Mounting data on benefits of male circumcision
Results from two randomized, controlled clinical trials show that circumcision of male adults reduced their risk of acquiring HIV by approximately 50%. These results were released on December 12, 2006 after an independent committee of clinical research experts, statisticians, ethicists, and community representatives reviewed the interim data collected in these trials. Based on the substantial benefit offered by circumcision, male volunteers in the control group will now also be offered the surgical procedure. Researchers will continue to monitor the HIV infection rates among all volunteers and will also study how the procedure affects their behaviors.
Both of these trials, one which took place in Rakai, Uganda, and the other in Kisumu, Kenya, were sponsored by the US National Institute of Allergies and Infectious Diseases (NIAID), part of the National Institutes of Health. They confirmed the results of a previous circumcision study conducted in South Africa, which was the first to show that removal of the foreskin offered some protection against HIV infection (see VAX August 2005 Spotlight article, A comprehensive response). According to NIAID, studies in Africa have found that circumcision is an accepted practice, with 50-86% of those surveyed saying they would either have the procedure or want their partner to undergo circumcision if it was known to be safe, affordable, and have minimal side effects.
Organizations like UNAIDS and WHO are currently working on recommendations for the implementation of adult male circumcision in countries where sexual transmission of HIV predominates. Another study sponsored by US-based Johns Hopkins University is still ongoing to determine if male circumcision reduces HIV transmission from men to women. However, public health experts agree that any intervention that reduces HIV rates in men by 50% will also benefit women.
All articles written by Kristen Jill Kresge.
Spotlight article was adapted from an article by Catherine Zandonella (IAVI Report, 10, 4, 2006)