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http://www.mg.co.za/articlePage.asp...rnational_news/
Male circumcision 'promising' in fight against HIV
Beth Duff-Brown | Toronto, Canada
18 August 2006 08:35
With people dying of Aids in far greater numbers than those who have
access to treatment and prevention, male circumcision could be a
promising tool in the prevention of transmitting HIV, scientists told
the International Aids Conference in Toronto, Canada, on Thursday.
Others cautioned that the procedure could give men a false sense of
security and may not protect women from contracting the disease.
Former United States president Bill Clinton said earlier in the week
that while two clinical trials under way in Africa were promising, it
would be a "headache" to implement, due to the medical and religious
debates surrounding the surgical removal of the foreskin from the
penis.
In June, the US National Institutes of Health announced that, following
an interim review, two ongoing trials in Uganda and Kenya should
continue examining the link between male circumcision and the risk of
getting the virus that 40-million people are living with today.
The virulent virus -- for which scientists have yet to develop a
vaccine -- has killed an estimated 25-million people since the first
cases of HIV were reported 25 years ago.
Between 2003 and 2005, the number of people in low- and middle-income
countries on anti-retroviral drugs increased by 450 000 each year. Yet
over the same period, the number of people who became infected with HIV
averaged more than four million a year.
Data from the trials, scheduled to conclude next year, could validate
findings reported in July 2005 from a South African trial, known as the
Orange Farm intervention trial, which showed a reduction of 60% in the
risk of acquiring HIV among circumcised men.
"The results of the two ongoing trials will help clarify the
relationship between male circumcision and risk of HIV in differing
contexts, which is key to determining the reproducibility and
application of the Orange Farm findings," said Dr Kevin de Cock, head
of the World Health Organisation's HIV/Aids programme.
Clinton, whose foundation is heavily involved in Aids programmes, told
reporters that while current studies indicate circumcision may be
effective, it could lead to a whole new set of personal debate and
medical problems.
"I think for men the most promise is in the circumcision studies,"
Clinton said earlier in the week when asked about the current buzz over
promising HIV-prevention tools, such as microbicides for women. "But
it's going to be a total headache trying to help them."
Catherine Hankins, chief scientific adviser for the United Nations
Joint Programme on HIV/Aids, said researchers are excited about the
potential use of circumcision as a tool to fight HIV, but cautioned
that it could give men a false sense of security and may not protect
women from contracting the infection.
"Even if further trials show a lower risk of HIV infection in
circumcised men, male circumcision will not provide complete protection
against HIV infection," she said. "Circumcised men can still contract
HIV and pass it to their partners. If male circumcision is proven to be
effective, it must be considered as just one element of a comprehensive
HIV-prevention package."
In Africa, about 70% of men are circumcised at birth or in tribal
ceremonies. The soaring HIV infection rates in sub-Saharan Africa are
found in communities that do not practice circumcision, such as
Swaziland, which has the world's highest HIV infection rate of 33%.
Studies show that HIV infection rates drop dramatically in West Africa
and other parts of the continent where circumcision is routinely
performed.
Hankins said that tests have shown that the male foreskin is rich in
blood cells that are favoured targets of HIV. -- Sapa-AP
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