Male Circumcision: Another HIV Prevention Method Competing for Limited Funding?

Washington, DC - April 30, 2007

Male circumcision, which has been shown to reduce a man’s risk of contracting HIV by up to 65%, should be made available in countries highly affected by AIDS, according to the WHO and UNAIDS. Used in addition to other proven HIV prevention methods – especially those focused on protecting women – circumcision is proving to be another effective weapon to fight the spread of HIV; the latest tool in a growing arsenal of prevention methods that will face limited prevention resources due to the large abstinence-until-marriage spending requirement in PEPFAR. This earmark should be repealed to give countries that have the most to gain by promoting circumcision adequate resources with which to support this effort.

For male circumcision to make the largest impact in curbing the spread of HIV/AIDS, it must be part of a broader campaign to prevent infection. The WHO and UNAIDS have recommended that the procedure be offered in conjunction with other prevention programs, including promotion of safer sex practices and condom distribution. Because male circumcision has not been shown to be an effective protective measure for women, it is crucial that it not replace elements of prevention that are geared toward stemming the skyrocketing HIV infection rates in women. Male circumcision’s impact on HIV prevention offers exciting new possibilities for saving lives, but a procedure that can only help half of the population is not enough. It must be part of a comprehensive prevention program that empowers both men and women with the ability to protect themselves in the best ways possible.

Comprehensive, evidence-based approaches to HIV prevention are the most effective in curbing the spread of HIV, but they are also extremely hindered by the abstinence-until-marriage spending requirement in PEPFAR. By limiting the percentage of prevention funding that can be spent outside of abstinence-until-marriage programs, PEPFAR constrains countries’ ability to design programs tailored to their country needs, putting those programs most likely to work out of reach of the people who need them. As new prevention methods are discovered, including male circumcision and microbicides, the abstinence-until-marriage spending requirement forces them to compete against one another for an ever-shrinking supply of funds.

PAI urges Congress to pass the PATHWAY Act that would overturn the abstinence-until-marriage earmark in PEPFAR. When the U.S. is ready to support male circumcision and other evidence-based prevention methods – and we hope that will be soon - it must do so with adequate resources.

Population Action International (PAI) works to improve individual well-being and preserve global resources by mobilizing political and financial support for population, family planning and reproductive health policies and programs.