Reports came in last Wednesday that circumcision reduces transmission of HIV, in regions where transmission is high. To researchers, this procedure proves to be a cost-effective way to handle the pandemic. In South Africa, a study reported that men with circumcisions reduced new HIV infections by 76%.
Clinical trials demonstrated that circumcisions reduced transmission of HIV and at the International AIDS Society conference, this procedure was shown to have actual benefits in practice. The trial took place in South Africa, in the Orange Farm township. All men over the age of 15 years old were offered free circumcisions. Between 2007 and 2010, about 20,000 men participated, which increased the number of circumcised men in the Orange Farm from 16 percent to 50 percent
For the study the team in 2007 and 2010, 1,200 men were included. Results revealed that on average there were 2.86 HIV infections per 100 uncircumcised men, compared to 0.42 HIV infections per 100 circumcised men. Thus it appears the circumcised men experienced a 76% reduction in infections. Additionally, it is important to mention there was no evidence of circumcised men being more likely to use condoms or otherwise change their behavior.
The cause behind this phenomenon is unclear. But there are theories that in the fold of the uncircumcised tip, viruses and bacteria can grow. In addition, a study showed that the foreskin has been found to have a high concentration of HIV infected cells.
“Reducing the number of new infections with adult male circumcision will save lives and reduce the need for antiretroviral therapy” study author Professor Bertran Auvert, professor of public health at the University of Versailles, said in a written statement. “The roll out of adult safe male circumcision should become a top health priority in Southern and Eastern Africa… We are changing the social norms. It's the first time in the world that we have a successful intervention in a community to reduce the sexual transmission of HIV between adults,” he said.
Other African countries are also encouraging circumcisions. According to the World Health Organization, Kenya has already circumcised about 290,00 men in the last three years. Tanzania announced plans to circumcise at least 2.8 million men over the next five years, and Swaziland plans to circumcise 152,800 men. Looking at circumcisions economically, each procedure costs $108, and every five men circumcised prevent one new HIV infection. Thus every dollar spent on the procedure would potentially save $15 that would have been spent on treatment.
The Centers for Disease Control and Prevention (CDC) adds that African circumcision studies may not have much bearing on U.S. HIV rates. They write that the studies have only shown efficacy for reducing HIV transmission from penile-vaginal sex, the predominant mode of HIV transmission in Africa, “Whereas the predominant mode of sexual HIV transmission in the U.S. is by penile-anal sex among men who have sex with men.”
Another Ugandan study found that HIV and AIDS patients receiving antiretroviral “cocktail” therapy can expect to live nearly as long as their compatriots who don't have HIV. “They can have almost a normal life expectancy, and live approximately two thirds as long as if they had not had HIV,” said Edward Mills, a professor of global health at the University of Ottawa in Canada and lead author of the study. “This is very good news.”
Mills and his colleagues looked at the health records of more than 20,000 people who received medications from The AIDS Support Organization in Uganda. The total cost of an individual's AIDS treatment in Uganda averages about $1,000 a year. Much of the funding for the drugs, which became available to these patients in 2004, has come from the United States. About 1,500 of the patients died between 2000 and 2009.
From the data, the researchers predicted that patients in their 20s and 30s who are on the drugs would be expected to live an additional 27 years. The normal life expectancy in Uganda is 55.
“One of the reasons this study is important is it looks at the most simple therapy available,” Mills said, referring to the lack of laboratory testing and treatments for other diseases that are available to HIV patients in the U.S. “Given that, we still demonstrate excellent outcomes.”
“We were heartened” by the results”, said Dr. Deborah Cotton, deputy editor of the Annals of Internal Medicine, where the study was published. “Even in a country like Uganda that has fewer options for drugs and people start later than is ideal, there's a significant benefit of treatment,” said Cotton, who was not involved in the research.
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