WASHINGTON, Dec 13, 2006 (AFP) - Circumcision reduces by about half the risk of contracting the AIDS virus, according to two new studies released Wednesday and that could have significant implications in the fight against the deadly disease.
The trials conducted in Kenya and Uganda showed that men who had their foreskin removed were much less likely to contract HIV through heterosexual intercourse than their counterparts who had not undergone the procedure.
The studies that began in September 2005 were to last through mid-2007 but were stopped this week because of the significance of the findings.
"These findings are of great interest to public health policy makers who are developing and implementing comprehensive HIV prevention programs," NIH director Dr. Elias Zerhouni said.
"Male circumcision performed safely in a medical environment complements other HIV prevention strategies and could lessen the burden of HIV/AIDS, especially in countries in sub-Saharan Africa where, according to the 2006 estimates from UNAIDS, 2.8 million new infections occurred in a single year," he added.
The trial in Kenya involved 2,784 HIV-negative men and showed a 53-percent reduction of HIV acquisition in those who were circumcised as opposed to those who were not.
In Uganda, 4,996 men took part in the study that showed that HIV acquisition was reduced by 48 percent in circumcised men.
The studies, conducted by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institute of Health (NIH) in the United States, confirm the findings of a similar French-funded study conducted in South Africa.
Dr. Kevin De Cock, director of the HIV/AIDS department at the World Health Organization, said the findings constitute a significant scientific advance in the study of AIDS and could have deep implications as far as policy.
"It (circumcision) does have the potential to prevent many tens of thousands, many hundreds of thousands and perhaps even millions of infections over coming years," he said.
"A once-only intervention that confers 50 percent efficacy is obviously a very important development and I am sure countries are likely to say we need to invest in this," De Cock added.
But he and others warned that the findings should not lull people into believing that circumcision provides full-proof protection against AIDS.
"It is very clear that this is not a substitute for but an addition to, so we anticipate that the prevention messages (...) will have to have the big caveat that (...) this does not mean that you have an absolute protection," said Dr. Anthony Fauci, head of NIAID.
He and others also stressed the importance of circumcisions being carried out by medically trained professionals and with patients receiving proper care following surgery to avoid infections or other complications.
Experts in addition said that in advising circumcision, agencies and governments need to take into account cultural differences, as in some countries the practice is not widely accepted.
"These studies are providing the scientific basis for countries and regions to make their policy," Fauci said. "We are providing the science, the policy needs to be country sensitive and acceptable to the countries involved."
The studies in Kenya and Uganda involved men between the ages of 18 and 24 in Kenya and between the ages of 15 and 49 in Uganda.
In Uganda, 65 of those who took part in the trial contracted HIV, 22 in the circumcised group and 43 in the other group. In Kenya, there were 69 HIV infections among those who took part in the trial, 22 circumcised and 47 who were not circumcised.
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