Male circumcision could prevent HIV/AIDS infection

Dr. Augustino Hellar of Jhpiego conducting male circumcision

By Nasser Kigwangallah, recently in Dodoma

MALE circumcision has been proven to prevent female-to-male infection with the human immunodeficiency virus (HIV).

The theory that male circumcision may be protective against HIV infection was invented and developed first in North America and practiced in Africa.

This was revealed by Dr. Augustino Hellar, of Jhpiego in his paper presented at a two day conference of Tanzania Parliamentarians Aids Coalition (TAPAC) in Dodoma on Sunday last week.

According to Dr. Augustino Hellar, removing the foreskin can prevent HIV infection by at least half.

He said those who advocate of male circumcision, have further promoted male circumcision as a way of fighting the pandemic.

“Countries that have been practicing male circumcision have low rate of HIV/AIDS infection as compared to those countries that do not practice the norm,” he said.

He said numerous observational studies were carried out in Africa.

Circumcision advocates conducted randomized controlled trials (RCTs) in Africa.

Three RCTs to study the value of male circumcision in reducing HIV infection have been conducted in Africa.

The studies were intended to find out if circumcision is an effective intervention to prevent female-to-male HIV infection.

A RCT was carried out in Orange Farm, South Africa; a RCT was carried out in Kenya and a RCT was carried out in Uganda.

All three studies found that non-circumcised males contract HIV infection more quickly than circumcised males.

All three studies were terminated early, before the incidence of infection in circumcised males caught up with the incidence of infection in the non-circumcised males.

He said: “National strategy for scaling up male circumcisionfor HIV prevention started in Tanzania since 2009 by starting with Iringa, Mbeya and Kagera regions,” he added.

According to him, the strategy intended to be conducted in eight regions, now there are 12 regions conducting male circumcision namely;

Mara,Rukwa,Iringa,Tabora,Mbeya,Mwanza,Kagera and Shinyanga regions.

The World Health Organisation (WHO) recommended that male circumcision, if done properly could reduce HIV/AIDS infection by 60 per cent.

Circumcision by male is one strategy of fighting the spread of HIV/AIDS to a greater extent.

It is my hope that this initiative, if spread all over the country, could be way effective ways of reducing the spread of HIV/AIDS.

Circumcision practices are largely culturally determined and as a result there are strong beliefs and opinions surrounding its practice.

It is important to acknowledge that researchers' personal biases and the dominant circumcision practices of their respective countries may influence their interpretation of findings.

Circumcision does not prevent HIV infection, all together if the particular person does not adhere to norms and practices of abstinence and of being faithful to his wife or partner.

There are many methods of HIV transmission, including: mother-to-child infection, transfusion of tainted blood, infection with non sterile needles used in health care, infection by homosexual and heterosexual anal intercourse, infection by needle sharing to inject illegal drugs, traditional African scarring practices, tribal (ritual) circumcision, female circumcision, male-to-female heterosexual transmission, and female-to-male heterosexual transmission.

Male circumcision might only reduce infection by the last method, so the overall influence on the HIV epidemic in Africa, at best, would be likely to be slight, however, the risk of male-to-female transmission is much higher than that of female-to-male transmission, so a means of partial prevention that targets only the second means at the expense of the first would be counterproductive.

There is no indication that male circumcision would protect women.

Viral load is the chief predictor of the risk of HIV transmission.

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