Department of Urology, School of Medicine, University of Washington, Seattle, WA 98195, USA.
World J Urol. 2012 Feb;30(1):3-13. doi: 10.1007/s00345-011-0696-x. Epub 2011 May 18.
Male circumcision is being promoted to reduce human immunodeficiency virus type 1 (HIV) infection rates. This review evaluates the scientific evidence suggesting that male circumcision reduces HIV infection risk in high-risk heterosexual populations.
We followed the updated International Consultation on Urological Diseases evidence-based medicine recommendations to critically review the scientific evidence on male circumcision and HIV infection risk.
Level 1 evidence supports the concept that male circumcision substantially reduces the risk of HIV infection. Three major lines of evidence support this conclusion: biological data suggesting that this concept is plausible, data from observational studies supported by high-quality meta-analyses, and three randomized clinical trials supported by high-quality meta-analyses.
The evidence from these biological studies, observational studies, randomized controlled clinical trials, meta-analyses, and cost-effectiveness studies is conclusive. The challenges to implementation of male circumcision as a public health measure in high-risk populations must now be faced.
男性割礼被推广以降低人类免疫缺陷病毒 1 型（HIV）的感染率。本综述评估了科学证据，表明男性割礼可降低高风险异性恋人群的 HIV 感染风险。
我们遵循国际泌尿外科学会更新的循证医学建议，对男性割礼和 HIV 感染风险的科学证据进行批判性评估。
一级证据支持男性割礼可显著降低 HIV 感染风险的概念。有三条主要证据支持这一结论：生物学数据表明这一概念是合理的，高质量荟萃分析支持的观察性研究数据，以及高质量荟萃分析支持的三项随机临床试验。
这些生物学研究、观察性研究、随机对照临床试验、荟萃分析和成本效益研究的证据是结论性的。现在必须面对在高风险人群中实施男性割礼作为公共卫生措施的挑战。
