Gender and ethical issues relating to male circumcision. The feasibility and cost of introducing male circumcision as a public health intervention. Behavioral consequences of introducing male circumcision. The cost-effectiveness of male circumcision. The immediate next steps for operations research in this area.
Practices differ greatly in areas where male circumcision is routinely performed.
Circumcisions may be done in clinical settings by trained health professionals, or by religious or traditional practitioners whose methods and experience vary. There is anecdotal evidence that more and more traditional healers in some sub-Saharan African countries are recommending male circumcision as a means of preventing HIV infection. Many of these healers lack training and may place boys and men at risk for complications such as infection or sepsis, hemorrhage, partial penile amputations, or even death. 14 Cultural customs that surround circumcision, such as alcohol consumption and increased sexual activity, may be associated with increased risk of sexual transmission of STIs and HIV infection in some areas. Assess current practices in traditional as well as clinical settings.