Circumcising newborn males cost effective strategy for HIV prevention, Rwandan study finds

Performing circumcisions on newborn boys to lower their risk for HIV infection later in life is more cost-effective than adolescent or adult circumcision, according to researchers at Rwanda's health ministry, Reuters reports. The findings, published in the journal PLoS Medicine, suggest that "the operation, which has been shown to cut dramatically the virus' transmission from women to men, is quicker, simpler and more cost-effective in newborns," the news service writes.

For the study, the researchers analyzed the cost associated with male circumcisions and treating new HIV infections, finding "each newborn male circumcision [MC] would cost $15, while each adolescent or adult operation would cost $59," Reuters writes. "They also found that circumcising male babies would ultimately save more money than it costs, because the operation would prevent HIV infections that are expensive to treat and lead to AIDS, which kills" (Kelland, 1/19).

"The next step for Rwanda is to explore how best to introduce male circumcision at different ages, including the appropriate mass media campaigns," the authors of the study wrote, according to Scientific American. "These types of strategies, they add, should be part of a growing shift from treating HIV as a national emergency to developing a sustainable plan," the magazine adds.

"Rwanda in particular 'may represent a best case scenario for neonatal scale-up in Africa,' wrote Seth Kalichman, a psychologist at University of Connecticut in Storrs, in an accompanying editorial published in the same issue of PLoS Medicine. He reasons that, because more than 90 percent of the country is Christian, and thus not necessarily adverse to circumcision for religious reasons, the potential to expand newborn circumcisions is promising," according to Scientific American (Storrs, 1/19).

According to a PLoS press release, the study authors "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young." The release also includes this quote from Kalichman's commentary, "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa" (1/19).