Reply #245: Newer research was conducted by the WHO and announced last July. [View All]

There are two more large scale studies being conducted under the auspices of the U.N. whose preliminary results are expected to be released this summer. Together, these studies are expected to provide the definitive answer. Note that the latter two studies "will be important to clarify the relationship between male circumcision and HIV in differing social and cultural contexts." In other words, they are expected to address the cultural issues that muddied the results of the earlier research.

http://www.who.int/mediacentre/news/releases/2005/pr32/en/

"26 JULY 2005 | RIO DE JANEIRO -- The Joint United Nations Programme on HIV/AIDS notes with considerable interest the results of a trial examining the potential link between male circumcision and a lower risk of HIV acquisition that were presented today at the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, being held in Rio de Janeiro, Brazil. The trial was carried out in Gauteng province in South Africa among men aged 18-24 years and was funded by the French Agence Nationale de Recherches sur le SIDA (ANRS).

"Although the trial shows promising protective effects of adult male circumcision in reducing HIV acquisition, UNAIDS emphasizes that more research is needed to confirm the reproducibility of the findings of this trial and whether or not the results have more general application. In particular the findings from two ongoing trials in Uganda and Kenya, funded by the US National Institutes of Health, will be important to clarify the relationship between male circumcision and HIV in differing social and cultural contexts.

"The results of these trials will need to be considered by governments and other key stakeholders in order to determine whether male circumcision should be promoted as an additional public health intervention to reduce the risk of sexual transmission of HIV.

"If male circumcision is confirmed to be an effective intervention to reduce risk of acquiring HIV, this will not mean that men will be prevented from becoming infected with HIV during sexual intercourse through circumcision alone. Nor does male circumcision provide protection for sexual partners against HIV infection. It will therefore be essential that it be part of a comprehensive prevention package, which includes correct and consistent condom use, behaviour change, and voluntary counselling and testing. Any new prevention modality must not undermine existing protective behaviours and prevention strategies that reduce the risk of HIV transmission."

MORE HERE:

http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/07/06/MNGANDJFVK1.DTL&type=printableL

"French and South African AIDS researchers have called an early halt to a study of adult male circumcision to reduce HIV infection after initial results reportedly showed that men who had the procedure dramatically lowered their risk of contracting the virus.

"The study's preliminary results, disclosed Tuesday by the Wall Street Journal, showed that circumcision reduced the risk of contracting HIV by 70 percent -- a level of protection far better than the 30 percent risk reduction set as a target for an AIDS vaccine.

"According to the newspaper account, the study under way in Orange Farm township, South Africa, was stopped because the results were so favorable. It was deemed unethical to continue the trial after an early peek at data showed that the uncircumcised men were so much more likely to become infected."

The problem, as I understand it from reading elsewhere, is not whether the results are valid or not -- they were received with a great deal of interest at the July international aids conference in Brazil. The problem is that the dramatic drop in transmission because of circumcision benefits the man who has the circumcision, but not the female partner (who is exposed to the virus through the semen). While they think male circumcisions could sharply reduce the infection in males, they don't want men to stop using condoms, both for their own sake and for the sake of their partners.

No one is saying that condoms don't provide the most protection, but that other measures should be taken, too, including circumcision, biocides, and vaccines. Circumcisions are a preventative measure that can be offered immediately, while the others are in development.