Using more than one form of HIV/STI prevention method; CIRCUMCISION alone is not enough

The studies do show a reduction in the "incidence rate" - the number of new cases in a population in a given time period - of 60%, not 1.3% - Compared to the group of participants who were not circumcised within the number of participants in the studies, circumcised men were 60% less likely to become infected. Another way to think of this is to consider how many infections would be averted if the small number of people in the study match the large real world population as a whole.

Instead of ~5500 male participants imagine if ~5,500,000 individuals were circumcised and 5,500,000 were not. In the circumcised group we might see 64,000 new infections if we use the numbers in this article, in the uncircumcised group we would see 137,000 new infections -in other words a very significant absolute reduction. 73,000 fewer men would become infected than they would otherwise if they were not circumcise. Clinical trials enrol a limited number of people carefully selected to see if an intervention works and is safe under study conditions and consent before using an intervention widely in the whole population.

Last year there were 2.7 million new HIV infections worldwide. Imagine if we could reduce that number by 50% or 60% using all new and existing prevention tools. The number of infections would be less than 1.35 milion,that would be a step forward.

Often the reduction rates in a trial cannot be duplicated in the whole real world population unless we make efforts to overcome the barriers to using the prevention correctly and with the agreement of the people who use it. No prevention is 100% effective. What about the 64,000 who could become infected compared to 137,000 without? This is why we need more than one prevention used method together and used in a thoughtful way of combination where they can do most good.

SOURCE: This excerpt is collated from various journals of medicine


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