Briar Rabbit
October 20th 05, 05:45 AM
Halting the spread of AIDS
The New York Times
MONDAY, OCTOBER 17, 2005
For years, doctors and policy makers have suspected that male
circumcision is a powerful protector against AIDS. Now, a new study in
South Africa has found that circumcision reduced mens' risk for HIV
infection by more than 65 percent. If the results are confirmed by two
similar studies in progress, circumcision may offer a way to curb the
AIDS explosion in some of the most affected countries.
Researchers have long noted that in Africa, Muslim countries where males
are routinely circumcised have much lower HIV infection rates than
Christian ones. But other factors could have mattered, such as Islam's
prohibition on drinking alcohol, which could reduce risky behavior.
But the South Africa study is the first to offer a high scientific
standard of evidence that circumcision is responsible. The study,
carried out by French and South African researchers, recruited young men
who were HIV-negative and uncircumcised, as are most men in South
Africa. Half were randomly assigned to be circumcised. After adjustment
for other factors, circumcision produced a two-thirds reduction in the
risk of HIV infection after 21 months. The difference was so great that
the trial was stopped and the other men immediately offered
circumcision. Two studies similar in design but working with very
different groups of people are under way in Uganda and Kenya. But it may
be two years before they can show results.
Circumcision is effective because the foreskin of the penis contains
cells that are particularly receptive to the AIDS virus. The studies are
only looking at whether circumcision protects men from becoming
infected. Circumcised men may also be less likely to transmit the virus
to their sexual partners, but that is a much harder question to research
and the current studies are not examining it. But even if circumcision
doesn't make a man less contagious, it helps protect everyone by
lowering the chance that males are infected.
If the Kenya and Uganda studies confirm the South Africa results, AIDS
policy makers should immediately begin discussing how best to promote
circumcision. While it is no easy sell, the operation is at least widely
performed. Circumcision at puberty is a common traditional ritual in
Africa. The vast majority of circumcisions in Africa are performed
without sterile instruments or anesthesia, so it will be important to
provide training and equipment so the operation does not become a source
of infection. There is also the challenge of fighting complacency;
circumcised men must be taught that they cannot abandon safe sex.
If an AIDS vaccine were discovered today that could prevent 6 to 7 of
every 10 potential new HIV infections, it would be heralded as a triumph
of mammoth importance. The results from Uganda and Kenya are necessary
before anyone can declare that circumcision is the equivalent. But
policy makers should be getting ready if the news is good.
For years, doctors and policy makers have suspected that male
circumcision is a powerful protector against AIDS. Now, a new study in
South Africa has found that circumcision reduced mens' risk for HIV
infection by more than 65 percent. If the results are confirmed by two
similar studies in progress, circumcision may offer a way to curb the
AIDS explosion in some of the most affected countries.
Researchers have long noted that in Africa, Muslim countries where males
are routinely circumcised have much lower HIV infection rates than
Christian ones. But other factors could have mattered, such as Islam's
prohibition on drinking alcohol, which could reduce risky behavior.
But the South Africa study is the first to offer a high scientific
standard of evidence that circumcision is responsible. The study,
carried out by French and South African researchers, recruited young men
who were HIV-negative and uncircumcised, as are most men in South
Africa. Half were randomly assigned to be circumcised. After adjustment
for other factors, circumcision produced a two-thirds reduction in the
risk of HIV infection after 21 months. The difference was so great that
the trial was stopped and the other men immediately offered
circumcision. Two studies similar in design but working with very
different groups of people are under way in Uganda and Kenya. But it may
be two years before they can show results.
Circumcision is effective because the foreskin of the penis contains
cells that are particularly receptive to the AIDS virus. The studies are
only looking at whether circumcision protects men from becoming
infected. Circumcised men may also be less likely to transmit the virus
to their sexual partners, but that is a much harder question to research
and the current studies are not examining it. But even if circumcision
doesn't make a man less contagious, it helps protect everyone by
lowering the chance that males are infected.
If the Kenya and Uganda studies confirm the South Africa results, AIDS
policy makers should immediately begin discussing how best to promote
circumcision. While it is no easy sell, the operation is at least widely
performed. Circumcision at puberty is a common traditional ritual in
Africa. The vast majority of circumcisions in Africa are performed
without sterile instruments or anesthesia, so it will be important to
provide training and equipment so the operation does not become a source
of infection. There is also the challenge of fighting complacency;
circumcised men must be taught that they cannot abandon safe sex.
