Male circumcision may reduce chance of contracting HIV

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February 27, 2007

1:42 PM

The arsenal for fighting one of human health’s biggest challenges became a little bit stronger this month. Recent studies have shown that male circumcision can reduce a man’s chances of contracting the HIV virus from heterosexual intercourse by almost 65 percent. Research from two clinical trials in Africa were published in the Lancet, a British medical journal, this month. The studies, conducted in Kenya and Uganda, compared men who agreed to undergo circumcision with those who decided to forego the procedure.

p. It is currently estimated that 40 million men, women and children are currently living with HIV/AIDS, according to the UNAIDS website. Almost 5 million more people are added to that list annually, the majority living in sub-Saharan Africa.
In 2005, the death toll from the virus measured above 3 million. Massive global efforts to prevent and treat the disease are expensive and complicated.

p. The National Institute of Allergy and Infectious Diseases sponsored the studies. “[Circumcision] is a one-time, permanent intervention that’s safe when done under the appropriate medical conditions. If we had an AIDS vaccine that was performing as well as this, it would be the talk of the town,” the Institute’s director, Dr. Anthony S. Fauci, told the New York Times.

p. The studies were closed early because the researchers saw such a clear correlation in their data analysis that it was deemed unethical to continue keeping the men in the control group uncircumcised when the procedure could protect them from infection.

p. More than 2,500 young men participated in the study in regions where more than a quarter of the traditionally uncircumcised men are HIV-positive. All of the men in the study received HIV/AIDS educational information, testing and condoms in addition to undergoing the actual operation. Condom use increased almost equally in both groups of participants.

p. Some critics of the study point to the fact that the sample was in some ways not randomized — men could volunteer for the procedure or refuse it. Critics argue that perhaps the men open to the idea of circumcision were also the men more actively concerned with HIV prevention in other aspects of their sexual health decisions.

p. While this is a potentially viable criticism of the study, and one that merits further research, the conclusions drawn from the large sample of men seem to be more than significant.
Several health officials have stressed that circumcision should not be viewed as the perfect solution. Dr. Robert Bailey, a lead investigator in the study, told ScienceDaily that their findings are not a cure-all.

p. “Circumcision is by no means a natural condom,” Bailey said. “We do know that some circumcised men become infected with HIV.”

p. Currently, the United States’ global HIV/AIDS focus uses the Bush Administration’s “ABC” plan. “Abstinence” is the first focus, followed by “Being Faithful” with “Condom distribution” ranking third. This policy has been criticized by many for being out of touch with the reality of the sexual practices and patterns of the societies most at risk for HIV/AIDS.

p. Increased education for men, as well as accessible options such as professional circumcision by a well-equipped, trained hospital staff, is expected to play a large role in reducing overall transmission rates. A portion of President Bush’s new $15 billion AIDS initiative could be allocated toward circumcision programs based on the results of this study, according to the New York Times.

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