Routine Male Circumcision Could Reduce a Man's HIV Transmission Risk by About 50 Percent, According to Studies Conducted in Kenya, Uganda
December 14, 2006
Routine male circumcision could reduce a man's HIV transmission risk through heterosexual sex by about 50%, according to data from two studies conducted in Kenya and Uganda released Wednesday by NIH, the New York Times reports (McNeil, New York Times, 12/14). Researchers monitored 4,996 men ages 15 to 49 living in Uganda and 2,784 men ages 18 to 24 living in Kenya -- half of whom were randomly assigned to be circumcised and the other half served as a control group -- to determine if circumcision reduced HIV transmission, the Los Angeles Times reports. According to the Times, all participants in both studies received counseling on HIV risk reduction and were advised to use condoms (Maugh, Los Angeles Times, 12/14). According to researchers, male circumcision eliminates the cells most vulnerable to HIV. In addition, a circumcised penis develops thicker skin that is resistant to HIV transmission, the Washington Post reports. Many African tribes used to perform ritual male circumcisions when adolescent boys became men, but the practice in recent years has declined, according to the Post. African countries with low male circumcision rates -- including Botswana, South Africa, Swaziland and Zimbabwe -- have the highest HIV prevalence, compared with West Africa, where male circumcision is a common practice and HIV prevalence is lower, the Post reports. The Uganda study found 43 cases of HIV among the uncircumcised men, compared with 22 among the circumcised men -- a 48% reduction of HIV transmission. The Kenya study found 47 cases of HIV among uncircumcised men, compared with 22 among the circumcised men -- a 53% reduction. According to the Post, the results of the studies were so overwhelming that NIH stopped the trials early and offered circumcision to all participants (Timberg, Washington Post, 12/14). The researchers also found no evidence that the circumcised men in the studies adopted higher-risk sexual behaviors, including sex with multiple partners and unprotected sex (Smith, Boston Globe, 12/13).
South Africa Study
Implications, Reaction, Next Steps
The results of the male circumcision studies might be "the most important development in AIDS research since the debut of antiretroviral drugs," and groups such as UNAIDS and WHO should "move as quickly as possible" to determine how best to promote the procedure in developing countries, a New York Times editorial says. Donors also should "work urgently to provide new financing to help high-risk countries train community workers to do safe circumcision," the editorial adds. According to the editorial, HIV prevention efforts until now have "largely failed" because they "requir[e] people to resolve every day either not to have sex or to use condoms"; however, circumcision is a "one-time procedure" that is "familiar and widely accepted" worldwide. The editorial notes that any campaign to promote circumcision must be "coupled with warnings" that the procedure offers "only partial protection against HIV and should not become a license for risky sex." For years, the "holy grail of AIDS prevention has been a vaccine," but with the release of the study, "we know [a vaccine's] near equivalent exists," the editorial says, concluding, "International donors and governments should join together to spread the good news about circumcision and make the procedure available everywhere" (New York Times, 12/14).
New Jersey Legislature's Approval of Measure That Would Establish Needle-Exchange Programs in Six Cities "Significant Public Health Victory," Editorial Says
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.