Kakaire Kirunda
15 May 2008
Kampala — Policy analysts at two leading American Universities are urging that male circumcision and partner reduction should become the focus of prevention efforts in countries such as Uganda with generalised HIV epidemics.
Writing in the journal Science, the researchers argue that although condom use, testing, and treatment of sexually transmitted infections are of value, resource constraints mean that attention should be shifted to the promotion of initiatives which they say have been scientifically proven to work.
According to the researchers, from the University of California and Harvard University, some of the assumptions underlying such strategies - such as poverty or war being major causes of Aids in Africa- are unsupported by rigorous scientific evidence.
They argue that male circumcision and reducing multiple sexual partnerships, two interventions currently getting less attention and resources, would have a greater impact on the Aids pandemic.
Reacting to the latest developments on Tuesday, the Uganda Aids Commission (UAC) Public Relations Officer, Mr James Kigozi, said the country will not promote some strategies over others.
"As UAC we have always promoted a package of initiatives. And that is why we have been able to achieve what we have achieved to date as a country," Mr Kigozi said in an interview.
"We believe that each one of these initiatives has a role to play in the national response against HIV. I actually don't believe that circumcision should be promoted more than the rest of the other initiatives."
Uganda currently uses the ABC+ strategy that promotes abstinence, being faithful and condom use.
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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§
The jury is in and it is only a small but vocal group of the sexually motivated and gay dominated anti-circumcision movement which is howling into the wind.
Read the joint statement by WHO and UNAIDS:
New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications http://data.unaids.org/pub/Report/2007/mc_recommendations_en.pdf
Their recommendations:
"Recommendations : 1.1 Male circumcision should now be recognized as an efficacious intervention for HIV prevention. 1.2 Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men."
It is not safe to think that just because a man has been cimcumcised he is no longer at rick for HIV.Removing the forskin has to do with being able to clean the area better.Less ares for germs,and infections to grow.The HIV/Aids is not bacterial ,it is viral.Over exposure to UVR weakens the immune system putting all at risk.African men women and children shave off all their hair,don't wear hats.no sunglesses,no sunscreen and work/play all day in the SUN! Uganda is on the equator.The UVR are strongest and cause the most damage.Immune system is just one! Women nerver should be circumcised,but men should have a choice!"ABC" still works if all will use it.Romellfox
Will the mutilation of these men prevent them from having to use a condom? NO - so what exactly is the point?
Are we expecting men to go through the torture of getting circumcised and expect them to continue to wear a condom even after this painful and dangerous surgery?
Will these men be told and taught that being circumcised is not a replacement for safer sex?
How is this surgical approach going to succeed where other efforts have failed?
What is the message - Get circumcised and wear a condom?
This truly is an horrific approach to HIV/AIDS prevention.
I think the researchers and doctors should be first in line for circumcision.
The studies which allegedly show a reduction in HIV among circumcised men are highly questionable. Not one of them was finished, despite the protective affect appearing to decline well below the oft-reported 65%, and several of the subjects disappeared. The fact that one study described circumcision as "comparable to a vaccine of high efficacy" seems to show clear bias. They appear to have been seeking a certain result. One has to wonder how many of the people promoting circumcision in Africa are themselves circumcised. Daniel Halperin is the grandson of a mohel, and seems to think that "maybe in some small way (he's) destined to help pass along (circumcision)" so his objectivity is questionable.
Other epidemiological studies have shown no correlation between HIV and circumcision, but rather with the numbers of sex workers, or the prevalence of "dry sex".
The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circed men than intact men, yet they've just started a nationwide circumcision campaign. Other countries where circumcised men are *more* likely to be HIV+ are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. That's six countries where men are more likely to be HIV+ if they've been circumcised. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives.
Circumcised male virgins are more likely to be HIV+ than intact male virgins, as the operation sometimes infects men. The latest news is that circumcised HIV+ men are more likely to transmit the virus to women than intact HIV+ men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised.
Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that.
For a good summary of the case against promoting circumcision in Africa, see this link: http://www.doctorsopposingcircumcision.org/info/HIVStatement.html