http://www.afrol.com/articles/24469

FGM, circumcision "likely to spread HIV"

afrol News, 26 February - New research dramatically contradicts the
popular conclusions of recently published reports, holding that
male circumcision protects against contracting AIDS. Scientists
looking at male circumcision and female genital mutilation (FGM)
practices in Kenya, Lesotho and Tanzania found that the cut in
itself was causing many new AIDS cases among adolescents.

The research, published in the March issue of the scientific journal
'Annals of Epidemiology', was carried out by a team of researchers
led by Devon Brewer, director of the research firm Interdisciplinary
Scientific Research. "We found that circumcised virgins and adolescents
in Kenya, Lesotho, and Tanzania were consistently and substantially
more likely to be infected with HIV than their uncircumcised
counterparts," Mr Brewer said.

The researchers analysed data from the 'Demographic and Health
Surveys', which are based on nationally representative samples of
adolescents and adults. In the three African countries studied,
circumcision is typically performed in adolescence or early adulthood
and often in unhygienic circumstances where many individuals are
circumcised with shared, unsterilised cutting instruments.

"SEXUALLY EXPERIENCED MALE ADOLESCENTS WERE NO MORE LIKELY TO BE
INFECTED THAN ADOLESCENT VIRGINS, FURTHER HIGHLIGHTING HOW HIV MAY
BE SPREADING BY MEANS OTHER THAN SEX," THE RESEARCHERS CONCLUDED.

Mr Brewer said "a key problem with nearly all prior research on
circumcision in Africa is that researchers have treated circumcision
only as an anatomic characteristic, and not also as a potential
exposure to others' blood during the circumcision operation." He
continued, "this is striking, because over the last 20 years, many
Africans, including children, have warned that HIV can spread through
circumcision procedures."

The new results in particular raise questions about how to understand
the recent randomised trials of male circumcision in South Africa,
Kenya, and Uganda. These studies, in which some uncircumcised men
were randomly assigned to be circumcised in presumably sterile
conditions and others were not circumcised, showed that male
circumcision reduced HIV acquisition.

The popular news reporting of these findings has been widespread
in Africa. And the basic message in African media has been that
circumcising young boys - and sometimes girls - will protect them
from contracting HIV-AIDS. The new study however shows that this
conclusion is not only wrong, but also a dangerous message, due to
the poor hygienic standards normally applied at circumcision
ceremonies.

Mr Brewer said, "If we had known several years ago what we know now
from the national surveys, there would not have been a good empirical
basis even to conduct the trials. Therefore, it is crucial to
investigate thoroughly the possible mechanisms - which are speculative
at this point - for the protective effect observed in the trials."

The US researcher and his colleagues finally called for more intensive
study of HIV transmission in the context of both traditional and
medical circumcision in sub-Saharan Africa.