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HIV prevention in Africa: is VMMC useful and acceptable?

International Journal of Impotence Research volume 35, pages 279–281 (2023)Cite this article

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Comment on the paper by Winnie Kavulani Luseno, Stuart Rennie and Adam Gilbertson. (2021): “A review of public health, social and ethical implications of voluntary medical male circumcision programs for HIV prevention in sub-Saharan Africa”. IJIR (26 October 2021).

In 2007, the World Health Organization (WHO) made a controversial recommendation to promote Voluntary Medical Male Circumcision (VMMC) in the hope of preventing HIV transmission in 15 countries of Eastern and Southern Africa; another country (South-Sudan) was added later. This recommendation was enacted in a “technical consultation” held in Montreux, Switzerland, which was organized by a highly selected group of experts who were uniform in their support of VMMC, which led to a within-group consensus based on what they regarded as “compelling evidence”. Had the meeting involved scientists with contrary views or presenting contrary evidence, the policy recommendations likely would have been different [1]. Some 15 years later, Luseno, Rennie and Gilbertson provide a comprehensive review of the evidence, arguing that VMMC campaigns have had little substantive impact on HIV trends, while raising serious ethical issues [2]. The authors are right to say that HIV incidence has continued at about the same pace after VMMC, either declining, holding steady or increasing depending on the dynamics of the epidemic in each country. They are also right to draw attention to the numerous ethical issues raised by VMMC campaigns: high levels of adverse events among young boys, risk compensation in certain sub-populations, inadequately informed consent, and problematic social and cultural impact [2].

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The author thanks the Associate Editor and the Anonymous Reviewer, for sharing ideas and providing useful comments on the draft of this paper.

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  1. FERDI, Université d’Auvergne, Clermont-Ferrand, France

    Michel Garenne

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Correspondence to Michel Garenne.

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Garenne, M. HIV prevention in Africa: is VMMC useful and acceptable?. Int J Impot Res 35, 279–281 (2023). https://doi.org/10.1038/s41443-022-00575-3

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