Male Circumcision Is the "Real-World Equivalent" to an AIDS Vaccine, Opinion Piece Says

Male circumcision in "some ways" is "closer to the fantasy" of "the magic bullet" that would end the HIV/AIDS pandemic than a "real" vaccine might be, and it "would be given more weight if the world recognized that it is, in fact, the real-world equivalent of an AIDS vaccine," Tina Rosenberg, a contributing writer for New York Times Magazine, writes in an opinion piece. Last month, two NIH studies "confirm[ed] ... what scientists had long suspected: circumcision helps protect men from" HIV transmission, Rosenberg writes (Rosenberg, New York Times Magazine, 1/14). The studies, which took place in Kenya and Uganda, found that routine male circumcision could reduce a man's HIV infection risk through heterosexual sex by about 50%. 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 infection. All participants in both studies received counseling on HIV risk reduction and were advised to use condoms. The results of the studies were so overwhelming that NIH stopped the trials early and offered circumcision to all participants. 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 (Kaiser Daily HIV/AIDS Report, 12/14/06). According to Rosenberg, men must be encouraged to come to clinics, countries will need to equip clinics and train counselors and medical professionals, and the procedure must be provided at no cost. Circumcision and a vaccine with an efficacy rate of 50% to 60% "might be enough to stop AIDS," but "behavior change, microbicides, fighting malaria, treating genital herpes and other interventions we don't even know about yet" also must be implemented to help curb the pandemic, Rosenberg writes. "Research on an AIDS vaccine is more crucial than ever," Rosenberg writes, adding, "But we must not let our hope for a thunderbolt prevent us from racing ahead with circumcision now." She concludes, "For the biggest difference between circumcision and a vaccine is this: only one of them exists" (New York Times Magazine, 1/14).

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