Friday, July 20, 2007

Namibia: Male Circumcision Reduces HIV Infection

The Namibian (Windhoek)

19 July 2007
Posted to the web 19 July 2007

Staff Reporter

THE Namibian branch of the Southern African HIV Clinicians Society has welcomed recent evidence that male circumcision reduces HIV transmission by 60 per cent but warned that circumcised men can still get the disease.

Dr Bernard Haufiku, President of the HIV Clinicians Society, said the scientific evidence of six in 10 circumcised men not getting HIV through intercourse with women, was "overwhelming".

"As it is very clear to everyone, this 60 per cent reduction in risk of transmission is just an 'add on' intervention. Our ABC (abstain, be faithful, condomise) can actually include another C (circumcision) to become ABCC", Haufiku said.

In short, he said, circumcision was "neither a magic bullet nor a "licence to unprotected sex or any risk behaviour".

The World Health Organisation (WHO) and UNAIDS recently endorsed male circumcision as an intervention to be included in the HIV prevention strategy.

"Circumcision is not new to Africa or to Namibian society. It is not an attempt at neo-colonialism. It is being practised for religious, cultural, hygienic or medical reasons," Haufiku said.

However, when done by untrained, unskilled or unscrupulous practitioners it can lead to several complications such as bleeding, infection of HIV and other diseases, permanent damage to the penis or even death.

While efforts were being made to improve on routine offers of male circumcision, Haufiku appealed to medical aid funds and health care workers not to deny individuals the right to have access to circumcision where available and safe.

Researchers from the University of Illinois at Chicago conducted a clinical trial enrolling 2 784 HIV negative, uncircumcised men between 18 and 24 years old in Kisumu, Kenya, where an estimated 26 percent of uncircumcised men are HIV infected by age 25.

The majority of the men in the study were Luo, an ethnic group that does not traditionally practice circumcision.

Half the men were randomly assigned to circumcision and half the men remained uncircumcised for two years.

Participants received free HIV testing and counselling, medical care, tests and treatment for sexually transmitted infections, condoms and behavioural risk counselling during periodic assessments throughout the study.

The clinical trial found that 47 of the 1 391 uncircumcised men contracted HIV, compared to 22 of the 1 393 circumcised men.