Male Circumcision

Saturday, September 29, 2007

Rwanda to urge male circumcision in AIDS fight

KIGALI, Sept 28 (Reuters) - Rwanda plans to encourage male circumcision to help the tiny African nation curb HIV/AIDS rates, a senior official told Reuters on Friday.

Studies on the continent have found circumcision reduces the risk of HIV transmission from females to males by 60 percent.

However, U.N. research carried out last year said only about one in every five Rwandan men had undergone the procedure.

"We want to embark on a sensitisation campaign to have males in our country circumcised as one way of combating HIV/AIDS," Anita Asiimwe, managing director at the Health Ministry's Treatment and Research AIDS Centre, told Reuters.

"But we don't want to confuse our people to replace circumcision for other preventive measures like the use of a condom and abstinence. It is just coming as an addition."

Asiimwe said the government would soon begin training health workers for the task, before launching a countrywide programme to encourage voluntarily male circumcision which she said could also help prevent other sexually transmitted diseases.

"We want to channel it right from the major hospitals down to the health centres so that access for every willing male is provided," Asiimwe said.

Nearly 25 million people suffer from HIV/AIDS in sub-Saharan Africa.

The U.N. agency UNAIDS says male circumcision has the potential to prevent about 5.7 million new HIV infections and 3 million deaths over 20 years in the region.

In Rwanda, the disease was often spread on during its 1994 genocide, when militiamen raped women and girls.

However, a recent survey showed a 3 percent HIV/AIDS prevalence rate in the country, relatively low compared with neighbouring states.

Friday, September 21, 2007

Rwanda: Government Readies for Mass Male Circumcision

New Times (Kigali)

19 September 2007

Edwin Musoni

The government has at last officially supported male circumcision as a tool to fight against HIV/Aids. But the acknowledgement comes with a call for maximum caution from the health ministry.

As such, the government says it is about to start mass male circumcision as a way of reducing the spread of HIV/Aids and Sexually Transmitted Diseases.Recently, the World Health Organisation (WHO) recommended male circumcision as a tool for reducing risks of acquiring f HIV/Aids virus. It said circumcised men have around 60 percent-risk free chances of not acquiring the virus during sexual intercourse.

The Health ministry says that Rwanda has adopted male circumcision as one of the preventive measures against the disease.

The State Minister for HIV/Aids and other Infectitious Diseases, Dr Innocent Nyaruhirira, has urged Rwandan men to start going for circumcision at recommended medical centers where there are qualified medical personnel.

"The entire exercise would lose meaning if done unethically by just anyone because the intended goal would be missed since it would give rise to other problems resulting from complications," Nyaruhirira said.

He said that the Health ministry is currently in the process of upgrading and availing relevant equipment in hospitals and health centers to enable the operation.

A document from the ministry states that mass circumcision would kick off with the army, police and students from higher institutions of learning.

However, Dr Nyaruhirira warned that circumcision does not provide a "green light for promiscuity because it does not guarantee 100% prevention of the virus."

"Let no one understand that once circumcised, men can go ahead and indulge in unprotected sex because circumcision only protects you from HIV/AIDS by 60 percent.

There is a big risk of 40 percent," he cautioned.

The Director of the Aids Treatment and Research Center (TRAC) Anita Asiimwe said that circumcision had been proved several researches in Africa as a strategy for reducing HIV/Aids prevalence rate.

Last year, three groundbreaking studies conducted in Uganda, Kenya and South Africa found that male circumcision reduces a man's risk of being infected by the human immunodeficiency virus (HIV).

"Male circumcision has been proven to be one of the ways through which Aids transmission can be prevented. Males who are not circumcised are more vulnerable to the virus than those who are circumcised," she said.

She said that the reason why a circumcised male may not contract Aids mainly lies in the absence of the foreskin. "The foreskin harbors and nurtures many organisms including the Aids virus, which eventually enter the bloodstream.

"The same organisms will not survive on a circumcised male because they are exposed and lack the fovourable conditions from which to launch their entry into the body," Asiimwe said.

For an uncircumcised man, she observed, the foreskin peels away during sexual intercourse, leaving a tender muscle that is quite susceptible to ulceration, hence the easy transmission of the Aids virus if the partner is positive.

