The first scientific study to find that post-sex washing reduces risk of HIV infections was conducted in Kibera, which is heavily populated by Luo.

This study found that regardless of whether a man was circumcised, "bathing" for 10 minutes within an hour of sexual intercourse reduced his risk of HIV infection.

The most prestigious member of the team that did this study is Professor King K. Holmes, American dean of research on sexually transmitted diseases. He suggests that male circumcision might be effective because it makes it easier for men to wash their penises.

But the key variable is the post-sex washing. In response to the publication of this study's findings in the fall of 2006 the U.S. National Institutes of Health began to solicit large-scale studies of post-sex washing for AIDS-prevention.

Post-sex washing might turn out to be far more important than male circumcision.

The following quotations comes from the way the "Journal of AIDS" summarized this study's findings:

JAIDS Journal of Acquired Immune Deficiency Syndromes:Volume 43(1)September 2006pp 117-118 Independent Association of Hygiene, Socioeconomic Status, and Circumcision With Reduced Risk of HIV Infection Among Kenyan Men [Epidemiology and Social Science] Meier, Amalia S. PhD*∥; Bukusi, Elizabeth A. MBChB, M Med(ObGyn), MPH†§¶; Cohen, Craig R. MD, MPH#; Holmes, King K. MD, PhD‡§

From the Departments of *Laboratory Medicine, †Gynecology, and ‡Medicine, and the §Center for AIDS and STD, University of Washington, Seattle; the ∥Program in Biostatistics, Fred Hutchinson Cancer Research Center, Seattle; the ¶Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; and the #Department of Obstetrics, Gynecology, and Reproductive Science, University of California, San Francisco.

Received for publication November 23, 2005; accepted April 18, 2006.

Supported by the University of Washington Center for AIDS Research (AI 27757), STI-Topical Microbicide Cooperative Research Center (AI 31448), and AIDS International Research & Training Program (NIH FIC D43 TW00007).

Reprints: King K. Holmes, MD, PhD, Harborview Medical Center, Box 359931, 325 9th Ave, Seattle, WA 98104 (e-mail: worthy@u.washington.edu).

Article Outline Abstract METHODS RESULTS DISCUSSION ACKNOWLEDGMENTS REFERENCES Citing Articles Figures/Tables Table 1 Abstract TOP Summary: Among Kenyan men recruited as sex partners of women with genital symptoms, 22 of 150 were HIV seropositive. Because male HIV infection and male hygiene were unexpectedly found to be associated with each other, we examined the relationship of 5 hygiene variables with HIV infection in the men in a principal components analysis, controlling for socioeconomic status and other potential confounders. By multivariate analyses, HIV infection in men was not only independently associated with previous illness (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.4-19.1) and inversely associated with being circumcised (OR, 0.12; 95% CI, 0.02-0.91), but also independently associated with a combined measure of hygiene (OR, 0.41; 95% CI, 0.19-0.90).

Your article has some serious errors. You say, "In the study, 3,000 HIV-negative men were circumcised and followed up for five years."

No, 1,391 were circumcised and 1,393 were left intact ("controls"). 87 circumcised men and 92 controls were "lost to study", their HIV status unknown, creating an uncertainty much greater than the supposed benefit.

They were followed up for two years, not five, but the study was cut short (it was not thought ethical to carry on - though it was thought ethical to test men for HIV and not tell them they had the disease) and now we will never know what the long-term outcome will be.

"Among them, 54 per cent did not get infected with HIV."

No, 22 circumcised men and 47 controls got HIV - that is the basis of the claim of 54% relative risk reduction. The absolute risk reduction (IF circumcision is actually responsible) is only 1.79% (from 3.37% to 1.58%).

They ignored men who said they hadn't had sex, preferring to assume that sex was responsible for all infections, yet we know there are several other ways. One possiblity for several is infection from the circumcision itself.

Bravo to the Luo elders for urging restraint! We need to know much more about these studies before using them as a basis for action.