Max Fish
Arianne Shahvisi
Tatenda Gwaambuka
Godfrey B Tangwa
Brian D Earp
14 years into the medical male circumcision (MMC) campaign for HIV prevention in sub-Saharan Africa, questions about scaling up remain. Researchers have reported evidence of increased sexual risk behaviours among a subset of men in some communities, possibly due to a false sense of security against HIV transmission from MMC.
Therefore, the appropriate response, both scientifically and in terms of public health, is not to call for a generalised promotion and expansion of circumcision programmes, as Serwadda and Kigozi propose
In light of the outstanding ethical and public health concerns, failure to consider contextual factors related to risk compensation and perspectives from target communities that are already marginalised make the evidence presented insufficient for a generalised scale-up of MMC.