"A circumcised male, due to exposure, is unlikely to get any ulceration during intercourse because his skin is relatively hardened," she said, adding that male circumcision has more advantages than just the prevention of HIV/Aids and other STDs.

MPs back move

"Male circumcision will not only protect the man but also the woman.

The organisms harboured in the foreskin of an uncircumcised male can easily be passed on to the woman during intercourse and this is the main origin of cervical cancer," Dr Asiimwe noted.

Meanwhile Members of Parliament have pledged their support to the government's decision of mass circumcision.

Deputy Ezekias Rwabuhihi, a former Health minister, said: "male circumcision is a practice that we have to embrace.

However it must be properly and carefully conducted."

"If the research on male circumcision is correct as WHO said, then we have to give full support to the implementation of this policy," Senator Aloysia Inyumba observed.

The WHO has repeatedly called on policymakers to consider using male circumcision to contain the Aids pandemic.

Thursday, September 20, 2007

Uganda: If You Have Ears, Cut Your Foreskin

New Vision (Kampala)

19 September 2007

Hilary Bainemigisha

IF fire broke out in a building, the Government would not rush for the nearest exit! It would need to appoint a commission of inquiry to investigate the fire, organise debates on whether to put out the fire or evacuate the building, consult with partners on how best to react, build consensus, write a proposal on the way forward and then appeal for funding to be able to draft a policy on fire. That would take, on a conservative estimate, four to five centuries.

Governments are naturally like that. They only react spontaneously if it has something to do with teargas distribution. Those who are familiar with marital obligations know the amount of patience required to make a female partner ready for CHOGM. And there is nothing we can do about it, but be patient.

But, in the mean time, there are cases where it is suicidal to just sit and wait for the Government to snail through bureaucracy with a solution. Take circumcision for example. You must have heard of circumcision trials conducted in Uganda, Kenya and South Africa which proved that sharpening it actually reinforces the protective shield against HIV infection.

According to the World Health Organisation, male medical circumcision is the most compelling evidence-based HIV preventive strategy since the discovery of ARV's potential to stop mother-to-child transmission of HIV.

So what does the Government do?

What else, other than appointing commissions to see how best they can consult widely, draft a plan to roll out a policy which will roll out a programme which will roll out circumcision. But in the mean time, uncircumcised penises are allowing in goals and denying us a chance to advance to Ghana in 2008.

Are you going to be that patient? Do you know that medical experts rarely agree on anything? (They are still debating what limb was created first when it is obviously the penis, the sacred author of life).

If, for once in a long time, there is medical consensus that circumcision works, why should we wait for Ugandans to build consensus? We never vote together, after all!

Listen: Take the author of life for improvement IMMEDIATELY - no, first read to the end. Get to know the facts, decide on your own, ask the tough questions and face the knife. Just make sure you do it medically and safely and, like the Cranes, wait for 60 days before you can qualify for the Nations Cup finals.

A study in the 12 months before the population survey revealed that 32% of HIV-positive women and 22% of HIV-positive men had sex with non-regular partners in the past year. 34% men and 5% women who were HIV-positive had sex with more than two partners. Of these, only 16% men and 17% women used condoms. And among discordants (where one partner is positive and the other negative), 5% used condoms consistently.

Is this the environment you and your sons want to swim through with an uncircumcised tail?

If I were you, I would look at my penis, look at all the male members of my family and think about the five million who die annually of HIV. Then I would mobilise all of us, at whatever age, to get to hospital. I would also vow to afford the same protection to any newly born son to the family.

But remember, circumcision does not make you invincible. It only improves your escape chances by 60%. You still need to move along with the Abstinence Be Faithful, Use a Condom (ABC) approach, if you want to see your grandchildren.

Finally, I call upon our female population to add a voice to my plea.

Find a way of getting men off their behinds to face the knife. The tool in question belongs to you as much as it belongs to men and had it not been for you, there would not be need to circumcise it.

For the rest of Ugandans, if you have ears, cut your foreskin!

Neonatal circumcision: Effects on breastfeeding

J Paediatr Child Health. 2007 Sep 4

Neonatal circumcision: Effects on breastfeeding and outcomes associated with breastfeeding.

Fergusson DM, Boden JM, Horwood LJ.

Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand.

Aim: There have been recurrent claims made that neonatal circumcision disrupts the development and maintenance of breastfeeding in infants. The aim of the current study was to use a longitudinal birth cohort study to examine the associations between neonatal circumcision status and both breastfeeding outcomes, and health and cognitive ability outcomes associated with breastfeeding.

