Safety in circumcision

Stephen Smith

Stephen Smith

Two studies have confirmed that the widespread circumcision of adult men is a powerful weapon against HIV infections in sub-Saharan Africa.

The US Global Aids coordinator, Mark Dybul, on Wednesday said that the Bush administration, which has committed R105billion to treating and preventing Aids in the developing world, will now support circumcision as a prevention tool.

In the two studies researchers in Kenya and Uganda enrolled thousands of uncircumcised men to determine if the procedure could reduce HIV transmission among heterosexuals, with some men having their foreskin removed and others remaining intact. Preliminary results so overwhelmingly favoured circumcision that US health authorities said they were ethically obligated to stop the trials and offer circumcision to all the men.

The trial in Kenya, involving nearly 2800 participants, found that the circumcised men were 53percent less likely to contract HIV. The Ugandan study, with nearly 5000 men, showed a 48percent reduction.

The research results emerge a year after a South African study reached a similar conclusion.

Circumcision "does have the potential to prevent many tens of thousands, many hundreds of thousands, maybe millions of infections over coming years", said Kevin DeCock, chief of the Aids branch at the World Health Organisation.

DeCock said he expected health ministers from Africa to meet global health officials next year to translate the findings into policy.

A Ugandan researcher involved in the study, David Serwadda, predicted that there would be "very strong demand" for the procedure in his country.

For more than a decade, African physicians have observed that circumcised men seemed less susceptible to HIV.

There are biological explanations for this - the skin of the penis of circumcised men is thicker and less prone to penetration by HIV, but cells in the foreskin of uncircumcised men are especially welcoming to the virus.