There are multiple avenues for addressing the results of these studies

ADDRESSING QUESTIONS ABOUTHIV and CIRCUMCISIONBackground: In 2003, the Cochrane Institute published a statement evaluating the scientific evide nce onmale circumcision for prevention of HIV acquisition in heterosexual men. The authors concluded: “We foundinsufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexua lmen. The results from existing observational studies show a strong epidemiological association between ma lecircumcision and prevention of HIV, especially among high-risk groups. However, observational studies a re1inherently limited by confounding which is unlikely to be fully adjusted for.” They also cautioned: “ It isimportant to acknowledge that researchers' personal biases and the dominant circumcision practices of theirrespective countries may influence their interpretation of findings.”Since then, three randomized controlled studies (South Africa 2005, Kenya 2007, Uganda 2007) have beenpublished which showed a reduction in HIV acquisition of 50-60% during the study period, in circumcised men as compared to intact men. The actual number of men who became infected was small, for exampl e, in one ofthe studies, 1.8% of circumcised men compared to 3.6% of intact men. Based on the apparent significanc e of theearly results, all three studies were ended early (none went longer than 24 months), preventing furthe r study ofthe trends over time of HIV rates after circumcision. In March 2007, due ...