Circumcision to Avert HIV Infection

Adopting male circumcision throughout Africa could help to avert about 5,7-million HIV infections by 2026.

A scientific study that was published in Public Library of Science Medicine, stated that male circumcision could avert 300 000 deaths and about two million new infections over the next decade.

According to the report, "Circumcision can avert a further 3,7-million infections and 2,7-million deaths by 2026. 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 study theorized that circumcision reduced the risk of male infection because the vulnerable tissue inside the foreskin containing the Langerhans cells, which are particularly vulnerable to HIV infection, are removed.

In addition the report also stated, "The area under the foreskin is also vulnerable to trauma and is more likely to become abraded if vaginal lubrication is not present. 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."

Epidemiologists from the United Nations Joint Program on HIV/Aids (UNAIDS), World Health Organization, the University of California, France and South Africa carried out the study in Kenya and Uganda last year. Full results of the study will be known only by next year.

However they have asserted the need for better data before these estimates can be used to make public health policy decisions. The researchers said, 'Better information is needed on HIV prevalence. UNAIDS prevalence estimates have a margin of error of up to 30%.'

Bertrand Auvert is the researcher who carried out the South African study last year. His acceptability studies in South Africa, Kenya and Uganda show that between 50% and 75% of uncircumcised men would choose to have themselves and their sons circumcised if it could be proved to reduce the risk of HIV transmission.

Presently the prevalence of circumcision varies in Africa from 10% to 15% in Zimbabwe, Zambia, Rwanda and Lesotho, 25% in Botswana and Uganda and 80% to 95% in the Muslim-dominant countries of West Africa to 85% in Kenya. These are the results of the data gathered between 1967 and 2004 in three separate surveys.