If an AIDS vaccine were discovered today that could prevent 6 to 7 of
every 10 potential new HIV infections, it would be heralded as a triumph
of mammoth importance. The results from Uganda and Kenya are necessary
before anyone can declare that circumcision is the equivalent. But
policy makers should be getting ready if the news is good.
http://www.iht.com/articles/2005/10/17/opinion/edaids.php
The New York Times
MONDAY, OCTOBER 17, 2005
For years, doctors and policy makers have suspected that male
circumcision is a powerful protector against AIDS. Now, a new study in
South Africa has found that circumcision reduced mens' risk for HIV
infection by more than 65 percent. If the results are confirmed by two
similar studies in progress, circumcision may offer a way to curb the
AIDS explosion in some of the most affected countries.
Researchers have long noted that in Africa, Muslim countries where males
are routinely circumcised have much lower HIV infection rates than
Christian ones. But other factors could have mattered, such as Islam's
prohibition on drinking alcohol, which could reduce risky behavior.
But the South Africa study is the first to offer a high scientific
standard of evidence that circumcision is responsible. The study,
carried out by French and South African researchers, recruited young men
who were HIV-negative and uncircumcised, as are most men in South
Africa. Half were randomly assigned to be circumcised. After adjustment
for other factors, circumcision produced a two-thirds reduction in the
risk of HIV infection after 21 months. The difference was so great that
the trial was stopped and the other men immediately offered
circumcision. Two studies similar in design but working with very
different groups of people are under way in Uganda and Kenya. But it may
be two years before they can show results.
Circumcision is effective because the foreskin of the penis contains
cells that are particularly receptive to the AIDS virus. The studies are
only looking at whether circumcision protects men from becoming
infected. Circumcised men may also be less likely to transmit the virus
to their sexual partners, but that is a much harder question to research
and the current studies are not examining it. But even if circumcision
doesn't make a man less contagious, it helps protect everyone by
lowering the chance that males are infected.
If the Kenya and Uganda studies confirm the South Africa results, AIDS
policy makers should immediately begin discussing how best to promote
circumcision. While it is no easy sell, the operation is at least widely
performed. Circumcision at puberty is a common traditional ritual in
Africa. The vast majority of circumcisions in Africa are performed
without sterile instruments or anesthesia, so it will be important to
provide training and equipment so the operation does not become a source
of infection. There is also the challenge of fighting complacency;
circumcised men must be taught that they cannot abandon safe sex.
If an AIDS vaccine were discovered today that could prevent 6 to 7 of
every 10 potential new HIV infections, it would be heralded as a triumph
of mammoth importance. The results from Uganda and Kenya are necessary
before anyone can declare that circumcision is the equivalent. But
policy makers should be getting ready if the news is good.
For years, doctors and policy makers have suspected that male
circumcision is a powerful protector against AIDS. Now, a new study in
South Africa has found that circumcision reduced mens' risk for HIV
infection by more than 65 percent. If the results are confirmed by two
similar studies in progress, circumcision may offer a way to curb the
AIDS explosion in some of the most affected countries.
Researchers have long noted that in Africa, Muslim countries where males
are routinely circumcised have much lower HIV infection rates than
Christian ones. But other factors could have mattered, such as Islam's
prohibition on drinking alcohol, which could reduce risky behavior.
But the South Africa study is the first to offer a high scientific
standard of evidence that circumcision is responsible. The study,
carried out by French and South African researchers, recruited young men
who were HIV-negative and uncircumcised, as are most men in South
Africa. Half were randomly assigned to be circumcised. After adjustment
for other factors, circumcision produced a two-thirds reduction in the
risk of HIV infection after 21 months. The difference was so great that
the trial was stopped and the other men immediately offered
circumcision. Two studies similar in design but working with very
different groups of people are under way in Uganda and Kenya. But it may
be two years before they can show results.
Circumcision is effective because the foreskin of the penis contains
cells that are particularly receptive to the AIDS virus. The studies are
only looking at whether circumcision protects men from becoming
infected. Circumcised men may also be less likely to transmit the virus
to their sexual partners, but that is a much harder question to research
and the current studies are not examining it. But even if circumcision
doesn't make a man less contagious, it helps protect everyone by
lowering the chance that males are infected.
If the Kenya and Uganda studies confirm the South Africa results, AIDS
policy makers should immediately begin discussing how best to promote
circumcision. While it is no easy sell, the operation is at least widely
performed. Circumcision at puberty is a common traditional ritual in
Africa. The vast majority of circumcisions in Africa are performed
without sterile instruments or anesthesia, so it will be important to
provide training and equipment so the operation does not become a source
of infection. There is also the challenge of fighting complacency;
circumcised men must be taught that they cannot abandon safe sex.
If an AIDS vaccine were discovered today that could prevent 6 to 7 of
every 10 potential new HIV infections, it would be heralded as a triumph
of mammoth importance. The results from Uganda and Kenya are necessary
before anyone can declare that circumcision is the equivalent. But
policy makers should be getting ready if the news is good.
http://www.iht.com/articles/2005/10/17/opinion/edaids.php