UN Integrated Regional Information Networks - February 12, 2007

KAMPALA, 12 February (PLUSNEWS) - Recent findings that male circumcision reduces the risk of contracting HIV have generated a heated national debate, with President Yoweri Museveni arguing that the findings could hurt the fight against the pandemic.

"These days, there are many confusing messages: one of them is that if you are circumcised, you are less likely to catch AIDS even if you behave recklessly - now what sort of message is that?" the president said recently, adding that such messages sent the wrong signal to the people and caused apathy in the fight against HIV/AIDS.

In December 2006, the National Institute of Allergy and Infectious Diseases in the United States, part of the National Institutes of Health, announced an early end to two clinical trials investigating the effects of adult male circumcision after an interim review of the data revealed that medically performed circumcision significantly reduced a man's risk of acquiring HIV from having heterosexual intercourse.

The trial involved almost 3,000 HIV-negative men in Kisumu, western Kenya, and showed a 53 percent reduction in contracting HIV among those who were circumcised, while a trial with about 5,000 HIV-negative men in the Rakai District of central Uganda showed that HIV acquisition fell by 48 percent in circumcised men.

Dr Godfrey Kigozi, one of the investigators in the Ugandan study, told IRIN/PlusNews that the study highlighted the protective effect of male circumcision on transmission of the virus, but emphasised that it did not remove the risk altogether.

"When you say circumcision reduces acquisition ... it does not mean it eliminates HIV/AIDS," Kigozi said. "It is just one component in our arm of prevention. If you are circumcised, then it is fine, but if you practice safe sex or abstain [that is] better."

Museveni argued that Uganda's success in controlling HIV/AIDS was because of the clear message his government has sent. "The way we controlled AIDS was because of an unequivocal message that there is a sickness which is not curable, you get it through sex, and when you get it you die. Therefore, avoid all risky sexual behaviours," he said.

Addressing the nation at celebrations in the capital, Kampala, to mark 21 years of his rule on 26 January, Museveni advised young people to abstain from sex until they had found a partner for marriage.

"I am worried that HIV infection rates have started to rise, and people think that HIV is no longer there," he said. "Abstain until you get a permanent partner. You have to know that the ARVs [antiretrovirals] don't cure but only prolong your life."

Museveni's government has been credited with reducing HIV prevalence in Uganda from over 20 percent in the early 1990s to about six percent by 2000. However, there was a marginal rise in prevalence from 6.4 percent in 2005 to 6.7 percent in 2006: a trend some analysts have blamed on complacency and wide use of the life-prolonging drugs.

Dr Sam Okware, director of health services in the health ministry, told PlusNews that the ministry was still assessing the findings on male circumcision to see how they could be factored into the country's general prevention strategy.

070212
IR070218

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2007. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .