Two-drug antiretroviral treatment of mothers during labour (or starting before labour) and of mothers and infants for 1 week after delivery reduces HIV-1 transmission in the first 6 weeks but has little effect on HIV-1 infection rates by age 18 months (

). But this approach to the problem of mother-to-child transmission may be outdated. A commentator (ibid: 1168–9) suggests that such treatments may induce drug resistance and make later treatment of the mother ineffective. Reductions in cost have made three drug combination treatments feasible for poor countries and in future the best way of preventing transmission may be effective treatment of the mother. Two drug short course regimens may prevent transmission but make orphans of the children.

It has been recognised for a long time that male circumcision may reduce the risk of cervical cancer in female partners. It now seems almost certain that the relevant male factor is penile human papillomavirus (HPV) infection. Data from seven case control studies in five countries (

) have shown that circumcised men are 63% less likely to have penile HPV infection. There was a 58% reduction in risk of cervical cancer in the current partners of circumcised men compared with those of uncircumcised men but only if the male partner reported having had at least six lifetime female sexual partners. Whether all this is a reason to promote routine neonatal circumcision …