[3]: 3/42 Newly circumcised men must refrain from sexual activity until the wounds are fully healed.[3]
The prevalence of circumcision varies across Africa.[28][29] Studies were conducted to assess the acceptability of promoting circumcision; in 2007, country consultations and planning to scale up male circumcision programmes took place in Botswana, Eswatini, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Uganda, Tanzania, Zambia and Zimbabwe.[30]
Programs
In 2011, UNAIDS prioritized 15 high HIV prevalence countries in eastern and southern Africa, with a goal of circumcising 80% of men (20.8 million) by the end of 2016.[31] As of 2020, WHO estimated that 250,000 HIV infections have been averted by the 23 million circumcisions conducted in the 15 priority countries of eastern and southern Africa.[3]
Misinformation about VMMC programs
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![]() | This article contains close paraphrasing of a copyrighted source, https://www.cgdev.org/blog/brief-look-president-trumps-list-appalling-aid-projects (Copyvios report). (June 2025) |
Misinformation about circumcision has been spread by United States President Donald Trump, many members of the Republican Party, and other Western right-wing populists and national conservatives, who have falsely alleged that it is ineffective in reducing HIV transmission, portrayed it as a threat to masculinity, or an ineffective use of the dollars of taxpayers.[failed verification] The scientific consensus positions of major medical organizations, including that of the World Health Organization, is that circumcision is one of the most effective methods of preventing HIV transmission in high-risk locations.[3][32][33][34][35][36] In the 2025 speech to a joint session of Congress, President Trump falsely[improper synthesis?] cited a circumcision grant to Mozambique as a supposed example of government waste.[35] It also marked the first time circumcision has ever been mentioned or criticized in a State of the Union or speech to a joint session of Congress.[37] Reaching targeted male circumcision rates in Mozambique would have prevented 220,000 HIV infections 2011–2025.[35]
See also
- Reproductive health
- Female Circumcision
- Prevalence of circumcision
- Circumcision controversies
References
- PMID 34201976.
There is disputed immunological evidence in support of MC in preventing the heterosexual acquisition of HIV-1.
- ISBN 9783319471334.
This led to a [medical] consensus that male circumcision should be a priority for HIV prevention in countries and regions with heterosexual epidemics and high HIV and low male circumcision prevalence.
- ^ a b c d e f g h i j k l "Preventing HIV Through Safe Voluntary Medical Male Circumcision For Adolescent Boys And Men In Generalized HIV Epidemics". World Health Organization. 2020. Retrieved 2021-05-24.
- ^ a b Information for providers counseling male patients and parents regarding male circumcision and the prevention of HIV infection, STIs, and other health outcomes (Report). Centers for Disease Control and Prevention. August 22, 2018. Archived from the original on 2021-05-06. Retrieved 2021-05-26.
- ^ S2CID 2158164.
- ^ PMID 32558344.
- ^ "Models To Inform Fast Tracking Voluntary Medical Male Circumcision In HIV Combination Prevention" (PDF). World Health Organization. March 2016. Archived (PDF) from the original on 2020-09-23. Retrieved 2021-05-26.
- S2CID 10432723.
- S2CID 208085886.
- ^ "WHO and UNAIDS Secretariat welcome corroborating findings of trials assessing impact of male circumcision on HIV risk" (Press release). World Health Organization. February 23, 2007. Archived from the original on 2007-02-26. Retrieved 2007-02-23.
- PMID 22926175.
- ^ "Non-therapeutic circumcision of male minors KNMG viewpoint". 31 March 2022.
- PMID 28893286.
- PMID 21042054.
- PMID 10845974.
- PMID 27684495.
- .
- PMID 3463895. Archived from the originalon 10 January 2014. Retrieved 10 January 2014.
- from the original on 2014-01-10. Retrieved 2014-01-10.
- PMID 3762636.
- PMID 10845974.
- S2CID 21857086. Archived from the original(PDF) on 2014-01-10.
- PMID 15766651.
- ^ PMID 19370585.
- PMID 19370585.
- PMID 32558344.
- ^ Seeth, Avantika (June 1, 2018). "'It's hassle-free,' says actor Melusi Yeni about his medical circumcision". News24. Retrieved September 6, 2022.
Actor Melusi Yeni was the millionth man to undergo voluntary male medical circumcision at the Sivananda Clinic in KwaZulu-Natal.
- PMID 10173099. Archived from the original(PDF) on 2008-09-06. Retrieved 2009-03-23.
- ^ "Male circumcision: global trends and determinants of prevalence, safety and acceptability" (PDF). Who/Unaids. 2007. Archived (PDF) from the original on 2015-07-15. Retrieved 2008-10-16.
- ^ "Towards Universal access: Scaling up priority HIV/AIDS interventions in the health sector" (PDF). Who/Unaids/Unicef: 75. 2008. Archived (PDF) from the original on 2008-10-18. Retrieved 2008-10-16.
- ^ Joint strategic action framework to accelerate the scale-up of voluntary medical male circumcision for HIV prevention in Eastern and Southern Africa, 2012-2016. Archived 2017-07-29 at the Wayback Machine WHO. 2014.
- ^ Uribe, Grace Abels, Maria Ramirez. "The facts behind the 19 programs Trump described as 'waste'". @politifact. Retrieved 2025-05-22.
{{cite web}}
: CS1 maint: multiple names: authors list (link) - ^ Roldan, Bec (2025-03-06). "Trump says 'male circumcision in Mozambique' is a 'scam.' What's the program about?". NPR. Retrieved 2025-05-22.
- PMID 40394388.
- ^ a b c Kenney, Charles (2025-03-06). "A Brief Look at President Trump's List of "Appalling" Aid Projects". Center For Global Development. Retrieved 2025-05-22.
This is potentially referring to a grant to an organization in the country. It is worth noting how powerful a tool male circumcision is in the fight against AIDS. Reaching targeted male circumcision rates in Mozambique would have prevented 220,000 HIV infections 2011–2025.
- ^ N. P. R. Staff (2025-03-04). "Read NPR's annotated fact check of President Trump's address to Congress". NPR. Retrieved 2025-05-22.
- ^ Keating, Dan; Mourtoupalas, Nick; Dormido, Hannah (2025-03-05). "You've never heard that in a presidential address to Congress before". The Washington Post. Archived from the original on 2025-03-07. Retrieved 2025-05-22.