Circumcision Urged in Curbing AIDS Spread
By MERAIAH FOLEY, Associated Press Writer
(AP) -- A U.S. health expert urged governments worldwide Tuesday to endorse circumcision to slow the spread of HIV, saying men without the procedure have a greater risk of contracting the virus from infected female partners.
Experts at an AIDS conference in Sydney also warned that HIV infection rates were rising among men who have sex with men in developing countries because of discrimination and lack of access to health services.
The World Health Organization says male circumcision reduces the risk of female-to-male transmission of the disease by around 60 percent. But only 30 percent of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons.
Robert Bailey, a professor of epidemiology at the University of Illinois, said studies in Africa showed that uncircumcised men were 2 1/2 times more likely to contract HIV from infected female partners, though many health officials were still unclear about its benefits.
"If we had a vaccine that was 60 percent protective, we would be very happy and we would be rolling it out as fast as we can," Bailey told reporters at an International AIDS Society Conference in Sydney, Australia.
"The next step is to get the leaders of countries to actually come up with policy statements endorsing the practice," said Bailey, who has conducted circumcision-related studies in Africa and the United States.
Without local support, international agencies would be unlikely to encourage the procedure to avoid being seen as imposing foreign cultures or values, he said.
Circumcision, the removal of the foreskin from the penis, has long been suspected of reducing men's susceptibility to HIV infection because the skin cells in the foreskin are especially vulnerable to the virus.
In March, the WHO urged heterosexual men to undergo the procedure because of compelling evidence that it reduces their risk of getting the disease. However, it cautioned that male circumcision is not a complete protection against HIV, and said men should still use condoms and take other precautions such as abstinence, delaying the start of sexual activity and reducing the number of sexual partners.
"Circumcision could drive the epidemic to a declining state toward extinction," Bailey said. "We must make safe, affordable, voluntary circumcision available now."
Bailey also called on international agencies to ramp up funding for circumcision in countries hardest-hit by the epidemic.
Michel Kazatchkine, the executive director of the Global fund, a leading international health agency, also called for increased funding.
"I believe that the evidence is overwhelming for the efficacy of circumcision," Kazatchkine told The Associated Press on the sidelines of the meeting. "And if countries come to us ... I see no reason at all why we wouldn't fund that."
Kazatchkine said his organization had not yet received any requests for funding for circumcision, and noted that the WHO advice on the topic was only released in March.
Also at the conference, a leading American AIDS research group said HIV infection rates among men who have sex with men were rising in Africa, Asia and Latin America, citing figures from UNAIDS.
Studies also show that less than 5 percent of that group have access to HIV-related health care, the American Foundation for AIDS Research, or amfAR, said.
"This is a massive failure of the HIV/AIDS response globally and I think one that needs to be addressed," said Kevin Frost, amFAR's chief executive officer.
In Kenya, around 40 percent of men who have sex with men are estimated to be HIV positive, compared to a 6 percent rate in the country's overall population, amFAR said. In Senegal, nearly 22 percent are believed to be infected, compared to less than 1 percent of the general population.
In Uruguay and Mexico, 21 percent and 15 percent are estimated to have the disease.
Under an initiative launched at the AIDS Society Conference, amFAR will seek to raise $3 million in the next three years to provide grants for AIDS education and research among men who have homosexual sex in developing countries.
© 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
You've assumed Italian978 means "men" but he may also include infants. He needs to clarify that.let me understand this correctly. let's circumcise men, although our evidence is a little shaky, just in case?
Perhaps you read something Italian978 posted in another thread? For everyone's convenience I'm copying it below. I've emphasized portions.And, Steve, the agenda you described appears to have gone to bed with that loony faction of religious and social ultraconservatives who are desperately trying to discredit condom use, despite (because of?) its proven track record in combatting STDs...
Italian978, specifically what are you advocating?
Perhaps you read something Italian978 posted in another thread? For everyone's convenience I'm copying it below. I've emphasized portions.Jovial, it's normal to fear HIV and other STD's since there are so many people infected worldwide. The best thing you can do to protect yourself is to get into a monogamous, loving relationship with another person. If you love and trust each other, and the sex is great, you'll never have to worry about getting anything you don't want.Source: http://www.lpsg.org/936676-post11.html
I know it's easier said than done but we're living in crazy times. People didn't have to think about these things years ago. It's a known fact that people lie about sex. I've heard about so many people getting herpes or something worse from a hookup because the person seemed sincere.
You have to weigh the risks. Condoms can help, but they're not 100%, and I'm not positive about this, but I don't think condoms have ever been actually approved for anal sex. They are made for vaginal sex, and if you look on any condom box I'm pretty sure the word "anal" is not even mentioned.
Warped?
You're advocating. I not sure of what, though. Is there only one solution?I'm not really advocating. Just looking for a solution. ...
What country?1. 4000 guys in that one country alone are getting HIV every day
I guess you believe it won't ever work.2. education has obviously not worked
Have they been tried universally? Do they fail often?3. condoms have obviously not worked
So you can forecast the speed of medical advances?4. an AIDS vaccine is nowhere in sight
I think you have something in mind.What's left when you think about it?
As a percentage, how safe?... monogamy is safe.
You're advocating. I not sure of what, though. Is there only one solution?What country?I guess you believe it won't ever work.Have they been tried universally? Do they fail often?So you can forecast the speed of medical advances?I think you have something in mind.
Did you read Hunt3ed's post. Did any of it register? I think I know the answer.As a percentage, how safe?
You can't even quote yourself correctly! Read item #1 in: http://www.lpsg.org/937471-post87.html ... look for the words "in that one country". I asked you to reveal the name of the country. State it!If you look at my prior post it says :
"About 4,000 men are infected with HIV every day in sub-Saharan Africa, including 3,000 who are uncircumcised." ...
You can't even quote yourself correctly! Read item #1 in: http://www.lpsg.org/937471-post87.html ... look for the words "in that one country". I asked you to reveal the name of the country. State it!
O.K. I'm done with you. You're not qualified to be in these discussions.
Italian, what some of us have been trying to point out to you is that the statistics quoted may not actually mean anything. In other words, the numbers may be there, but without the proper controls, there is no cause/effect relationship, and no scientific basis.Thanks a lot. You have to admit that 4000 new HIV infections a day is a lot.
Italian, what some of us have been trying to point out to you is that the statistics quoted may not actually mean anything. In other words, the numbers may be there, but without the proper controls, there is no cause/effect relationship, and no scientific basis.
As mentioned before, if the group which has begun widespread circumcision is also the same group that converted to Islam, and the group that is not practicing circumcision is a pagan group that practices fertility rites, that's not a fair comparison. They would have to monitor infection rates within the Muslim group, and convince them to only circumcise half the male population. There is more evidence to support the assertion that behavior, not foreskin, has the greater influence on infection rates.
For what it's worth, I've never experienced a condom failure in my 35 years of being a sexually active person.