Circuncisión y HIV

World J Urol. 2011 May 18. [Epub ahead of print]
Male circumcision and HIV infection risk.
Krieger JN.
SourceDepartment of Urology, School of Medicine, University of Washington, Seattle, WA, 98195, USA, jkrieger@u.washington.edu.

Abstract
BACKGROUND: Male circumcision is being promoted to reduce human immunodeficiency virus type 1 (HIV) infection rates. This review evaluates the scientific evidence suggesting that male circumcision reduces HIV infection risk in high-risk heterosexual populations.

METHODS: We followed the updated International Consultation on Urological Diseases evidence-based medicine recommendations to critically review the scientific evidence on male circumcision and HIV infection risk.

RESULTS: Level 1 evidence supports the concept that male circumcision substantially reduces the risk of HIV infection. Three major lines of evidence support this conclusion: biological data suggesting that this concept is plausible, data from observational studies supported by high-quality meta-analyses, and three randomized clinical trials supported by high-quality meta-analyses.

CONCLUSIONS: The evidence from these biological studies, observational studies, randomized controlled clinical trials, meta-analyses, and cost-effectiveness studies is conclusive. The challenges to implementation of male circumcision as a public health measure in high-risk populations must now be faced.