Issues arising from lobby of UN to outlaw circumcision [letter]

Hopkins Tannes news item on a US group lobbying the UN to outlaw circumcision conflates two unrelated stories into one. The first is Hesss call for UN action to declare male circumcision a human rights violation the second the self described randomised controlled trial of circumcision by Auvert et al to prevent transmission of HIV from women to men. The Wall Street Journal reports that the Lancet refused to print this report so only the scant information from the abstract is available. The private peer review at the Lancet that resulted in a refusal to print the article is not encouraging and public scrutiny is therefore speculative. Several observations however are possible from the abstract. The study purports to be a randomised controlled trial yet the men were not selected at random. Auvert et al eliminated those men who were not willing to be circumcised so selection has entered into the picture. The Auvert study claims circumcision reduces but does not eliminate infection with HIV. The authors terminated the study early. Had the study continued for its planned length it would probably have shown that circumcision merely delays infection. (excerpt)