Does infant MC reduce male to female HIV transmission?
************** Dear Dr. Nelson and ProCAARE colleagues, There are observational data from cohort studies and HIV prevention trials which suggest that HIV+ men who were previously circumcised (for example in infancy or childhood) are between 30 and 50% less likely to transmit HIV to their female partners than uncircumcised, HIV+ men. However, as you know the clinical trial of male circumcision (MC) among HIV+ men did not find any reduction in HIV transmission from men to women, and there are concerns about the potential for increased transmission if recently circumcised HIV+ men resume sex before wound healing is complete. While the observational data which found reduced transmission from previously circumcised men to their female partners are intriguing, we should keep in mind that we had more than 40 ecological, observational and biological studies suggesting that MC reduced female to male HIV transmission, but MC was not officially endorsed for HIV prevention until the results of the
