Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
 |
Voice of America - July 16, 2009
Jessica Berman
Washington
A new study concludes that circumcision of HIV positive men does not reduce the risk of transmission of the AIDS virus to women. But researchers say male circumcision remains a potent weapon against the spread of HIV.
AIDS campaigners were optimistic after a study three years ago among circumcised males in Kenya, Uganda and South Africa which found foreskin removal more than halved men's risk of infection by HIV.
One of the big questions, though, was whether male circumcision could also reduce the risk for women who have intercourse with an HIV-infected man.
The answer, according to a more rigorous trial in Uganda, was no.
Maria Wawer, a professor with the Department of Population, Family and Reproductive Health at the Bloomberg School of Public Health in Baltimore, Maryland is lead author of the study conducted in Uganda.
"Yes, of course we are disappointed. But the data are what the data are," she said.
The study involved 922 uncircumcised Ugandan men aged 15-49 who were infected with HIV but who did not show any symptoms.
Half of the group then had circumcision. The other half remained uncircumcised for two years.
The study included uninfected female partners of the men. The couples were counseled about safe sexual practices.
Researchers found that 18 percent of women became infected by their male sexual partners who were circumcised at the start of the study. That's compared to 12 percent of women who had relations with their uncircumcised husbands for two years until the procedure was performed.
The study was halted because Maria Wawer says investigators essentially saw no difference in the HIV transmission rate between circumcised and uncircumcised men to their uninfected wives.
"As long as couples abstained from sex until full wound healing which is about six weeks then we didn't see any increased risk. We didn't see decreased risk but we didn't see increased risk," she said.
Wawer says the results of the study - published this week in the journal The Lancet - do not mean that circumcision overall is ineffective in reducing the rate of HIV transmission.
Wawer says the fact that uncircumcised men may still be at risk of transmitting the virus to women opens the door to education about safe sexual practices," she said. "In other words, if men come in for circumcision, it's a great opportunity to also provide them with HIV health education, to promote and offer condoms, to promote and if at all possible offer counseling. It's also a way of reaching the partners of men."
Even though the study shows that circumcision appears to offer no benefit to the female partners of men who are infected with HIV, Jared Baeten, a professor of global health at the University of Washington in Seattle, says programs promoting circumcision reduce the spread of the AIDS-virus in entire communities.
"Preventing men from getting HIV in the first place by offering them circumcision, by circumcising them in the first place, will prevent them from getting HIV and will thereby prevent HIV in women," said Baeten.
Researchers say the longer term benefits of male circumcision to women still need to be further studied.
090716
VA090705
Copyright © 2009 - Voice of America. You are welcome to use any material that is published by voanews.com, or you may link to any of the web pages that Voice of America has published on the internet. There is no need to request further permission. Should you wish to establish a link to any VOA web pages, please send your request to pubaff@ibb.gov. We would appreciate that credit for any use of VOA material be given to voanews.com, Voice of America, or VOA, and we ask that you not abridge or edit any VOA material which you may use.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.
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 not meant to be a substitute for the advice provided by your own physician or other medical professionals. This article first appeared in 2009. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2009. 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. .