International health organizations endorse male circumcision

Procedure aligned with HIV/AIDS risk reduction

By: Courtney Burks

Posted: 4/23/07

The world may be one step closer in winning the battle against HIV/AIDS, as organizations worldwide have taken further action on preventing the infectious disease. On Mar. 28, the World Health Organization and the UN Aids Secretariat convened in Paris, France to officially recommend male circumcision to be included in a comprehensive HIV-prevention package.

Recent studies have shown that there is a relationship between male circumcision and the prevention of HIV infection, specifically in areas where HIV is prevalent among heterosexual males. In trials taken in Uganda, Kenya and South Africa, results showed that there was an approximately 60 percent risk reduction for contracting HIV among circumcised males.

Dr. Kevin DeCock, director of the WHO's HIV/AIDS department, said in a UNAIDS press release that these findings have been momentous in helping decrease HIV rates in countries where the disease is currently widespread.

"The recommendations represent a significant step forward in HIV prevention," DeCock said. "Scaling up male circumcision in such countries will result in immediate benefit to individuals. However, it will be a number of years before we can expect to see an impact on the epidemic from such investment."

By endorsing male circumcision as a means for reducing the risk of HIV, the WHO and UNAIDS continue to emphasize the point that such a precaution is not the only way males can avoid contracting the disease. According to the organizations, male circumcision should be part of a comprehensive prevention package that also includes HIV counseling and testing services, treatment for other sexually transmitted infections, health education that promotes safer sex practices and access to condoms and support for their correct and consistent use.

Catherine Hankins, associate director for the department of policy, evidence and partnerships at UNAIDS, said in a WHO media statement that this recommendation and additional HIV prevention will be significant factors in the fight to end the AIDS epidemic. However, Hankins emphasized how important it is that men do not think circumcision is the only means of risk reduction to which they must submit.

"[W]e must be clear: Male circumcision does not provide complete protection against HIV," Hankins said. "Men and women who consider male circumcision as an HIV preventive method must continue to use other forms of protection such as male and female condoms, delaying sexual debut and reducing the number of sexual partners."

Dr. Marc Schenker, chair of the department of public health sciences at UC Davis, said he thinks it was a good initiative for the WHO and UNAIDS to endorse such a public-health intervention as male circumcision, but he knows that individuals will take the information as they wish to use it and it may serve as a more complex issue.

"As with any public-health intervention, there will be those who choose not to participate," Schenker said. "In this case, appropriate personal hygiene can accomplish the same end. The question is whether this active intervention (hygiene) will be implemented as much as the passive reliance on circumcision."

As stated by UNAIDS, an estimated 665 million men are circumcised, making up approximately 30 percent of men worldwide. These numbers, however, only demonstrate what studies have done so far. Additional research will be conducted to further update and enhance the development of male circumcision programs in accordance with HIV risk reduction.

COURTNEY BURKS can be reached at
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