IT HAS been labelled the cruellest cut of all but HIV experts are calling for a return to routine male circumcision in Australia to help curb transmission of the virus into the future.

Alex Wodak, a physician who has worked on HIV since it was identified in the 1980s, has called for parents to be educated about the benefits of circumcision after research showed it reduced the likelihood of transmission between heterosexuals in Africa.

"This is an intervention which is effective, inexpensive, lifelong, safe and could dramatically alter the course of an epidemic," said Dr Wodak, who is also director of the Alcohol and Drug Service at St Vincent's Hospital in Sydney.

"It's been estimated by mathematical modelling that if the whole of Africa had high levels of male circumcision at the start of the AIDS epidemic, there would have been 5.7 million fewer cases of HIV alone."

Although circumcision has become unfashionable and even considered child abuse in some circles, Dr Wodak said government departments and health professionals should encourage the circumcision of infant males in Australia as the number of heterosexual transmissions of HIV had increased in recent years.

"Male homosexual transmissions have declined from almost 90 per cent in the early years to 64 per cent, and they continue to fall," Dr Wodak said.

"The same is true in Europe and North America. We have to try to anticipate the threats Australia will be exposed to from HIV, not just for 2009 but for 2029, too."

Dr Wodak said that if the results of 38 studies, mostly from Africa, were combined, circumcised men were half as likely to contract HIV as uncircumcised men. He said three studies comparing more than 11,000 circumcised and uncircumcised men in South Africa, Kenya and Uganda were recently terminated early because such a large protective effect was found in circumcision. The researchers believed it was unethical to continue and leave some participants uncircumcised.

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