Circumcision could save millions from AIDS: studies

SYDNEY Tue Jul 24, 2007 11:06am EDT

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SYDNEY (Reuters) - Millions of new HIV infections in Africa could be avoided if more men were circumcised, an International AIDS Society conference was told on Tuesday.

Studies in Africa have found that male circumcision, the world's oldest surgical procedure dating back to 2300 BC, reduces HIV transmission from females to males by 60 percent.

Universal circumcision could avert 2 million new infections and 300,000 deaths in sub-Saharan Africa over 10 years, said Professor Robert Bailey from the School of Public Health at the University of Illinois in Chicago.

"If we had a vaccine that was 60 percent protective we would be very happy and rolling it out as fast as possible," Bailey told the IAS conference in Sydney.

"But no one stands to profit from male circumcision -- no one but the 4,000 in Africa who will be infected tomorrow."

Africa is the epicenter of the AIDS epidemic. South Africa has an estimated 5.5 million people with HIV and is struggling to stem the spread of the disease in the general population.

But African nations such as Cameroon and Nigeria, where circumcision is common, have a much lower rate of HIV infection than Zimbabwe and Swaziland where there is little circumcision.

The idea of using circumcision as a weapon against AIDS emerged after studies in Uganda, Kenya, Malawi, Zambia and the United States found the potential to significantly reduce infections, said Bailey, adding the World Health Organisation has now endorsed circumcision as a disease prevention method.

"The challenge ahead for us is how to roll out circumcision safely ... and to persuade leaders in countries that it is going to help their populations," Bailey told a news conference.

"Circumcision is not just simply a surgical procedure. Its tied up in a complex web of cultural and religious practices and beliefs," he added.

"It's not easy for politicians and ministers of health to quickly come out in favor of circumcision in countries where circumcision is not traditionally practiced."

Bailey said aid organizations would not offer the service until local governments endorsed it, for fear of being seen as culturally insensitive.

WOMEN BACK CIRCUMCISION

Women in African nations are expected to be the drivers behind using circumcision to stop HIV infection as they are traditionally associated with ensuring hygiene in communities.

"Women, more than men, equate circumcision with improved hygiene," said Bailey.

"It's often up to women to provide the water, the soap and the materials for men to bathe and cleanse themselves. Many of the women complain the men are not as clean as they could be."

Circumcision should not be seen by men as their only preventative measure against HIV and must still be combined with safe sex practices. Condom use should still be encouraged.

"It's very important not to view this as a standalone surgical procedure," said Bailey.

Many Africans were already seeking circumcision to try and stop the spread of HIV, but many were suffering medical complications because of poor procedures.

There also was some evidence that circumcision may help prevent infection between homosexual men, with one study in Uganda showing a 30 percent reduction in infection.

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