Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - July 17, 2006
Maryian Alowo
According to a scientific study published in Public Library of Science Medicine, male circumcision could avert two million new infections and 300 000 deaths over the next 10 years.
"Circumcision can avert a further 3,7-million infections and 2,7-million deaths by 2026," it said. "Because circumcision reduces male vulnerability to HIV infection, the proportion of HIV-positive people who are women in sub-Saharan Africa would continue to grow, reaching 58% by 2026."
The publication said circumcision is believed to reduce the risk of male infection because it removes the vulnerable tissue inside the foreskin that contains Langerhans cells (a type of cell particularly vulnerable to HIV infection).
"The area under the foreskin is also vulnerable to trauma and is more likely to become abraded if vaginal lubrication is not present," it said. "Uncircumcised men may be more vulnerable to sexually transmitted infections because the area under the foreskin can retain bacteria acquired during sex, thus increasing the chance that an infection will become established."
The study was carried out by epidemiologists from the World Health Organisation, the United Nations Joint Programme on HIV/Aids (UNAids), the University of California, South Africa and France in Kenya and Uganda last year. Full results will not be known until next year.
They warned that better data will be needed before the figures can be used to make public health policy decisions. "Better information is needed on HIV prevalence. UNAids prevalence estimates have a margin of error of up to 30%," the researchers said.
According to Bertrand Auvert, the researcher who carried out last year's South African study, acceptability studies conducted in Kenya, South Africa and Uganda show that between 50% and 75% of uncircumcised men would opt to have themselves and their sons circumcised if it was proven to reduce the risk of HIV transmission.
Circumcision prevalence varies in Africa from 80% to 95% in the Muslim-influenced countries of West Africa to 85% in Kenya, 25% in Uganda and Botswana and 10% to 15% in Zambia, Lesotho, Rwanda and Zimbabwe, according to data gathered between 1967 and 2004 in three separate surveys.
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