Circumcision cuts the risk of HIV infection

December 13, 2006 at 3:54 pm (Alex's Posts)

Huge AIDS news today, picked up all over the world – male circumcision reduces the risk of contracting HIV by about 50%, as shown by two large-scale clinical trials in Africa.  The outcomes were so decisive that the studies were stopped midway through. Read the Reuters story here.  Stay tuned for reactions from the NGO community and governments, especially the American administration.

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2 Comments

  1. sstolper said,

    Right, sounds really good. I wonder, though, why this hasn’t been agreed before now. I have not followed the progress of research into circumcision’s role in HIV reduction, but there’s certainly a lot of literature out there on the subject. In fact, the first BBC article that I clicked on, after a Google search, landed me in an article from October of 2005, about a South African study of similar methods. 60% reduction was the big number there. Apparently that wasn’t good enough for the public health world.

    Also while searching, it was striking to see so many opinions trying to prove circumcision advocates wrong. The issue really seems to have been polarized a lot. So why is the end of these two studies so definitive? Or is it? Sounds like there’s going to be a lot of work to do before sterile circumcision ‘facilities’ are set up. I hope the train doesn’t lose steam.

  2. Alexandra Coria said,

    Let me preface this by saying that the WHO and other institutions have gotten a lot of flak for not making recommendations based on the Orange Farm study in South Africa. That said, there are a few more or less legitimate reasons for the news breaking now. First, the Orange Farm study was the first large-scale study of circumcision and HIV, and the NIH trials were already ongoing, so part of the rationale was to wait and see if the pattern was replicable on a large scale, in a different country. Also, the Orange Farm study was only conducted among men in their teens and twenties, whereas one of the NIH trials spanned a thirty-year age range, and therefore was simply more comprehensive and widely applicable.

    The other issue is that, while big news, these results must also be taken with a grain of salt. Condom use may drop if circumcision goes on the rise, which would negate any protective effect. It’s as yet unclear whether circumcision protects women from acquisition of HIV (though there’s a study ongoing on that issue). People may get circumcised in un-sterile conditions because it’s cheaper and more convenient and they don’t understand the health risks. There are so many “what ifs” attached to these results, that it’s understandable that researchers and policymakers didn’t want to address these issues until they were totally sure that the Orange Farm study wasn’t just a one-off.

    However, this situation does seem to pose a moral problem – if you think something could be so effective, with so little health risk, is it moral to wait a year for another study to come out before making policy recommendations, regardless of the other concerns involved?

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