Current Research and Research Gaps

Ongoing and planned research

Much of the ongoing research on male circumcision and HIV prevention is operations research to identify the safer, more effective ways to deliver male circumcision services and evaluation research to assess the safety and impact of those services. Most of this research is being undertaken in the three sites in Kenya, South Africa, and Uganda, where the randomised controlled trials (RCTs) were conducted.

Research gaps

Although the RCTs confirmed the protective effect of male circumcision for HIV prevention, a number of unanswered questions remain. Further research on male circumcision is needed to:

• Clarify the risks and benefits of male circumcision for preventing HIV transmission in female or male partners of HIV-positive men and to assess whether male circumcision offers any protection against HIV in the context of heterosexual anal sex.
• Document changes in HIV-related individual and community perceptions and behaviours as a result of the expansion of male circumcision services.
• Determine the best models and packages for service delivery in different epidemic settings, for different populations and at different ages.
• Identify the resources required to expand safe male circumcision services.
• Refine mathematical models for assessing the impact of different programmatic options on HIV epidemics.
• Investigate other potential benefits or risks of male circumcision, including its potential protective effects on other sexually transmitted infections.
• Develop and assess simpler, safer methods for performing male circumcision in resource-limited settings, including the use of suture-less, blood-free procedures and devices.
  
• Better understand variations in the time it takes for healing and keratinisation after male circumcision and identify the factors that contribute to these differences.
  

Resources

New data on male circumcision and HIV prevention: policy and programme implications (2007, PDF, 1.11 MB). Conclusions and recommendations from "Technical consultation on male circumcision and HIV Prevention: research implications for policy and programming", Montreux, 6-8 March 2007. WHO/UNAIDS, 2007.

Meeting Report: Civil Society Dialogue on Male Circumcision for HIV Prevention: Implications for Women (PDF, 208 KB). Mombasa, Kenya, 22-23 June 2008. AVAC, 2008.

Male circumcision and HIV prevention: operations research implications. Report of an international consultation (PDF, 522 KB). Nairobi, Kenya, 21-22 June 2007. WHO/
UNAIDS, 2007.

United Nations Information Package on Male Circumcision. Insert 5: Implications for Women (PDF, 836 KB). WHO/UNAIDS, 2008.