Circumcision Could Prevent AIDS, Researchers Say

Patrick Goodenough | July 11, 2000 | 8:08pm EDT
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( - Male circumcision may help to prevent AIDS-HIV infection in Africans, academics and researchers have told an international conference on the disease, which is wreaking havoc in sub-Saharan Africa.

An American specialist told the conference in the South African port city of Durban that more than half of all HIV infections in some groups might have been prevented had the men been circumcised.

Not only would the men have been at lower risk, they would also have been less likely to infect women, said Robert Bailey of the University of Illinois in Chicago.

He suggested that the conference consider whether health officials should begin to promote male circumcision in Africa as another tool in the fight against the devastating disease.

AIDS kills an estimated 6,000 people in Africa every day. Most at risk on the continent are young, heterosexual men and women - and babies, who can be infected through breast milk. It is the number one overall cause of death in Africa, according to the U.N. With 20 percent of adults HIV-positive in 1999, South Africa is hardest-hit.

Bailey presented research he had done in Kenya among an ethnic group badly hit by HIV infection, and which does not practice circumcision.

Another study was presented by researchers from the Institute of Tropical Medicine in Belgium. It compared two locations with high HIV infection rates - a town in Kenya and one in Zambia - with two others with much lower incidence, in Cameroon and Benin.

In the latter two, HIV prevalence among sexually-active adult men was 3.8 percent and 4.4 percent. More than 99 percent of the men are circumcised.

By contrast, the infection rate among the same profile group in the Zambian and Kenyan towns was 21.9 percent and 25.9 percent. Only 7.6 percent of the males in the one, and 26.8 percent in the other, are circumcised.

A third study, presented by the School of Hygiene and Tropical Medicine in London, found that circumcised men were less likely to be HIV infected.

Numbers falling

Once a common practice and said to promote health and hygiene, the surgical removal of the foreskin has become less prevalent in recent years, as campaigners target a practice they say is unnecessary and potentially harmful physically and psychologically.

It is reported that most baby boys in America were circumcised in the years following the Second World War. By the late 1960s the figure was around 85 percent, and by the late 1990s it had dropped to some 60 percent.

That is still considerably higher than the number in Europe, Asia and Latin America. In some African cultures, circumcision plays a part in manhood rituals in the mid- to late-teens.

Jews and Muslims circumcise their males as part of religious tradition, going back some 4,000 years for Jews and 1,200 for Muslims.

Proponents of circumcision say it has hygienic and health advantages, that it reduces the risk of urinary tract infections and penile cancer.

Research has shown that harmful bacteria are more likely to exist beneath the foreskin.

Women whose partners are uncircumcised are believed to be also more likely to suffer from vaginal bacterial infections - and the existence of those infections makes a woman more vulnerable to HIV infection.


In March 1999, the influential American Academy of Pediatrics said while there may be some health benefits, there was no evidence to justify the routine circumcision of babies.

The academy agreed that UTIs were more common in uncircumcised males in the first year of life, and that penile cancer was three times more common in uncircumcised men.

The body, which represents 55,000 doctors in North America, did not advise against the procedure but said parents should discuss the pros and cons of the procedure with doctors before making a decision.

The announcement was welcomed by anti-circumcision campaigners in the U.S.

"I think what that means is the medical debate is over," a spokesman for a Boston-based anti-circumcision group, was quoted as saying. "I think circumcision is now an ethical issue. It challenges us to empathize with newborn infants."

Marilyn Milos, director of the California-based National Organization of Circumcision Information Resource Centers (NOCIRC), said: "Now that the American Academy of Pediatrics has aligned itself more closely with medical organizations worldwide by not recommending routine male circumcision, the already declining circumcision rate in the U.S. should drop dramatically."

NOCIRC's reaction to the claims made at the AIDS conference was not available by press time.

The debate has become an emotive one. In a typical argument used by anti-circumcision campaigners, the writer of a letter published in the Nevada City Union last week described the procedure as "barbaric" and constituting "mutilation."

Writing to the same paper, an apparent supporter of the procedure noted that God told Abraham in the Bible to circumcise the sons of the Hebrew nation on the eighth day.

Observing that an infant's blood does not have a clotting factor until the eighth day after birth, the writer said: "God knew it wouldn't be a good idea to perform surgery until that day. A gift from the mind of a loving Creator-God, like so many of His commandments and laws. We can trust Him and His Word fully."


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