In response to the launch of a new website, www.malecircumcision.org, by Family Health International, WHO, UNAIDS, and AIDS Vaccine Advocacy Coalition to promote male circumcision as a prevention for HIV, the International Coalition for Genital Integrity (ICGI) issues a renewed warning to the world health community that male circumcision is the wrong approach to curb the HIV epidemic in Africa and elsewhere.
West Lafayette, IN (PRWEB) February 26, 2009 -- In response to the launch of a new website, www.malecircumcision.org, by Family Health International, WHO, UNAIDS, and AIDS Vaccine Advocacy Coalition to promote male circumcision as a prevention for HIV, the International Coalition for Genital Integrity (ICGI) issues a renewed warning to the world health community that male circumcision is the wrong approach to curb the HIV epidemic in Africa and elsewhere.
“We are gravely concerned that the push for mass circumcision in Africa will have detrimental consequences, including placing women at greater risk of HIV transmission, creating a false sense of security in circumcised males, and leading to increased risk-compensation behaviors such as no longer using using condoms. Circumcision campaigns will result in huge numbers of circumcision complications. This will severely strain the already burdened healthcare infrastructure,” says Dr. John Travis, MD, MPH, and ICGI advisor. “Furthermore, these campaigns will cause the re-direction of money that could be better spent on more effective HIV prevention strategies such as condom distribution and education campaigns.”
The recent push for male circumcision has resulted primarily from three studies on adult males in Africa that showed a decrease in HIV in circumcised males during the study period. The studies were conducted in a highly controlled and medicalized environment, were terminated early, were not double blind, and condoms and other safe sex practices were heavily promoted. Consequently, it is unsure if their results were from the surgery, wearing condoms, education, or some other factor. There is no evidence these studies can be extrapolated to the general population. The results of these studies have since been contradicted by other studies from Africa and in the Americas.
“Obviously, the world is desperate for any solution that might help stem the HIV crisis. Unfortunately, circumcision is being treating like popping a pill. This is surgery. It carries the risk of major surgical complications. Male circumcision is not the answer to the HIV crisis,” warns Travis. “We find it especially troubling that infant circumcision is also being promoted. This is a severe human rights violation. To surgically remove a part of an infant’s body for a possible benefit, if any, 15–20 years from now when he becomes sexually active, is simply wrong—especially when there are more effective methods available.”
For more information on why male circumcision is a dangerous distraction in the battle to fight, health policy leaders and other concerned individuals can go to www.icgi.org/aids or www.circumcisionandhiv.com to learn more.
http://www.prweb.com/releases/2009/02/prweb2178774.htm
1 comment:
The studies which allegedly show a reduction in HIV among circumcised men are indeed highly questionable. Not one of them was finished, despite the protective affect appearing to decline well below the oft-reported 65%, and several of the subjects disappearing. The fact that one study described circumcision as "comparable to a vaccine of high efficacy" seems to show clear bias. They appear to have been seeking a certain result. One has to wonder how many of the people promoting circumcision in Africa are themselves circumcised.
Other epidemiological studies have shown no correlation between HIV and circumcision, but rather with the numbers of sex workers, or the prevalence of "dry sex".
The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circed men than intact men, yet they've just started a nationwide circumcision campaign. Other countries where circumcised men are *more* likely to be HIV+ are Cameroon, Ghana, Lesotho, Malawi, Swaziland, and Tanzania. That's seven countries where men are more likely to be HIV+ if they've been circumcised.
Cameroon: http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf table 16.9, p17 (4.1% v 1.1%)
Ghana: http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf table 13.9 (1.6% v 1.4%)
Lesotho: http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf table 12.9 (22.8% v 15.2%)
Malawi: http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf table 12.6, p257 (13.2% v 9.5%)
Rwanda: http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf , table 15.11 (3.5% v 2.1%)
Swaziland http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf table 14.10 (21.8% v 19.5%)
Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives not save them.
If you read those reports btw, the level of knowledge about HIV is quite frightening. In Malawi for instance, only 57% know that condoms protect against HIV/AIDS, and only 68% know that limiting sexual partners protects against HIV/AIDS. There are people who haven't even heard of condoms. It just seems really misguided to be hailing male circumcision as the way forward. It would help if some of the aid donors didn't refuse to fund condom education, or work that involves talking to prostitutes. There are African prostitutes that sleep with 20-50 men a day, and some of them say that hardly any of the men use a condom. If anyone really cares about men, women, and children dying in Africa, surely they'd be focussing on education about safe sex rather than surgery that offers limited protection at best, and runs a high risk of risk compensatory behaviour.
Circumcised male virgins are more likely to be HIV+ than intact male virgins, as the operation sometimes infects men. The latest news is that circumcised HIV+ men appear more likely to transmit the virus to women than intact HIV+ men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised. This is not the first time that HIV in women has been linked to partner circumcision.
ABC works against HIV. Circumcision appears not to. Remember that circumcision won't make any difference unless someone is having unsafe sex with an HIV+ partner.
Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that.
For a good summary of the case against promoting circumcision in Africa, see this link:
http://www.doctorsopposingcircumcision.org/info/HIVStatement.html
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