'The illusive promise of circumcision to prevent female-to-male HIV infection – not the way to go for South Africa'

Medical journal article here. Excerpt:

'That was before the three RCTs, publication of which has led to the current drive to inflict mass circumcision on southern African men. Circumcision intervention has now been embraced by the WHO, the Centers for Disease Control, other health-based organisations and some researchers. Even the MRC has since reversed its position, with lead researcher Siegfried declaring on 15 April 2009 that ‘Research on the effectiveness of male circumcision for preventing HIV in heterosexual men is conclusive. No further trials are required to establish that HIV infection rates are reduced in heterosexual men for at least the first two years after circumcision.’

However, the three RCTs have not been without detractors. ... They conclude from their recalculations and statistical reasoning that ‘Conservatively for the three trials, 89 of the 205 infections (43.1%) were sexually transmitted. Without knowing which infections were sexually transmitted [and which were not], it is impossible to test the hypothesis of whether circumcision reduces the rate of sexually transmitted HIV.’
...
Several authors have pointed out as well that, without field testing, it is impossible to predict the applicability and repeatability of the RCT findings in real-world situations. ... On the other hand, the Western Cape, with a spotty circumcision tradition, has the lowest prevalence (6%) in the country, almost half that of the EC (ASSA2003 Projections for 2010). According to one nationwide demographic survey,10 12.3% of circumcised men were HIV-positive, and 12.0% of intact men were similarly HIV-positive...Within the USA, black Americans have the highest rate of circumcision and the highest rate of heterosexually transmitted HIV. These data certainly show no distinct pattern relative to circumcision and the risk of HIV infection.'