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Male Circumcision

The UCLA Program in Global Health was commissioned by the Ford Foundation to analyze the policy landscape pertaining to male circumcision, a procedure shown in three large clinical trials to be an effective HIV prevention intervention. The purpose of the analysis was to explore the broader contextual factors -- such as personal autonomy, bodily integrity, human rights, social and cultural dynamics, and health systems' capacity to deliver integrated HIV/AIDS prevention and treatment interventions to the majority of the population. UCLA prepared an extensive report that summarizes available information on male circumcision as an HIV prevention strategy, and the policy and prevention implications of its implementation. A modified version of this report has been published in the journal Lancet.

In November 2007, UCLA PGH worked in collaboration with the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) in convening a think tank meeting, The Future Direction of Male Circumcision in HIV Prevention, at the UCLA campus in Los Angeles. The think tank brought together 60 international expert researchers, clinicians, policy experts, advocates, government representatives, and foundation funders to examine the current state of knowledge of male circumcision as an HIV prevention intervention, and to discuss the behavioral, social, policy, and international and domestic research implications of male circumcision as an HIV prevention strategy in populations where HIV transmission is commonly transmitted through vaginal vs. anal sex. A monograph outlining policy and research recommendation based on the working groups has been published.

A follow-up meeting, From Scalpel To Scale Up: Shaping Perceptions Of Male Circumcision, that addresses how the male circumcision intervention should be framed in public health and other contexts in sub-Saharan Africa, Latin America, and the Caribbean was held in August 2008 to coincide with the IAS conference in Mexico City. A monograph covering these issues is in development.

UCLA Program in Global Health: Male Circumcision Publications and Resources:

• Male Circumcision and HIV Prevention: Looking to the Future
  Brooks RA, Etzel M, Klosinski LE, Leibowitz AA, Sawires S, Szekeres G, Weston M, Coates TJ. AIDS Behav. 2009 Feb 11. [Epub ahead of print]
• From Scalpel To Scale Up: Shaping Perceptions Of Male Circumcision
  August 2, 2008; Mexico City. Speaker Presentations: See links to PowerPoint presentations.
• The Future Direction of Male Circumcision in HIV Prevention
  Conference Proceedings: November 29-30, 2007; Los Angeles. Published July 2008.
• Male circumcision and HIV/AIDS: challenges and opportunities
  Sawires SR, Dworkin SL, Fiamma A, Peacock D, Szekeres G, Coates TJ. Lancet. 2007 Feb 24;369(9562):708-13.
• Male Circumcision and HIV/AIDS: Opportunities and Challenges
  Sharif R. Sawires, Shari L. Dworkin, and Thomas J. Coates, PhD. UCLA Program in Global Health, February 2, 2007.
• The Snip Could Save Many Lives: New Study Shows that Male Circumcision Could Reduce HIV Transfer
  Thomas J. Coates. The Star (South Africa), October 31, 2005 (Edition 1).