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Done in Unhygienic Conditions, Circumcision Can Spread HIV

In recent years, studies have shown that male circumcision can help prevent the spread of HIV, the virus that causes AIDS. But new research shows that unless the procedure is done under hygienic conditions, it could actually spread infections. VOA’s Joe De Capua reports the findings could help developing nations control the spread of the pandemic.

Devon Brewer is the director of Interdisciplinary Scientific Research, a Seattle, Washington-based company that reviewed data on circumcision in Kenya, Tanzania and Lesotho. He summarizes the conclusion of their research.

“Virgins and adolescents who were circumcised were much more likely to be HIV infected than their uncircumcised counterparts. Right there is kind of an indication that HIV transmission may be occurring through both male and female circumcision practices,” he says.

Brewer explains why.

“In many places in sub-Saharan Africa, circumcision takes place in group settings in which many individuals are circumcised in rapid succession, often with the same unsterilized cutting tool. And so if one person circumcised is infected, those who are circumcised after that person could get infected from blood that’s on the blade or the knife or on the circumciser’s hands or what have you,” he says.

He says while many circumcisions take place in traditional settings, having them done at clinics may be no guarantee of safety.

“It’s uncertain how hygienic the operations are even in clinical settings. Many clinics are under resourced. They have insufficient equipment, staff who are not adequately trained in the procedures. Universal precautions that we take for granted in the West often are not observed,” he says.

Brewer says a warning had been raised in the early days of the HIV/AIDS pandemic about circumcision methods.

“For over 20 years, Africans themselves, many Africans, have warned about the risk of HIV transmission through circumcision practices. Despite these warnings from Africans themselves, surprisingly, researchers had never assessed the possibility of HIV transmission through circumcision practices,” he says.

Considering that sub-Saharan Africa has been the epicenter of the pandemic, why did it take so long before researchers were asked to review the matter?

Brewer says, “I think it probably reflects a general tendency for epidemiologists and public health officials, particularly from the international organizations, the World Health Organization and UNAIDS, to overlook and minimize transmission that may not be occurring through sexual means.”

The Seattle researcher says he hopes the information will encourage Africans to insist on sterile conditions, whether in traditional or clinical settings, before any circumcisions are performed. The findings were published in the March edition of “Annals of Epidemiology.”