Male circumsion cut HIV

[toiletmarquis]

Male circumcision 'cuts' HIV risk

Foreskin cells are thought to be more vulnerable to HIV infection
Circumcision can cut the rate of HIV infection in heterosexual men by 50%, results from two African trials show.
The findings are so striking, the US National Institutes of Health decided it would be unethical to continue and stopped the trials early.

It supports a previous South African study which reported similar results.

Experts said it was a significant breakthrough but could not replace standard methods of preventing infection such as condoms.

These findings are of great interest to public health policy makers who are developing and implementing comprehensive HIV prevention programmes

Dr Elias Zerhouni
US National Institutes of Health


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The two trials of around 8,000 men took place in Uganda and Kenya were due to finish in July and September 2007 respectively.

But after an interim review of the data by the NIH Data and Safety Monitoring Board, it was decided to halt the trials as it was unethical not to offer circumcision in the men who were acting as controls.

Bleeding less likely

The trial in Kenya found a 53% reduction in new HIV infections in heterosexual men who were circumcised while the Ugandan study reported a drop of 48%.

Men must not consider themselves protected

Dr Kevin De Cock
World Health Organization

Results last year from a study in 3,280 heterosexual men in South Africa, which was also stopped early, showed a 60% drop in the incidence of new infections in men who had been circumcised.

There are several reasons why circumcision may protect against HIV infection.

Specific cells in the foreskin may be potential targets for HIV infection and also the skin under the foreskin becomes less sensitive and is less likely to bleed reducing risk of infection following circumcision.

When Aids first began to emerge in Africa, researchers noted that men who were circumcised seemed to be less at risk of infection but it was unclear whether this was due to differences in sexual behaviour.

A modelling study done by international Aids experts earlier this year showed that male circumcision could avert about six million HIV infections and three million deaths in sub-Saharan Africa.

A further trial in Uganda to assess the risk of HIV transmission to female partners is due to report in 2008 but the effect among men who have sex with men has not yet been studied.

Implementation

Dr Kevin De Cock, director of the HIV/Aids department of the World Health Organization told the BBC the results were a "significant scientific advance" but were not a magic bullet and would never replace existing prevention strategies.

"We will have to convene a meeting which we hope will happen quite soon to review the data in more detail and have discussions about the implications.

"This is an intervention that must be embedded with all the other interventions and precautions we have. Men must not consider themselves protected. It's a very important intervention to add to our prevention armamentarium."

Dr De Cock said that countries in Africa who wanted to use this approach would still have to decide what age groups to target and there would have to be training and hygienic practices in place.

"This is about as good epidemiological data as we can request. There will be many other research questions about implementation but this is very persuasive."

NIH director Dr Elias Zerhouni said: "Male circumcision performed safely in a medical environment complements other HIV prevention strategies and could lessen the burden of HIV/Aids, especially in countries in sub-Saharan Africa where, according to the 2006 estimates from UNAids, 2.8 million new infections occurred in a single year."

Dr Jeckoniah Ndinya-Achola, co-principal investigator at the University of Nairobi, Kenya said: "The Ministry of Health of the Kenyan government is already holding discussions about how this can be made available. It will need a certain amount of improvement to existing facilities."

But Tom Elkins, Senior Policy Officer at the National AIDS Trust warned: "There is a real danger in sending out a message that circumcision can protect against HIV. This is not the case and could lead to an increase in unprotected sex.

"There is still a long way to go in providing comprehensive prevention programmes in many countries, and resources should go into normalising the use of condoms, which are the most effective method currently available for preventing HIV."

[Faceless]

Haha, quite natural, less skin in the vagina, less chance of getting infected ..... not just HIV, all other STIs ...

[Midnightiger]

Even if circumcison reduces risks of HIV by 90%, the rule still is to always use a condom and don't do raw.

Tiger

Absolutely, but then this always fall o deaf ears ..... I think the thinking is, if everybody use CD with the ger, then she must be clean .... but they donno, if the ger can do raw with you, she can also do raw with others ... and if everybody think the same, everybody would be doing raw

[toiletmarquis]

Condoms with circumsion...it significantly reduces HIV,but still low risk is no risk...

[hollyboy123]

Hi Broz!

Even circucised, U hav to wear codom.

The shaft undergoes some of skin fractures.
And blood is exposed in these parts.
When penetrated these blood would come in contact and get the HIV.

Always wear a condom when HJ BJ and FJ

[cheongsan]

Originally Posted by Faceless

Haha, quite natural, less skin in the vagina, less chance of getting infected ..... not just HIV, all other STIs ...

Don't extend the findings to other STIs, please. The tests only mentioned HIV. Nothing was mentioned about syphilis, genital warts, chancroid, clamydia, gonorrhea, and the likes. A circumcised person will be as likely to contract these STIs as someone who is uncircumcised.

[wodemama]

Originally Posted by toiletmarquis

Condoms with circumsion...it significantly reduces HIV,but still low risk is no risk...

Ya, but the risk is at the lowest. hehehe

[daniely4]

yea, quite interestingly, the USA health authorities view circumcision as a 'vaccine' for HIV, by the claimed 50% reduction in risk, which is almost better than some vaccines for other diseases.

i'm actually seriously considering getting myself circumcised...but already 30....a bit too late maybe.