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anonymous Circumcision protects against AIDS December 13, 2006 2:42 PM

New research suggests that Circumcision greatly reduces the chances of men contracting AIDS. (And if they don’t catch it they can’t pass it on!) 

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salaam Tony December 14, 2006 12:01 PM

 Salaam Tony!

Thank you for posting the great article!!  I found some more (below).  This is a great finding, but wonder how many men who are not circumcised (especially in other countries where circumcision was not common upon the birth of male child) would be willing to go through circumcision at an adult age???  ouch???

love & blessings, A'isha

 

 
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salam-more on circumcision December 16, 2006 9:22 AM

New York Times, December 14th: Circumcision Halves H.I.V. Risk, U.S.Posted by: "New York AIDS Coalition" nyaidsc@yahoo.com  nyaidscFri Dec 15, 2006 8:04 am (PST)
NYT Health
December 14, 2006
Circumcision Halves H.I.V. Risk, U.S. Agency Finds
By DONALD G. McNEIL Jr.

Circumcision appears to reduce a man's risk of
contracting AIDS from heterosexual sex by half, United
States government health officials said yesterday, and
the directors of the two largest funds for fighting
the disease said they would consider paying for
circumcisions in high-risk countries.

The announcement was made by officials of the National
Institutes of Health as they halted two clinical
trials, in Kenya and Uganda, on the ground that not
offering circumcision to all the men taking part would
be unethical. The success of the trials confirmed a
study done last year in South Africa.

AIDS experts immediately hailed the finding. "This is
very exciting news," said Daniel Halperin, an H.I.V.
specialist at the Harvard Center for Population and
Development, who has argued that circumcision slows
the spread of AIDS in the parts of Africa where it is
common.

In an interview from Zimbabwe, he added, "I have no
doubt that as word of this gets around, millions of
African men will want to get circumcised, and that
will save many lives."

Uncircumcised men are thought to be more susceptible
because the underside of the foreskin is rich in
Langerhans cells, sentinel cells of the immune system,
which attach easily to the human immunodeficiency
virus, which causes AIDS. The foreskin also often
suffers small tears during intercourse.

But experts also cautioned that circumcision is no
cure-all. It only lessens the chances that a man will
catch the virus; it is expensive compared to condoms,
abstinence or other methods; and the surgery has
serious risks if performed by folk healers using dirty
blades, as often happens in rural Africa.

Circumcision is "not a magic bullet, but a potentially
important intervention," said Dr. Kevin M. De Cock,
director of H.I.V./AIDS for the World Health
Organization.

Sex education messages for young men need to make it
clear that "this does not mean that you have an
absolute protection," said Dr. Anthony S. Fauci, an
AIDS researcher and director of the National Institute
of Allergy and Infectious Diseases.

Circumcision should be used with other prevention
methods, he said, and it does nothing to prevent
spread by anal sex or drug injection, ways in which
the virus commonly spreads in the United States.

The two trials, conducted by researchers from
universities in Illinois, Maryland, Canada, Uganda and
Kenya, involved nearly 3,000 heterosexual men in
Kisumu, Kenya, and nearly 5,000 in Rakai, Uganda.
None were infected with H.I.V. They were divided into
circumcised and uncircumcised groups, given safe sex
advice (although many presumably did not take it), and
retested regularly.

The trials were stopped this week by the N.I.H. Data
Safety and Monitoring Board after data showed that the
Kenyan men had a 53 percent reduction in new H.I.V.
infection. Twenty-two of the 1,393 circumcised men in
that study caught the disease, compared with 47 of the
1,391 uncircumcised men.

In Uganda, the reduction was 48 percent.

Those results echo the finding of a trial completed
last year in Orange Farm, a township in South Africa,
financed by the French government, which demonstrated
a reduction of 60 percent among circumcised men.

The two largest agencies dedicated to fighting AIDS
said they would now be willing to pay for
circumcisions, which they have not before because
there was too little evidence that it worked.

Dr. Richard G. A. Feachem, executive director of the
Global Fund to Fight AIDS, Tuberculosis and Malaria,
which has almost $5 billion in pledges, said in a
television interview that if a country submitted
plans to conduct sterile circumcisions, "I think it's
very likely that our technical panel would approve
it."

Dr. Mark Dybul, executive director of President Bush's
$15 billion Emergency Plan for AIDS Relief, said in a
statement that his agency "will support implementation
of safe medical male circumcision for
H.I.V./AIDS prevention" if world health agencies
recommend it.

He also warned that it was only one new weapon in the
fight, adding, "Prevention efforts must reinforce the
A.B.C. approach — abstain, be faithful, and correct
and consistent use of condoms."

Researchers have long noted that parts of Africa where
circumcision is common — particularly the Muslim
countries of West Africa —  [ send green star]
 
cont December 16, 2006 9:26 AM

But drawing conclusions was always confounded by other
regional factors, like strict Shariah law in some
Muslim areas, rape and genocide in East Africa,
polygamy, rites that require widows to have
sex with a relative, patronage of prostitutes by
miners, and men's insistence on dangerous "dry sex" —
with the woman's vaginal walls robbed of secretions
with desiccating herbs.

