More Ugandan men seeking circumcisions to lower HIV risk

An increasing number of Ugandan men are seeking circumcisions in response to increasing evidence that the procedure could reduce a man's risk of contracting HIV, the AP/Advocate reports (AP/Advocate, 3/30).

According to final data from two NIH-funded studies conducted in Uganda and Kenya published in the Feb. 23 issue of the journal Lancet, routine male circumcision could reduce a man's risk of HIV infection through heterosexual sex by 65% (Kaiser Daily HIV/AIDS Report, 3/29).

According to the World Health Organization, many local radio stations in Uganda broadcast news about the studies, and several clinics in the country are offering male circumcisions for about $17 per procedure.

Godfrey Kigozi, who coordinated the circumcision trial in Uganda and works at the Rakai Health Sciences clinic, said recent requests for the procedure are "just too many given the facilities we have here," adding, "We can only handle the study participants first before we can offer surgery to outsiders."

The clinic is waiting for guidelines from WHO on how to provide the surgery to the general population to ensure that doctors receive adequate training and that men are aware they are at an increased risk of HIV if they resume sex before the circumcision wounds have healed, Kigozi said (AP/Advocate, 3/30).

WHO and UNAIDS on Wednesday recommended that male circumcision be made available in countries highly affected by HIV/AIDS.

The agencies recommended that the procedure be offered in addition to other prevention programs, including HIV testing and counseling, treatment for other sexually transmitted infections, promotion of safer-sex practices and condom distribution.

The agencies said that the procedure only should be performed by trained, certified providers in "sanitary settings with adequate equipment and with appropriate counseling and other services."

In addition, male circumcision should be offered at no cost or at the lowest possible price, the agencies said (Kaiser Daily HIV/AIDS Report, 3/29).

According to the AP/Advocate, although men in Rakai "appear to have wholeheartedly endorsed circumcision, their motivation may not just be about HIV prevention."

Studies by the Rakai Health Sciences Program indicate that women want their partners to undergo the surgery because they believe it will "improve [their] sexual prowess," the AP/Advocate reports.

Kigozi said he hopes the clinic will receive funding so that physicians can perform the surgery at no cost.

Kim Eva Dickson, a WHO HIV/AIDS specialist, said that although health services in many areas are "over-stretched," male circumcision is an "intervention with proven efficacy and could have a potentially great impact on the HIV epidemic" (AP/Advocate, 3/29).