Circumcision could hold key to the fight against HIV

By Henry neondo, Rio de Janeiro

Male circumcision significantly reduces the chances of female-to-male transmission of the AIDS virus, according to a new study, French researchers announced Tuesday.

A South African study of more than 3,000 men by the French agency for Aids and Viral Hepatitis and released at the 3rd International Aids Society conference currently taking place shows male circumcision prevented about seven of 10 infections.

But the UN health agencies are cautious and call for more trials before they could recommend this as a method against HIV and Aids.

The study found that circumcision reduced the risk of men contracting AIDS during heterosexual intercourse by about 65 percent.

"There had always been a suspicion that male circumcision prevented AIDS ... but this is the first randomized study using control trials," said Dr. Bertrand Auvert, who coordinated the study for France's National AIDS Research Agency.

The study was conducted between 2002 and 2005 in males aged between 18-24 years and all healthy, sexually active in Orange Farm, South Africa, where about 32 percent of the female population was HIV positive.

For the study, about half of the subjects were circumcised by medical professionals, and the rest remained uncircumcised.

All of the men received counseling on AIDS prevention. But after 21 months, 51 members of the uncircumcised group had contracted HIV, the AIDS virus, while only 18 members of the circumcised group had gotten the disease.
Circumcision "prevented six to seven out of 10 potential HIV infections," said Auvert.

But he added that the study did not analyze the effect of circumcision on male-to-female transmission or if circumcision provides effective protection over the long term. At least three more studies are under way to confirm the effectiveness of circumcision.

Previous studies have suggested that men who are circumcised have a lower rate of HIV infection.

It is thought that the cells of the foreskin are much more susceptible to HIV than cells on other parts of the penis, so by removing the foreskin, the likelihood of infection drops.

Just to be sure, a study funded by the U.S. National Health Institute involving 5,000 individuals is currently under way in Uganda. These studies follow previous work done in Kisumu Kenya that aimed to measure the effect of circumcision on populations. Scientists expect to announce the results only in early 2007.

Catherine Hankins, chief scientific adviser to UNAIDS, said that it was still too early to encourage widespread circumcision as a way to prevent the spread of AIDS. And she said many men would resist circumcision, even if other studies confirmed the findings.

"We know this is a sensitive issue, and I don't just mean biologically," Hankins said.


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