Outside Muslim regions, circumcision is spotty. In
South Africa, for example, the Xhosa people circumcise
teenage boys, while Zulus do not. AIDS is common in
both tribes.

Nelson Mandela's autobiography, "Long Walk to
Freedom," contains an unnerving but hilarious account
of his own Xhosa circumcision, by spear blade, as a
teenager. Although he was supposed to shout, "I am a
man!" he grimaced in pain, he wrote.

But not all initiation ceremonies are laughing
matters. Every year, some South African teenagers die
from infections, and the use of one blade on many
young men may help spread AIDS.

In recent years, as word has spread that circumcision
might be protective, many southern African men have
sought it out. A Zambian hospital offered $3
circumcisions last year, and Swaziland trained 60
doctors to do them for $40 after waiting lists at its
national hospital grew.

"Private practitioners also do it," Dr. Halperin said.
"In some places, it's $20; in others, much more. Lots
of the wealthy elite have already done it. It prevents
S.T.D.'s, it's seen as cleaner, sex is
better, women like it. I predict that a lot of men who
can't afford private clinics will start clamoring for
it." (S.T.D.'s are sexually transmitted diseases.)

Male circumcision also benefits women. For example, a
study of the medical records of 300 Ugandan couples
last year estimated that circumcised men infected with
H.I.V. were about 30 percent less likely
to transmit it to their female partners.

Earlier studies on Western men have shown that
circumcision significantly reduces the rate at which
men infect women with the virus that causes cervical
cancer. A study published in 2002 in The New England
Journal of Medicine found that uncircumcised men were
about three times as likely as circumcised ones with a
similar number of sexual partners to carry the human
papillomavirus.

The suspected mechanism was the same — cells on the
inside of the foreskin were also more susceptible to
that virus, which is not closely related to H.I.V.

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Grrr! Russian Roulette! No R&R [rest and relaxation] when it comes to: December 16, 2006 11:04 PM

Practice SAFE SEX!!!! IS THE RULE! -

Even though the weight of evidence increasingly suggests that circumcising men before they become sexually active does provide some protection against HIV, the practical implications for AIDS prevention are not obvious. Circumcision, where it is practised, usually has links to religious or ethnic identities and life-cycle ceremonies, and may customarily be done after puberty. If the same scalpel were used without sterilization on a number of boys, this could actually contribute to the transmission of HIV. Finally, if circumcision were promoted as a way of preventing HIV infection, people might abandon other safe sexual practices, such as condom use. This risk is far from negligible - already, rumours abound in some communities that circumcision acts as a "natural condom". A sex worker interviewed in the city of Kisumu in Kenya summed up this misconception, saying: "I can sleep with circumcised men without a condom because they don't carry a lot of dirt on their penis"?????. While circumcision may reduce the likelihood of HIV infection, it does not eliminate it. In one study in South Africa, for example, two out of five circumcised men were infected with HIV, compared with three out of five uncircumcised men. Relying on circumcision for protection is, in these circumstances, a bit like playing Russian roulette with two bullets in the gun rather than three. [...assuming the gun has only five chambers - or, if it had the more usual six, 2.4 bullets rather than 3.6.]


UNAIDS, '00

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Lol! December 16, 2006 11:14 PM

 Hey Tony,

If your not very careful you may

       "spread a little more than happiness"!

"you cannot send a green star to Tony because you have done so withen the last week."
                      Oh well. thanx for the topic!

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anonymous  December 17, 2006 11:26 AM

I agree completely that promoting and practising safe sex is the best way to cut HIV transmission rates (assuming abstinence is not realistic). The studies don’t present circumcision as a ‘magic bullet’ that can halt the spread of HIV but they do suggest that it may have a role to play. There is a Q&A page from NIAID that gives more info.   

If I can borrow the metaphorical gun Angel referred to… circumcision may represent one bullet amongst many which can be fired at the HIV virus.

The issues raised against mass circumcision in Africa are of course valid, even though some of the information on which they are based is dated, but that doesn’t mean those issues are insurmountable. The benefits of circumcision (if they are genuine) could be taught at the same time as the benefits of safe sex… As well as, not instead of… This would probably benefit the next generation more than the present one as I doubt many adult men would willingly volunteer, I know I wouldn’t... My 23 year old nephew had it done and it hurt like hell!  

As for me being careful to spread only happiness… I'm always careful... I wore seatbelts in my car long before they were compulsory.

 

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WOW! December 17, 2006 6:11 PM

This piece of tidbit seems to have caused a bit of fury here!! 

