[Actual controversies about circumcision]

[Forensic issues raised by circumcision: Review and case report]

Circumcision is defined as the partial or total excision of the prepuce. It is one of the most frequently performed surgical procedures around the world. This practice primarily involves minors. The aim of this study was to review the legal aspects of ritual circumcision in France. We report the cases of an 11-year-old and a 15-year-old boy examined in the forensic unit at the Hôtel-Dieu hospital in Paris, after their father complained to the Minors Protection Brigade of Paris following the discovery of their circumcision. The examination conducted in the forensic unit found that the two boys had undergone recent circumcision. The total incapacity of work (ITT) was assessed as 5 days for the 15-year-old boy and 1 day for the 11-year-old boy. Ritual "medicalized" circumcision is legal in France, and does not fall under article 222-1 of the Criminal Code (torture and acts of barbarism) or article 16-1 of the Civil Code (inviolability of the human body). Circumcision is treated as a "serious act" by several areas of jurisprudence, which means it is imperative to obtain the consent of both parents. Moreover, it must be performed in a hospital by knowledgeable staff.

Male circumcision for protection against HIV infection in sub-Saharan Africa: the evidence in favour justifies the implementation now in progress

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 doing so, we direct readers to growing evidence of MC as an efficacious, safe, acceptable, relatively low-cost one-off biomedical intervention for HIV prevention.