Male circumcision may be associated with a lower risk of HIV infection in clinical trials, but researchers describe its high rate of side effects in a real-world setting as “shocking” and “unacceptable.” The alarming findings from a survey of 1,007 boys and young men, conducted in the Bungoma district of western Kenya by Robert C. Bailey, PhD, of the University of Illinois at Chicago School of Public Health and his colleagues, were reported in the September 2008 issue of the Bulletin of the World Health Organization and have been summarized in an article from aidsmap.com.

Surgical side effects, including damage to the penis, infections and delayed healing, occurred in 18 percent of the 445 Kenyan boys and young men who underwent medically performed circumcisions and 35 percent of the 562 male patients who underwent traditional circumcisions conducted by non-medical practitioners. Permanent adverse effects—including bending (torsion) of the penis, injuries to the head (glans) of the penis and loss of penile sensitivity—occurred in 6 percent of all circumcised individuals who participated in the study.

The rate of side effects observed in the study are significantly higher than those seen in controlled clinical trials of male circumcision, as well as in those supervised medical procedures conducted in industrialized nations. Stressing that “the levels of morbidity and mortality from circumstances documented as occurring in this study community are unacceptable,” the authors strongly recommend training practitioners, providing low-cost kits of circumcision materials and integrating circumcision into a full complement of HIV prevention and reproductive health services.