A new study concludes that circumcision of HIV positive men does notreduce the risk of transmission of the AIDS virus to women. Butresearchers say male circumcision remains a potent weapon against thespread of HIV.
AIDS campaigners were optimistic after a studythree years ago among circumcised males in Kenya, Uganda and SouthAfrica which found foreskin removal more than halved men's risk ofinfection by HIV.
One of the big questions, though, was whethermale circumcision could also reduce the risk for women who haveintercourse with an HIV-infected man.
The answer, according to a more rigorous trial in Uganda, was no.
MariaWawer, a professor with the Department of Population, Family andReproductive Health at the Bloomberg School of Public Health inBaltimore, Maryland is lead author of the study conducted in Uganda.
"Yes, of course we are disappointed. But the data are what the data are," she said.
The study involved 922 uncircumcised Ugandan men aged 15-49 who were infected with HIV but who did not show any symptoms.
Half of the group then had circumcision. The other half remained uncircumcised for two years.
The study included uninfected female partners of the men. The couples were counseled about safe sexual practices.
Researchersfound that 18 percent of women became infected by their male sexualpartners who were circumcised at the start of the study. That'scompared to 12 percent of women who had relations with theiruncircumcised husbands for two years until the procedure was performed.
The study was halted because Maria Wawer says investigatorsessentially saw no difference in the HIV transmission rate betweencircumcised and uncircumcised men to their uninfected wives.
"Aslong as couples abstained from sex until full wound healing which isabout six weeks then we didn't see any increased risk. We didn't seedecreased risk but we didn't see increased risk," she said.
Wawersays the results of the study - published this week in the journal - do not mean that circumcision overall is ineffective inreducing the rate of HIV transmission.
Wawer says the factthat uncircumcised men may still be at risk of transmitting the virusto women opens the door to education about safe sexual practices," shesaid. "In other words, if men come in for circumcision, it's a greatopportunity to also provide them with HIV health education, to promoteand offer condoms, to promote and if at all possible offer counseling. It's also a way of reaching the partners of men."
Even thoughthe study shows that circumcision appears to offer no benefit to thefemale partners of men who are infected with HIV, Jared Baeten, aprofessor of global health at the University of Washington in Seattle,says programs promoting circumcision reduce the spread of theAIDS-virus in entire communities.
"Preventing men from gettingHIV in the first place by offering them circumcision, by circumcisingthem in the first place, will prevent them from getting HIV and willthereby prevent HIV in women," said Baeten.
Researchers say the longer term benefits of male circumcision to women still need to be further studied.