A recent PLoS article [html] has made a persuasive argument that controlling for a single variable in the HIV epidemic can neutralize any potential benefit from male circumcision. The study suggests targeting said variable would be far more effective than a messy, ethically questionable, and expensive mass male circumcision campaign.
The study’s author, John R. Talbott, concludes that the size of the female sex worker population and their operation outside any regulatory environment are the drivers of the epidemic rather than low levels of male circumcision.
I find it extraordinarily interesting that highly sexually regimented societies or those with a history of such regimentation, primarily Muslim and Catholic countries, have a relatively controlled level of HIV infection. Post-modern or less religious countries such as those of Northern Europe and eastern countries, many with a Buddhist tradition, have moved quickly to stem the tied of HIV infection, and therefore also enjoy relatively low levels of infection from successful anti-HIV programs.
Sub-Saharan Africa has neither the tradition of sexual regimentation nor the reality of a post-modern/Buddhist society. Wouldn’t it be worth studying these problems of sociology to determine the drivers of the epidemic? Clearly, the Talbott article is a valuable contribution in this direction.
Or download it from the source: https://doi.org/10.1371/journal.pone.0000543