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A meta-analysis by Van Howe of 109 populations confirms the well-known association of male circumcision (MC) with reduced HIV prevalence. He then performed meta-regression adjusting for location, risk and MC prevalence. When one or two of these adjustments in combination were applied MC appeared protective, but when all three were introduced the association remained significant in high-risk populations, but not in general populations within Africa with a hypothetical MC prevalence of

Birth registration imposes major challenges in developing countries, with importance to rights, health and all levels of development. Despite targeted initiatives, often with focus on improved access and information, universal registration has been elusive. Using cross-sectional survey from Kenya, we provide new evidence for why parents may not register. We report high awareness, low barriers – however with over 50 per cent of children unregistered. We argue this is due to deliberate, informed choice by parents where they weigh perceived costs/benefits. We recommend new focus on this deliberation and policy piggybacking hospital delivery, vaccination and information and communications technology to re-balance parent decision.

This letter focuses on a debate of whether male circumcision reduces the risk of HIV acquisition in men during heterosexual intercourse. The authors of this letter state that their analysis of the scientific evidence has provided an affirmation on this issue while a previous article stated the contrary. This letter describes the problems in the contrary position in terms of using a one-sided approach and not using high-quality scientific evidence.

This article responds to a recent ‘controversy study’ in Global Public Health by de Camargo et al. directed at three randomised controlled trials (RCTs) of male circumcision (MC) for HIV prevention. These trials were conducted in three countries in sub-Saharan Africa (SSA) and published in 2005 and 2007. The RCTs confirmed observational data that had accumulated over the preceding two decades showing that MC reduces by 60% the risk of HIV infection in heterosexual men. Based on the RCT results, MC was adopted by global and national HIV policy makers as an additional intervention for HIV prevention. Voluntary medical MC (VMMC) is now being implemented in 14 SSA countries. Thus referring to MC for HIV prevention as ‘debate’ and viewing MC through a lens of controversy seems mistaken. In their criticism de Camargo et al. misrepresent and misinterpret current science supporting MC for HIV prevention, omit previous denunciations of arguments similar to theirs, and ignore evidence from ongoing scientific research. Here we point out the flaws in three areas de Camargo et al. find contentious. In so doing we direct readers to growing evidence of MC as an efficacious, safe, acceptable, relatively low cost one-off biomedical intervention for HIV prevention.