Method: Data were obtained from the Christchurch Health and Development Study, a longitudinal study of over 1000 individuals born in Christchurch New Zealand in mid 1977. Data were obtained for male cohort members (n = 635) on circumcision status, breastfeeding outcomes, health outcomes in infancy and cognitive ability outcomes later in life.

Results: Circumcision status was not significantly associated (P > 0.05) with breastfeeding outcomes in infancy, even following adjustment for covariate factors, including maternal age, family socio-economic status, ethnicity and birthweight. Also, circumcision status was not significantly associated (P > 0.05) with health in infancy and cognitive ability outcomes in later childhood, even after adjustment for covariate factors.

Conclusions: There was no evidence of an association between neonatal circumcision status and breastfeeding outcomes, or between circumcision status and health and cognitive ability outcomes associated with breastfeeding, and the findings do not support the view that neonatal circumcision disrupts breastfeeding.

Friday, September 14, 2007

Namibia: Govt to Mull Male Circumcision

The Namibian (Windhoek)
13 September 2007

Brigitte Weidlich

HEALTH issues seem to dominate in Parliament this session, with blood pressure and cholesterol levels being a topic of discussion during the first day and male circumcision surfacing yesterday.

After studies were made public in March that male circumcision trials reduced the risk of HIV infection from women to men by 60 per cent in several African countries, Namibia was also considering this as a preventative measure, Health Minister Dr Richard Kamwi told the National Assembly.

Delivering a ministerial statement on the topic, Kamwi said Government health services in Namibia were presently not geared to cater for male circumcision on a large scale.

The small surgical operation entails cutting a part of the foreskin covering the penis.

"We will carry out an assessment to determine shortcomings and needs and address them properly before we embark on this new service," Kamwi stated.

"It is also important to ensure that circumcised men do not develop a false sense of security, that could cause them to engage in high-risk (sexual) behaviour," the Health Minister cautioned.

Nora Schimming-Chase of the Congress of Democrats (CoD) proposed that all male babies born in clinics could be circumcised.

Safety and Security Minister Peter Tsheehama urged that during public awareness campaigns, the difference between circumcision and castration (removing the testicles) should be well articulated.

"There was a man who went to the doctor asking to be circumcised, but his English was not so good and he confused the two terms.

He asked for a castration, but he only wanted a circumcision.

The doctor however did what his patient told him and gone was the manhood," Tsheehama said.

Saturday, September 8, 2007

HIV Loosens Tribe's Resistance to Circumcision

Many Kenyans See Survival at Stake

By Craig Timberg
Washington Post Foreign Service
Friday, September 7, 2007; Page A01

MBITA, Kenya -- Family gatherings for Collins Omondi once were boisterous affairs here on the verdant shores of Lake Victoria. But in just 11 years, AIDS has killed seven of his uncles, six aunts, five cousins and both his parents. His extended family now consists of one surviving uncle, an aunt and their 2-year-old child -- all of whom have AIDS.

Omondi, 28, a tall, broad-shouldered fish trader, has come to believe that a quirk of culture contributed to the decimation of his family. They were Luos, members of the only major tribe in Kenya that does not routinely circumcise boys. The absence of this ritual, Omondi said, helps explain why Luos are dying from AIDS at a rate unheard of among other Kenyans and rare in East Africa.

Twenty years after the first reports of a connection between HIV rates and circumcision, scientists are saying it is essential to understanding the path of the disease through Africa and possibly to reversing its course. President Bush's $15 billion anti-AIDS program is pledging millions of dollars to Kenya and other countries so they can offer circumcision services in communities long defined, in part, by their reluctance to perform the procedure.

The unprecedented effort already has provoked a backlash from the Council of Luo Tribal Elders, which decided last year to officially oppose it. But along the beaches of Lake Victoria, where fishermen push their colorful sailboats into the waves before dawn each day, many express a willingness to leave this tradition behind if it means surviving an epidemic that seems to have no end.

"We are the people who are sick," said Omondi, who recalled the haunting feeling of walking through his father's empty home on a nearby beach. "We are the ones who lose people every day."

