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Three studies have shown that male
circumcision can reduce female-to-male HIV infection by 60 percent, but
barriers remain to the procedure’s adoption in Africa, where it would do the
most good.
Circumcision itself is simple and
getting simpler. Research shows nurses can perform it safely after three days
of training, and it can be done assembly-line-style with devices requiring no
scalpels or stitches. However, some countries forbid task-shifting from doctors
to less-expensive medical workers. In Uganda, it would take an act of
parliament to authorize nurses to do it, said Angelo Kaggwa, a Ugandan working
with AVAC, an advocacy organization.
In addition, many ethnic groups have
cultural traditions against male circumcision and, for adult men, healing
requires sexual abstinence for six weeks. Since circumcision is only partially
protective, preventive measures - such as using condoms - are still necessary.
Circumcision efforts are increasing
in 14 African nations, where international health agencies hope to reach 80
percent of males ages 15-49 by 2015, or 20 million men. Just 1.5 million
circumcisions have been conducted in the five years since the World Health
Organization recommended the procedure in countries hard-hit by AIDS.
The costs are $65-$95 per procedure,
in addition to about $60 for health system overhead.
Studies show men are willing, and
circumcision uptake has boomed at trial sites: Of men not randomly assigned to
be circumcised in a trial in Nyanza province, Kenya, 50 percent opted to have
the surgery within five years after the study, and follow-up since shows it
reduced their infection risk by 65 percent. In Orange Farm, South Africa,
circumcision prevalence grew from 17 percent to 54 percent in the past three
years. Researchers estimate HIV prevalence there would be 20 percent higher
without such uptake, and that more than 1,000 infections were averted.
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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