  I think if we merely take the article "as is" along with what we already know help prevent the spread of HIV-it would be a very good thing--for instance-knowing that circumcised males have lower risk-perhaps campagains in third world countries can be deveolped to encourage mothers to -be to consent to getting their newborn males circumcized to help protect them in the future ALONG with HIV education and condom use...I think the infor mation Tony presented was good information and in no way saying this should be the only method..and as he stated:

(And if they don’t catch it they can’t pass it on!) is a good thing--if no one catches it they can't pass it on! However in countries where circumcion is not done and condoms not available readily---they MAY help reduce spread..I think any information brought here is valuable and we all know that abstinience and condoms are the number one recomendation!  

It also goes to say--if you do a self breast examination is reduces the death rate of breast cancer if caught early-hence-recommendation for all females to do a monthly self breast exam..this is NOT to say "dont get a mammogram"....just some additional preventive info--such as in circumsiscion-all information is most important...

Thank you both for your great posts-debates, and all the happiness you BOTH spread around!!!  love you both!

hugs, A'isha

 

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Cut it out!!!! :0) January 15, 2007 10:42 PM

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salaam Karrie! January 19, 2007 1:08 AM

lolol..now THIS is funny!!  how cute!! 

love A'isha

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blue pin February 26, 2007 10:15 PM

"cut it out" Lol! link image: http://www.pbase.com/ethicalheretic/image/51695817

Oh I love the do you love the humor in the doctors name at the WHOs HIV/AIDS department?  it is so excellent! I'am sorry I did'nt notice it before! Dr Kevin  De Cock , Director, WHO HIV/AIDS Department! Wow! serendipity or sumthin?  Right on! God has a sense of humor!

Hi! This is an important discussion/study and it is not over - as we can read (from above) and here : http://www.who.int/mediacentre/news/notes/2006/np18/en/
lets pin it (blue) to keep track!

Thanks again to Tony!

I wuv u 2

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Article Date: 09 Mar 2007 March 10, 2007 12:19 PM

 Todays news

from external link: 
http://www.medicalnewstoday.com/medicalnews.php?newsid=64749&nfid=crss

According to the Post, some researchers have said they hoped male circumcision also might indirectly protect female partners because circumcised men are less likely to have genital ulcers, which increase the risk of HIV transmission. In addition, if circumcision reduces HIV prevalence in an entire population, both men and women would benefit. To examine the effect of male circumcision on their female partners, researchers from Uganda and the Johns Hopkins University Bloomberg School of Public Health enrolled about 1,000 HIV-positive men and randomly assigned half to be circumcised. The researchers followed 124 couples in which the men's regular female partner was HIV-negative when the man was circumcised. They found that among 70 partners including circumcised men, 11 women contracted HIV. In addition, among the 54 partners including men who were not circumcised, four women contracted HIV, according to the researchers. The researchers found that almost all new cases occurred within the first six months of the study. Among 12 partners including men who began having sex before the circumcision had healed, which takes about one month, three women contracted HIV. Among the 55 partners including men who waited until the wound had healed to resume sex, six women contracted HIV. An independent panel of scientists overseeing the study recommended that no new participants be enrolled (Washington Post, 3/7). The researchers said the increased risk might be because intercourse could cause small tears in the circumcision wound, transmitting HIV-infected blood into the women's vagina, Reuters south Africa reports (Dunham, Reuters South Africa, 3/7). Researchers said that the findings are too small to be statistically significant and that it is possible the HIV incidence rates were coincidental. However, researchers added that the findings suggest the increased HIV transmission was due to men having sex before their circumcision wounds healed. The men and women involved in the study received frequent HIV prevention education and free condoms, the AP/ Houston Cronicle reports (Cheng, AP/Houston Chronicle, 3/6). The study is expected to be completed in two years, Reuters South Africa reports (Reuters South Africa, 3/7).

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anonymous from in thses times May 17, 2007 11:40 AM

http://www.inthesetimes.com/article/3137/circumcision_promotion_divides_aids_activists/  [report anonymous abuse]  [ accepted]
 
anonymous sorry the typo May 17, 2007 11:41 AM

circumcision is news again in New York, but this time the city is promoting the practice. The April 5 New York Times reported that the city health department has decided to encourage male circumcision as an HIV-prevention method among at-risk populations, particularly gay and African-American men. The move comes after several clinical studies in Africa showed that circumcision of an adult male can decrease his likelihood of infection by as much as 60 percent.  [report anonymous abuse]  [ accepted]
 
salaam May 18, 2007 1:12 AM

Well...I wonder how this will go over in the big apple???  hmmm...Interesting Agnes...will have to follow this one-I will keep alert for San Fran news on this as well...

hugs A'isha

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anonymous sould have posted the article in full May 18, 2007 4:10 AM

and may do so tonight when I get up to it. I am very interested too Aisha,, and by the way what means' encouraged "payed for perhaps?

once you are grown up and mature a circumcision is no walk in the park  ..but to save your life..perhaps...if it is really studied and well researched...

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LEO'S ANGEL'S FOR HIV/AIDS ADVOCACY; KEEPING A BROTHERS DREAM ALIVE
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