High Complication Rates and Costs Are Potential Barriers to Using Circumcision to Prevent HIV in Africa

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High Complication Rates and Costs Are Potential Barriers to Using Circumcision to Prevent HIV in Africa
Melhado, L. and Doskoch, P.
International Family Planning Perspectives, Vol. 34, No. 4 (Dec., 2008), pp. 198-199.
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Full Text (PDF): High Complication Rates and Costs Are Potential Barriers to Using Circumcision to Prevent HIV in Africa


Abstract:

Recent evidence that the risk of female-to-male HIV transmission is reduced among men who have been circumcised has led to suggestions that circumcision programs could become a key component of anti-HIV efforts in Sub-Saharan Africa. However, findings from a pair of recent studies highlight some of the obstacles that large-scale circumcision programs would need to overcome. According to a prospective study conducted in Kenya, 35% of young men circumcised by traditional providers and 18% of those circumcised by medical providers experience complications after the procedure, suggesting that extensive training and resources will be needed if circumcision services are to be substantially expanded in developing nations. The second study found that circumcising all HIV-negative men in Sub-Saharan Africa would be far less cost-effective than distributing free condoms to men who need them. For example, on average, preventing one HIV infection via circumcision would cost an estimated $5,845–more than 100 times the cost of preventing a single infection with condoms.