Circumcision
April 27, 2003 - Circumcision - a vital report
"Circumcision can help reduce HIV risk" - Asian News
International, Washington
|
A sub - analysis of 10 African studies found a 71 per cent
reduction even among higher risk men, according to experts
at the US Agency for International Development (USAID).
"There is really a strong association between circumcision
and HIV protection," Dr Anne Peterson, assistant administrator
for global health at USAID, was quoted as saying by The
Washington Times.
Based on a systematic review of 28 scientific studies, published
by the London School of Hygiene and Tropical Medicine, the
experts say that the skin on the inside of the male foreskin
is 'mucosal', similar to the skin found on the inside of
the mouth or nose.
This mucosal skin has a high number of Langerhan cells, which
are HIV target cells, or doorway cells for HIV. |
|
The rest of the skin on the penis is more like the outer skin
on the rest of the body, a barrier that protects against germs.
"HIV looks for target cells, like the Langerhans; it's a
lock and key," said Edward G. Green, senior researcher at
Harvard University, who has been looking at circumcision and HIV
in Africa for 10 years.
"The rest of the skin on the penis is armourlike."
He said that it is better to be circumcised as a baby, rather
than as a teenager.
Green also said that if all males in Africa were circumcised,
the HIV/AIDS prevalence rate could be reduced from 20 per cent
in some regions to below five per cent.
In addition, circumcision reduces the transmission of other sexually
transmitted diseases, is more hygienic, reduces infections associated
with poor hygiene and makes it easier to use a condom, the expert
stated.
The researcher emphasised that circumcised men should not believe
that they are invulnerable to HIV.
"It reduces your risk. People who are circumcised still
get HIV. It is still better to abstain, be faithful in marriage,
or use condoms."
Philippines "Puzzle"
About a week earlier than the Washington report (above), the
International AIDS Society published a New York Times report about
:
"An unusually low HIV prevalence in the Philippines - about
0.01% according to the UN estimate- (that) has health experts
puzzled."
The New York Times report said a few factors suggest that the
(infection) rate should be much higher:
- Rare condom use (only 4% of men use them regularly)
- A large proportion of overseas workers (10% of population)
who could bring HIV with them on visits home
- The testing of 1,600 prostitutes in one city found only 5
infections.
The report said several variables may explain why HIV prevalence
is so low:-
- Low ratio of customers to sex workers
- Low rate of ulcerative sexually transmitted diseases
- Limited IV drug use
- Low rate of anal sex
- High rate of circumcision.
AIDS Information Services understands from its sources in Australia
that the Philippines puzzle is not as mystifying as it might seem.
THE HIGH RATE OF CIRCUMCISION, although placed on the bottom
of the list of variables, is certainly a key factor in the low
prevalence and the Philippines owes that not to chance but to
the presence and recommendations of American surgeons there following
the Second World War.
Prof. Roger Short is presently enroute to Europe and the United
States to continue his work on the Lemons and AIDS project.
He will be filing reports to this website while he's away from
Australia.
|
