With an estimated 8.5 million seropositive citizens, India is beginning to face an HIV crisis of sub-Saharan African proportions, and some public health officials fear that India has already lost the opportunity to stave off the pandemic. But in India, where even medical reports are saturated with political overtones, suggestions from public health officials that circumcision may help prevent HIV are generating heated controversy. Muslims, excited that a critical cultural practice may also be at the forefront of HIV prevention, may be over-stressing or misinterpreting the importance of recent medical research. Hindus, on the other hand, for whom circumcision is strictly taboo, have accused public health officials of unwanted cultural interference, privately and publicly suggesting that researchers may be practicing questionable science. When medicine and religion clash at waist level, how can public health officials remain culturally sensitive while holding fast on issues of medical importance?

The current circumcision controversy in India stems in part from a March 2004 Lancet article based on a study conducted by researchers from Johns Hopkins University and the National AIDS Research Institute. Their seven-year longitudinal study monitored 2298 Indian men, all of whom began their participation with seronegative status. Most of the men who were circumcised were Muslim, and most uncircumcised men were Hindu. At the end of the seven years, the American and Indian researchers turned their attention towards sexually transmitted diseases (STDs) and discovered that, after adjusting for behavioral and socio-demographic risk factors, uncircumcised men were six to seven times more likely to have contracted HIV-1, the most common strain of HIV, than their slightly lighter counterparts.