A study published in WebmedCentral Epidemiology, 2011;2(9):WMC002206, by Dr. Devon D Brewer. The study examined the association between male circumcision, scarification, and HIV infection in Mozambican children and youth with data from the 2009 Mozambique AIDS Indicator Survey. The study provides compelling evidence that male circumcision of infants and children, even if done in a medical setting, results in a higher rate of HIV infection for the males than if they remain intact. The study also calls into question studies that do not apply rigorous standards for controlling for other causes of HIV infection.
Results: Circumcised and scarified children and youth were two to three times more likely to be infected with HIV than children and youth who had not been circumcised or scarified, respectively. Circumcision and scarification were each associated with HIV infection for both virgins and sexually experienced youth. Males circumcised by medical doctors were almost as likely to be infected as those circumcised by traditional circumcisers. Circumcision and scarification were also independently associated with HIV infection in males.
Conclusions: To determine modes of HIV transmission with confidence, researchers must employ more rigorous research designs than have been used to date in sub-Saharan Africa. In the meantime, Mozambicans and other Africans should be warned about all risks of blood-borne HIV transmission, including scarification and medical and traditional circumcision, and informed about how these risks can be avoided.