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Health Experts Recommend Male Circumcision for HIV Prevention

  • Lisa Schlein

For the first time, the World Health Organization and UNAIDS are recommending that male circumcision be used as part of a comprehensive package of prevention of HIV, the virus that causes AIDS. Both agencies say strong evidence from trials in Kenya, Uganda and South Africa provide compelling evidence that male circumcision reduces the risk of heterosexually-acquired HIV infection in men by about 60 percent. Lisa Schlein reports for VOA from Geneva.

More than 10,000 men participated in these trials. Based on the results, the U.N. health agencies said circumcision should be added to current interventions to reduce the spread of HIV. But, they say it should not replace other known methods of HIV prevention.

They say countries with a high heterosexual HIV epidemic should consider urgently scaling up men's access to circumcision.

However, Jos Perriens, who is WHO coordinator of HIV/AIDS prevention, warns male circumcision does not provide complete protection against HIV infection.

"Circumcised men can still become infected with the virus," he said. "In fact, in the trials that took place in southern and eastern Africa between 0.7 and one percent of the males who were circumcised did have access to condoms, were treated for sexually transmitted infections, still became HIV infected. Male circumcision should, therefore, always be considered as part of a comprehensive HIV prevention package."

This package includes HIV testing and treatment for sexually transmitted infections, as well as counseling that covers such topics as abstinence, a reduction in sexual partners and delaying the onset of sexual relations.

Studies suggest that male circumcision in sub-Saharan Africa could prevent 5.7 million new cases of HIV infection and three million deaths over 20 years.

But a prevention expert in WHO's HIV/AIDS Department, Kim Dickson, says preliminary data from the clinical trial in Uganda indicate there may be an increased risk of transmission from HIV-positive men who are circumcised and resume sexual activity before their wounds from the procedure are fully healed.

"This emphasizes that all men who are circumcised, regardless of their HIV status, should abstain from sexual activity until their wounds have been certified as being fully healed or at least for six weeks after the intervention," she said.

WHO and UNAIDS say there would be limited public health benefits from promoting male circumcision in countries where the HIV epidemic is concentrated in specific population groups such as sex workers, injecting drug users or men who have sex with men.

And another senior official for UNAIDS, Susan Timberlake, says there is no evidence that male circumcision protects women from HIV infection.

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