Circumcision and HIV infection: review of the literature and meta-analysis

Thirty-five articles and a number of abstracts have been published in the m edical literature looking at the relationship between male circumcision and HIV infection. Study designs have included geographical analysis, studies of high-risk patients, partner studies and random population surveys. Most of the studies have been conducted in Africa. A meta-analysis was performed on the 29 published articles where data were available. When the raw data are combined, a man with a circumcised penis is at greater risk of acquirin g and transmitting HIV than a man with a non-circumcised penis (odds ratio (OR)=1.06, 95% confidence interval (CI)=1.01-1.12). Based on the studies pu blished to date, recommending routine circumcision as a prophylactic measur e to prevent HIV infection in Africa, or elsewhere, is scientifically unfou nded.