Newborn circumcision for HIV prevention in Zimbabwe
Previous efforts have been focused on circumcisions among adolescent and adult males. These are men who are (just about to be) sexually active and likely to acquire HIV. These were also the populations for the studies showing that circumcision lowers HIV risk. This is why the new plan in Zimbabwe to promote circumcision among newborns is interesting and potentially explosive, for different reasons. Circumcising infants would only have an effect on HIV prevalence in the next generation. By the time that the infants become sexually active, the landscape of HIV/AIDS may have changed: perhaps there will be more effective means of prevention, perhaps there will be a cure, perhaps there will be a vaccine. Importantly, infants are in no position to give informed consent: there are strong arguments in favor of allowing persons to choose for themselves in such a case. It is also not clear how the public health approach in Zimbabwe relates to traditional male circumcision practices, nor how the intervention is going to be 'sold' to parents in communities who do not traditionally circumcise. Worries about circumcised men feeling more protected than they really are abound. And as for the newborn circumcision policy: recommended circumcision? Incentivized circumcision? Mandatory circumcision? So this is very much a work in progress, and we will see where it goes.