With Uganda's high HIV prevalence, 5 - 15 men will need to be
circumcised to prevent one HIV infection in the next 10 years.
This was the expert review of mathematical models of the impact
of male circumcision, organised by UNAIDS, WHO and the South
African Centre for Epidemiological Analysis. The model was
published in the journal, PLoS Medicine.
Trials in Uganda, Kenya and South Africa produced compelling
evidence that circumcision reduces the risk of men acquiring HIV
through heterosexual sex.
Experts studied six of the mathematical models that have been
developed to estimate the likely impact of massive circumcision
and concluded thus:
Reduced HIV incidence
That, over 10 years, one new HIV infection would be averted for
every five to 15 men circumcised. In some circumstances, if 80%
of men are circumcised, HIV incidence could be reduced by 30-50%
in 10 years.
That circumcision would reduce the cost of managing HIV in the
long run. If sh60,000 - sh120,000 is spent per adult circumcision
and a life-time treatment cost per HIV infection requires $7,000
(sh14m) on first-line therapy only, we would save sh300,000 -
1,800,000 per infection prevented, calculated over a 10-year
That even if circumcised men believed they were protected fully
against infection and increased their sexual risk-taking, it
would have a "small effect" at the population level.
Women would then benefit indirectly because their likelihood of
meeting an HIV-positive male partner would decline. Reductions in
STDs in both men and women would reduce women's risk of acquiring
By July, Kenya, Namibia, Botswana, Zambia, Swaziland, Zimbabwe,
Rwanda and South Africa had rolled out free circumcision in
varying degrees. In Uganda, the situation analysis on universal
circumcision was completed and budget drawn. But consultations
with stakeholders are still being done.