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February 25, 2007: A group of scientists
say they have conclusive data that shows
circumcision reduces men’s chances of contracting
HIV by up to 60%.
Experts have hailed the new finding as a major
breakthrough in the fight against AIDS. Now, the
question now is how to put the finding to work to
combat AIDS across Africa.
The findings were first announced in December
2006, when initial results from two major trials –
in Kenya and Uganda – showed promising links
between circumcision and HIV transmission.
However, those trials were deemed so definitive
that the tests were halted early.
The full data from the trials, carried out by the
United States National Institutes of Health, were
published in The Lancet on Friday.
“This is an extraordinary development,” Dr Kevin
de Cock, director of the World Health
Organisation’s AIDS department, said.
“Circumcision is the most potent intervention in
HIV prevention that has been described,” he added.
Circumcision has long been suspected of reducing
men’s susceptibility to HIV infection because the
cells in the foreskin of the penis are especially
vulnerable to the virus.
A modelling study conducted in 2006 projected
that, in the next decade, male circumcision could
prevent 2 million AIDS infections and 300,000
deaths.
In 2006, 2.8 million people in sub-Saharan Africa
became infected with HIV, and 2.1 million people
died of the dreaded disease.
Experts say that the significance of the
breakthrough is on par with the identification of
the virus and the use of lifesaving combination
drug therapy.
The two studies conducted by the United States
confirm similar results from an earlier trial in
South Africa.
However, experts warn that solid evidence is no
justification for mass circumcisions, noting that
African health systems are already overburdened,
and circumcision requires more planning than, for
example, an immunisation campaign.
“It is a tricky one, but it is something we are
going to have to move on,” Dr Catherine Hankins, a
scientific adviser at UNAIDS, said. “Male
circumcision is such a sensitive religious and
cultural issue that we need to be careful.”
Several African countries have met United Nations
agencies to explore strategies for increasing
circumcision.
Together with the United Nations AIDS agency,
World Health Organisation (WHO) is convening a
meeting in Switzerland in March 2007 to evaluate
the data and decide the next steps in slowing the
AIDS pandemic.
In the study conducted in Kenya, 1,391 circumcised
men were compared to 1,393 who were not. In
Uganda, 2,474 circumcised men were compared to
2,522 men who were not.
Scientists tracked the men for two years and found
that those who were circumcised were 51-60% less
likely to contract HIV.
BY OUR PHARMA CORRESPONDENT
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