Scientists have suspected, but there is now enough evidence that circumcision reduces a man's chances of contracting the HIV virus through heterosexual contact by a good 50 percent.
Performed on the results of two large studies recently, offers a real hope that the deadly virus can be slowed relentless attack on sub-Saharan Africa.
"It has the potential to prevent many tens of thousands, many hundreds of thousands, perhaps millions of infectionsin the coming years, "said Dr. Kevin De Cock, Director of the World Health Organization's HIV-AIDS, on Wednesday after the announcement of the results.
While these studies only looked at infection rates among men, is the hope that fewer infected men, lower HIV rates among women would lead too. A study currently being conducted by the Bill and Melinda Gates Foundation will be funded, should have made a little light on this issue in the autumn of 2008, when the resultsrevealed.
The two clinical trials in Kenya and Uganda, were stopped early by their main sponsor, with the U.S. National Institute of Allergy and Infectious Disease, if a review has shown, is sufficient proof that circumcision works to reduce the risk of infection.
"While HIV / AIDS research will continue to strive for a policy of prevention technology protects sure everyone all the time, we look forward to a strategy that has the potential to be significantlyReduce new HIV infections in sub-Saharan Africa, "said the institute's director, Dr. Anthony Fauci.
The Kenyan study showed a 53 percent reduction in circumcised men aged 18 to 24 The Ugandan study found a 48 percent discount for circumcised men aged 15 to 49
"It said there is no real doubt about the extent of the impact of male circumcision in reducing risks for HIV acquisition," University of Manitoba's Dr. Stephen Moses, in an interview.
Moses was aJoint research in the Kenyan study, which was partially funded by the Canadian Institutes of Health Research.
These reports confirm an earlier South African study showing a 60 percent reduction in new HIV infections in circumcised men compared to uncircumcised. In addition to support so many of the observations made in Africa for many years that the infection rates are much lower among circumcised men.
Dr. Frank Plummer, director of Canada's National MicrobiologyLaboratory in Winnipeg, and co-author of the first scientific work in the New England Journal of Medicine in 1986, says that most recent studies are definitely a step in the right direction.
"I think this proves is that this is an important strategy for HIV reduction," he said from Winnipeg.
As Fauci said, it believed, a left intact foreskin increases the risk of HIV infection, because it is full of a cell-type called Langerhans, perfect targets for the virus. In addition, the delicateMucosa of the foreskin is in "micro-tears", which would allow easy access for the infection.
As promising as these results are, there are potential pitfalls.
First, the health systems in Africa are not all equipped to perform medically safe circumcisions on a large scale.
"The costs that are unlikely to be sustained by these mostly poor countries themselves. So it would be subsidized from outside, will be from external donors," Moses said.
ButDr. Alan Bernstein, President of Canadian funding agency, noted that if they go with the choice of financing the treatment or prevention, prevention is the way to face.
"The treatment is very expensive - the anti-retroviral drugs - and right now it's just to be treated very, very small percentage of people, particularly in Africa," Bernstein said. "The best solution is prevention."
"If circumcision is as effective as the study suggests, andIt is available now and it is certainly cheap, it offers, I think, a very effective strategy to prevent the spread of the virus throughout the world, but especially in Africa, "he concluded.
Fauci, however, also note that there is a concern that people will be dependent on the number of circumcision as a preventative cure for HIV and then let the guards in other areas of protection, such as the use of condoms .
"It is possible that the 48 to 53 percentReduction of HIV could be transmitted by small decreases in condom use, or the addition of more sexual partners be negated, "he said.
Fauci also said that male circumcision is no protective effect on injecting drug users or men who have receptive anal intercourse.
De Cock also expressed concerns, citing possible cultural resistance against female circumcision in some parts of the world. Plummer addressed these concerns and said that some observations have been made
AfricaEthic groups, which traditionally are opposed to circumcision, to the conclusion that it is of advantage, and in many incidents have started to get their children to get circumcised just on their own. "
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