Most African tribes traditionally circumcise boys in rituals marking the onset of manhood. But the Luos and some other Nilotic tribes, whose ancestors migrated south from Sudan, used to mark the end of childhood in a different but also painful way -- removing six bottom front teeth.

AIDS emanated from the jungles of Cameroon or Gabon but hit massive epidemic levels after reaching the uncircumcised tribes around Lake Victoria and, later, southern African tribes that had abandoned their own traditional circumcision rites. These differences help explain why West Africa, where circumcision is routine, has HIV rates much lower than in southern or East Africa. Within Kenya, roughly one in 17 adults has HIV. Yet among Luo adults, the virus has infected one in five.

Scientists say the cells in a man's foreskin are unusually easy for HIV to penetrate. Removing it through circumcision also makes the skin on the penis head grow thicker and more resistant to infection. Trials in Kenya, Uganda and South Africa have shown that circumcised men are 60 percent less likely to contract HIV. The World Health Organization endorsed it as a key prevention strategy in March.

"It's now the most proven, effective HIV prevention strategy we have for male heterosexuals, so it's really important that we make this widely available," said Robert C. Bailey, an epidemiologist at the University of Illinois at Chicago who oversaw the Kenyan trial in nearby Kisumu.

Bailey has calculated that a well-run program could lower the HIV rate among Luo men from 18 percent to 8 percent over 20 years, averting tens of thousands of infections. Women would also be less vulnerable to HIV because of the decreasing infection rates of their sexual partners. Across Africa, widespread circumcision programs could save 5.7 million lives -- far more than any prevention strategy yet tried, U.N. officials have estimated.

Several countries, including Zambia and Swaziland, are exploring how to expand circumcision services, but none is further along than Kenya. Peter Cherutich, a top health official overseeing the issue, said a policy on making circumcision "available in a safe and voluntary manner" probably will be completed in the next month or two.

Officials for the Bill and Melinda Gates Foundation have expressed interest in helping expand circumcision services in Africa but said no final decisions have been made. Several Kenyan health experts said a multimillion-dollar grant from the foundation supporting the effort is expected to be announced soon after Kenya's policy is adopted. The U.S. contribution, worth $5 million to Kenya this year, also is due after the government policy is released.

The program initially would focus here in western Kenya's Luoland. Existing clinics and youth centers could begin offering services as soon as early next year, and mobile teams would use vans to visit churches, markets and beaches where fishermen work, offering free circumcisions with sterile surgical kits they would bring along.

Kawango Agot, a circumcision researcher and herself a Luo, said the effort is likely to be popular. In a survey she and Bailey conducted, 60 percent of Luo men said they would like to be circumcised because they believed it was cleaner and healthier. The percentage was highest among those younger than 25. She called the cultural concerns overblown.

"Sincerely, I just don't care," Agot said. "What I care about is people are dying."

Fear and Education

Luos long have faced discrimination for not circumcising their sons. Members of other Kenyan tribes sometimes refused to vote for Luo politicians on the grounds that they had not become adults. Luos who traveled far from their homeland were mocked with a variety of cruel nicknames, such as "Kehe," which translates literally as "uncircumcised" but to Kenyan ears means "boy."

Meshack Riaga Ogalo, the 73-year-old leader of the Council of Luo Tribal Elders, said the true source of high rates of HIV in the tribe, which is one of Kenya's largest with a population of about 4.5 million, is not the lack of circumcision but the abandonment of traditional culture, especially by fishing communities.

"Nowadays, because of Christianity and all kinds of civilization, you introduce something like love affairs. The world is now horrible," said Ogalo, who favors a walking stick and black cowboy hat. "We don't want foreigners to interfere with our culture. It is absolutely wrong."

Lake Victoria's fishermen, following the winds, often kept girlfriends at several different beaches. The men generally were among the few in villages with steady supplies of cash, arriving home each day with $10 or $20 -- sometimes much more -- in areas where many earn less than $1 a day.

"With the fishermen, you can't trust them," said Mary Achieng Bunde, 41, a former fish trader and an AIDS activist whose husband died of the disease.

Of the women who trade in fish, she said, sexual favors were expected and generally granted. "Most of them, they are ready to do because maybe your husband has died, your children have school fees. . . . What can you do?"

She said attitudes are changing on the beaches because of fear and aggressive education programs. More fishermen are living in family houses, with their wives and children, rather than in communal dorms. The carousing has quieted as the toll of AIDS has grown.

