Prevalence of male circumcision

Export Indicator

Percentage of men 15–49 that are circumcised
What it measures

Progress towards increased coverage of male circumcision

Rationale

Compelling evidence indicates that male circumcision reduces the risk of men heterosexually acquiring HIV infection by approximately 60%. Three randomized controlled trials have shown that male circumcision provided by well-trained health professionals in properly equipped settings is safe and can reduce the risk of acquiring HIV. Other benefits of medical male circumcision include the reduced risk of some other STIs, including human papillomavirus, the cause of cervical cancer. The World Health Organization (WHO) and UNAIDS recommendations emphasize that voluntary medical male circumcision should continue to be provided as an additional efficacious HIV prevention option within combination prevention for adolescents 15 years and older and adult men in settings with generalized epidemics to reduce the risk of heterosexually acquired HIV infection. Voluntary medical male circumcision services should be provided as part of a package of prevention interventions including safer sex education, condom education and provision, HIV testing and linkages to care and treatment, and management of sexually transmitted infections.

Numerator

Number of male respondents aged 15–49 who report that they are circumcised

Denominator

Number of all male respondents aged 15–49 years

Calculation

Numerator/denominator

Method of measurement

Population-based surveys (Demographic and Health Survey, AIDS Indicator Survey, Multiple Indicator Cluster Surveys or other representative survey)

Measurement frequency

Every 3–5 years

Disaggregation
  • Age (15–19, 20–24, 25–29 and 30-49 years)
  • Source or practitioner of circumcision procedure: formal health-care system or traditional
Strengths and weaknesses

A programme may or may not change the rate of male circumcision. For example, changing societal norms not caused by a programme may lead to changing rates of male circumcision. This indicator measures the total change in the population, regardless of the reasons.

Existing population-based surveys (such as Demographic and Health Surveys) may not accurately measure true male circumcision status because people may lack knowledge of what male circumcision is, be confused about their circumcision status or perceive the social desirability of circumcision status. Other approaches to determining circumcision status might be used: for example, using photographs or drawings (drawings may be more culturally appropriate), prompts or even direct examination. Modelling how changing rates of male circumcision can potential affect HIV incidence requires accurate knowledge of male circumcision status over time.

Further information

Preventing HIV through safe voluntary medical male circumcision for adolescent boys and men in generalized HIV epidemics: recommendations and key considerations. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/rest/bitstreams/1296029/retrieve).

A guide to indicators for male circumcision programmes in the formal health-care system. Geneva: World Health Organization and UNAIDS; 2009 (http://whqlibdoc.who.int/publications/2009/9789241598262_eng.pdf).