2008 International AIDS Conference

Circumcision is Cutting-Edge HIV Prevention Tool

By Kenneth Miller

MEXICO CITY -- Multiple studies conducted by prominent authorities in the medical field conclude that male circumcision is an effective preventive tool against HIV infections, it was announced at the International AIDS Conference in Mexico City. Speaking to a packed audience at Centro Banamex, Fredrick Sawe, deputy director of Kenya Medical Research Institute/Walter Reed Project HIV Program in Kericho, shared research on circumcision that mirrored similar findings shared by three other experts.

According to the study, males between the ages of 15-49 who became circumcised were 51 to 76 percent less likely to be infected with HIV.

Sawe’s research was conducted in six districts, covering 11 locations and 172 villages; it indicated that areas with a high circumcision uptake represented opportunities for HIV prevention and sex education.

In nearly all of the studies, male reduction rates reached at least 50 percent in heterosexuals.

Because the studies were conducted in nations that did not include African American males or discuss how it applies to women, it is not known what impact, if any circumcision would have against HIV in the United States.

Circumcision is the surgical removal of the skin that covers the tip of the penis, usually performed on males shortly after birth. It is part of Jewish and Muslim religious rites. Though common in the U.S., the procedure is no longer recommended by physicians as a medical necessity.

Some experts said they worry that touting circumcisions as protection against HIV might be misinterpreted by some men as freeing them from the need to practice safe sex. If that happens, HIV infections might go up, not down.

While experts warned that circumcision is not the “silver bullet” in prevention treatment for HIV, it offered an optimistic view in the HIV puzzle.

Richard White of the London School of Hygiene and Tropical Medicine provided the theory that circumcision could also halve the susceptibility to such sexually transmitted diseases as chancroid.

“Male circumcision is important in explaining the heterogeneous spread of HIV in Africa,” White noted. The cost was about $50 per patient in South Africa, Kenya and Uganda, according to White.

The multiple studies also indicated that there was very little difference in penile erection, sexual performance or sexual pleasure in males who were circumcised and those who were not. A surprise finding was that many men in South Africa did not know whether they had been circumcised.

Nicolai Lohse of UNAIDS, suggested that male circumcision be recognized as an important strategy for prevention of heterosexually acquired HIV infection in men. She said one HIV infection could be averted for every five to 15 male circumcisions.

Additionally, the World Health Organization (WHO) and UNAIDS recommend that male circumcisions be included as part of any HIV prevention strategy.