Yet she suspected that circumcision would require a degree of change beyond what most fishermen would accept. "It will not be easy for them, because it is not our culture," she said.

Abandoning Tradition

Less than a mile away, down on the soggy, grass-covered beach where Bunde once bought fish, a new generation of fishermen has taken over. Erick Onyango Otieno, 21, called circumcision "a good idea" and said younger fishermen did not want to make the mistakes of the previous generation.

"The older ones are almost all dead," he said. "I do not want to die at this early age."

Otieno and other fishermen expressed concern about the procedure itself, the amount of pain involved and the possibility of side effects. They worried about losing profits during the days -- and in some cases weeks -- that men may miss work while healing from the procedure.

A few, including some women who worked the beach, echoed the concerns of tribal elders about abandoning culture. Yet more said a Luo man who is circumcised is no less a Luo.

A substantial minority of Luos, especially those who have lived in other parts of Kenya, already have been circumcised. That includes Omondi, whose father had him circumcised when he was a child to prevent him from being teased when he bathed with boys from other tribes.

On another nearby beach, Erick Okoth, 31, a fisherman and father of two, said he has grown weary of the shifting AIDS-prevention strategies -- condoms, abstinence, monogamy, testing -- brought to Luoland. He would rather see the Luos solve their problems themselves.

"Removing the skin is like taking my rights away," Okoth said. "If you are telling me to get circumcised at this age, it's like telling another tribe to remove the teeth."

Some also wondered whether circumcision would affect their fertility, though scientists say it does not. Luos traditionally have large families, and pressures to have several children have grown along with the death toll of AIDS.

"We are going to lose our strength," warned George Okoyo Mawere, 48, a part-time fisherman, politician and local tribal elder. "When you are circumcised, the hormones are lower. That's why within the Luos, we have a very small area, but we have a very big population."

Yet Mawere said that despite his misgivings, he would support making the procedure available if it curbs AIDS. "Obviously we shall, because it's a disaster," he said.

On the beaches closer to the town center of Mbita, where lifestyles are less traditional, few fishermen expressed opposition to circumcision. On the beach worked by Omondi, there was wide consensus about the need for expanding services.

"I'll do it, plus my three sons," said Arthur Odipo, 33, a lean but fit-looking fisherman. "If circumcision can reduce the risk, we will do it."

Fishermen have been dying in Luoland so quickly and for so long that several said they were eager for any solution, regardless of culture.

One respected fisherman died just last month, and his wife appears sick as well, other fishermen said. His picture hangs on the wall of the fishermen's association office, and they were preparing to go, as a group, to the funeral.

Tuesday, September 4, 2007

Uganda: Male Circumcision - Govt Not Ready, Urges Self-Initiative

New Vision (Kampala)

2 September 2007

Hilary Bainemigisha

THE commissioner for community health in the health ministry has advised men to go for circumcision.

Speaking at the first national circumcision dialogue forum at Kabira Country Club recently, Dr. Sam Okware said: "I advise men to take an individual decision to go for medical circumcision together with the male children under their care. The Government will start issuing guidelines and advice on how you can do it safely."

The ministry wants to use male circumcision as an opportunity to increase voluntary counselling and testing, as well as HIV preventive education. "It must be a comprehensive package, recommended to all but not mandatory," Okware said.

Male circumcision works as an HIV preventive strategy, is simple, 60% effective and can reduce HIV incidence dramatically if taken as a combination package with the official Abstinence Be Faithful, use condoms (ABC) policy, Dr Alex Opio of the Ministry of Health said.

However, the assistant commissioner of health services in the National Disease Control Department, told delegates that the Government will not rush into rolling it out before achieving a consensus on the male circumcision policy, the programme and the ethical implications.

"The Government is in a consultation process because any mistake in the implementation process may undermine the expected benefits," he said.

The average male circumcision prevalence in Uganda is 25%, with wide variations from 54.7% in Bugisu to 2.4% in the north central part, yet HIV prevalence there is 8.2%. "We need to make decisions on whether we roll out male circumcision or prioritise in high incidence areas," Opio said.

Other policy considerations in the discussions are training personnel, availing facilities and infrastructure, how to build on what is already there, doing it in full adherence to medical ethics and human rights, as well as minimising potential harmful outcomes.

