Voluntary Medical Male Circumcision to Reduce HIV Acquisition and Transmission.

Purpose of review: This commentary introduces the special Global Health Section on the state of voluntary medical male circumcision (VMMC) programs and current knowledge as to role of VMMC prevention of HIV infection acquisition in men and, indirectly, women.

Recent findings: Since the first clinical trial of VMMC in Africa was published in 2005, implementation of programs has depended on illuminating best practices and key obstacles in the effort to expand VMMC in areas of high HIV prevalence to reduce HIV acquisition among men, with consequent benefits that uninfected men will not infect others. Global efforts are focused on sub-Saharan Africa, given the favorable expected impact of VMMC deployment where HIV incidence is high and circumcision rates are low. With estimated field effectiveness estimated to exceed 60%, reduced HIV risk for circumcised men in sub-Saharan Africa based on a once-only minor surgical intervention provides extraordinary preventive benefits. Where high VMMC rates have been achieved, declining HIV incidence rates may be partially or substantially attributed to VMMC, but this remains to be investigated. Articles in this special section address achievements, obstacles and risks, and plans for future progress in partnership with affected communities.