The Government needs to develop a policy, plan and cost resources without hurting the existing health programmes and set standards and guidelines.

Prof Serwadda took the delegates through the male circumcision research findings from studies on more than 10,000 men in Kenya, Uganda and South Africa.

The Ugandan study, which was carried out under the Rakai Health Sciences Programme on 5,000 men, revealed that the procedure reduces the risk of new HIV infections in men by around 60%. The Uganda and Kenyan studies were halted prematurely when the positive effects shown were overwhelming.

Dr Jesse Kajimba, who represented the minister of health, said the 60% protection is even better than some of the vaccines around. "The efficacy of BCG, the tuberculosis vaccine is 33%, but don't we support it?" Kajimba, who is the senior presidential advisor of HIV/Aids, asked.

"Studies show that if we can reach 60% of circumcision in Uganda, we will have stopped transmission in the community".

The World Health Organisation simulation studies show that expanding male circumcision in Africa over the next 20 years could prevent three million deaths and nearly six million HIV infections.

Uncircumcised men are thought to be more susceptible to HIV infection because the underside of the foreskin is rich in the immune cells which attach easily to HIV. The foreskin also often suffers small tears during intercourse.

Saturday, September 1, 2007

Circumcision can offset AIDS, so encouraging procedure for African males is a wise course

Friday, August 31, 2007

Following up on major stud ies showing a greatly re duced risk of contracting AIDS among African men who had been circumcised, the Bush administration's new $15 billion anti-AIDS program will begin investing in the procedure.

The funding commitment marks a major turnaround since the administration previously cut money for an experimental circumcision program in Swaziland. But that was before findings were published last December from clinical trials conducted by the National Institutes of Health. The study found that new AIDS infections were 60 percent to 70 percent lower among Kenyan and Ugandan men who had been circumcised.

The findings were hailed by AIDS experts around the world, including those at the United Nations AIDS program and the World Health Organization. Although significant advances have been made in AIDS treatment, sexual abstinence and the use of condoms previously had been considered the only effective means of prevention.

Circumcision, experts said, could be a much more practical and effective approach in that it's a one-time procedure and is widely accepted throughout the world.

Ironically, circumcision of males was once widely routine as a tribal ritual of manhood in Africa, but was later discouraged by European missionaries who viewed it as primitive. Some tribes remain wary, but Kenya is showing significant leadership on the issue by planning to expand circumcision services.

A large part of the challenge now facing the international community is educating African nations on the findings, and training and equipping community workers and tribal leaders in conducting the procedure safely and with proper sanitation.

Despite the results showing circumcision greatly reduces the rate of contracting AIDS, experts note it's not 100 percent effective and that education must still emphasize the use of condoms and the increased risk from having multiple sexual partners.

Still, adding a major preventative tool to the arsenal needed to fight this insidious transmittable disease is a major development and one whose use should be encouraged.

An old ally in AIDS fight

DRUG THERAPY, education and prevention are mainstays in the fight against AIDS. But researchers have come up with another idea to stem infection: male circumcision.

In developed countries, the operation is a commonplace option given to parents with infant sons. In Africa, however, the removal of the penis foreskin isn't widespread. Health researchers have noted a important factor: the thin layer of uncut skin is highly vulnerable to the AIDS virus, and removing it could sharply drop infection.

Studies have taken years to establish the point, but now the world's biggest AIDS prevention program run by the United States will begin paying for the operations, mostly in sub-Sahara Africa where 60 percent of the world's 40 million infected people live.

It's a smart investment notable for another reason. In the past, the Bush administration was faulted for pushing abstinence in AIDS programs and obliging poor nations to purchase expensive American-made drugs. Both directives sidetracked the mission and detracted from the image of the United States, by far the biggest funder in the AIDS fight. The circumcision initiative, which makes no judgments on sexual conduct, recognizes science and is free of moralizing that has previously tripped up policymakers.

Circumcision is still far short of being a magic bullet. The operation requires experienced medical personnel and clean conditions. It may also be at odds with local cultural practices. Only 30 percent of males worldwide are believed to be circumcised.

But the efficacy is clear. Robert Bailey, an epidemiologist at the University of Illinois, said uncircumcised males were 2.5 times more likely to contract the AIDS-causing virus.

The potential in blocking a condition that has infected so many can't be ignored. It's time to expand the fight against AIDS with a familiar practice.