← Autodidact Archive · Original Dissent · Petr
Thread ID: 20395 | Posts: 6 | Started: 2005-09-25
2005-09-25 13:26 | User Profile
[I]It would appear that at least officially, AIDS rates are somewhat lower in Muslim countries (that practice circumcision) than in the rest of Africa or Asia... could this stuff have any factual basis?[/I]
[url]http://news.yahoo.com/s/ap/20050924/ap_on_he_me/south_africa_aids[/url] [FONT=Arial] [SIZE=5] S. African AIDS Expert Urges Circumcision[/SIZE] [B] By CLARE NULLIS, Associated Press Writer Sat Sep 24, 7:21 PM ET[/B]
CAPE TOWN, South Africa - A South African AIDS expert Saturday advocated male circumcision as the best available "vaccine" against the virus in his country, [B]where an estimated 6 million people are infected and more than 600 people die every day. [/B]
[B]Francois Venter told a congress of health activists in the Treatment Action Campaign that a recent survey in the Soweto township indicated that circumcised men were 65 percent less likely to contract AIDS than those who had not been circumcised.[/B]
"We dream of a vaccine which has this efficacy," said Venter, clinical director of the Reproductive Health and HIV Research at the University of Witwatersrand. "The results are phenomenal." [B] The association between circumcision and a reduced risk of HIV was noted as early as 1987, when Dr. William Cameron of the University of Manitoba in Canada reported findings from a study in Kenya. Some researchers in early studies have said they believe cells in the foreskin may be particularly susceptible to infection.[/B]
Venter urged the Treatment Action Campaign, an influential movement of 13,000 activists, to consider promoting circumcision as a vital prevention tool, given that existing methods were failing to slow the spread of the epidemic.
South Africa has the highest number of people living with HIV/AIDS in the world. Nearly 30 percent of pregnant women are infected, according to a health department survey published in July, and in the hardest hit province of KwaZuluNatal this rises to 41 percent. The disease is now one of the main causes of death among young adults and infants.
Some traditional communities in South Africa practice circumcision, but there are calls for tighter medical controls to limit health risks from blunt and contaminated instruments.
"We don't want our men to go to the chop shop but have medical circumcision," said Zackie Achmat, an AIDS activist who said the congress ââ¬â which meets every two years ââ¬â would debate whether to encourage mass circumcision.
Achmat, who is HIV positive, said much more needed to be done on prevention. He said that even though government distribution of condoms increased from one million in 1994 to 40 million in 2004, this still only amounted to 35 condoms per sexually active male per year.
He said that 73 percent of young people without the virus believed that they were not at risk of catching, and 62 percent of young people with the virus also believed there was no risk.
Achmat criticized the government's record on treatment. Of the 500,000 people who need AIDS therapy, only 76,000 are currently receiving it through the public health sector. The World Health Organization has singled out slow progress in South Africa as one of the main reasons it will likely miss its target of putting 3 million people worldwide on therapy by the end of this year.
"We are dying. We are still dying," he said.
Achmat has for years attacked the government for doing too little too late against the AIDS epidemic. In a sign of the mutual antagonism, health ministry officials refused invitations to attend the congress.
[B]"President Thabo Mbeki tragically still shows symptoms of AIDS denialism," said Achmat. Mbeki reputedly doubts the link between HIV and AIDS. Health Minister Manto Tshabalala-Msimang has repeatedly voiced doubts about the safety and efficacy of antiretrovirals, instead stressing the benefits of a diet heavy in garlic, lemon and olive oil.[/B]
The Soweto study, was conducted by French researchers between 2002 and 2005 with more than 3,000 healthy, sexually active males between 18 and 24. About half the volunteers were circumcised by medical professionals, and the rest remained uncircumcised.
All the men received counseling on AIDS prevention. But after 21 months, 51 members of the uncircumcised group had contracted HIV, the AIDS virus, while only 18 members of the circumcised group had gotten the disease.
The World Health Organization and UNAIDS welcomed the results of the study, released at a conference in Brazil in July, but says that more trials should be conducted before circumcision can be recommended as a preventive method.
A study conducted by the U.S. National Health Institute involving 5,000 individuals is now under way in Uganda.[/FONT]
2005-09-25 21:48 | User Profile
[I]Apparently Indians have also dabbled with this idea:[/I]
[url]http://timesofindia.indiatimes.com/articleshow/1191482.cms[/url] [FONT=Arial] [SIZE=5] Circumcision: It suits Hindus also[/SIZE]
[B]KOUNTEYA SINHA
TIMES NEWS NETWORK [THURSDAY, AUGUST 04, 2005 11:57:10 PM][/B]
NEW DELHI: Fear of raking up a communal controversy has made the health ministry keep mum about an international study which suggests that circumcised men are less prone to HIV infection.
While the study - which says HIV rates among those not circumcised are two to eight times higher than in those groups which practice circumcision - may have a significant bearing on the country's AIDS-prevention programme, government seems to be keeping a distance from it lest it is accused of 'appeasement.'
Conducted by France's National AIDS Research Agency in South Africa between 2002 and 2005, findings of the study were made public on July 26 at the 3rd International AIDS conference on HIV treatment in Rio de Janeiro. [B] Indian officials, who were present at the conference, agree that circumcision is a hygienic practice but they are loath to be seen as endorsing it because of its strong association with Muslims.[/B]
Speaking to TOI, a senior official conceded as much: "Over 25% of people in Europe go for circumcision for protection against AIDS. But in India, we cannot encourage it because of its association with Muslims. Leave alone implementing it, even agreeing with the study would mean being attacked by Hindus. Then, we also don't want to make the bulk of the Muslim population feel that they can be safe with unprotected sex."
Ministry officials refer to the experience of Richard Feachem, executive director of Geneva-based Global Fund to Fight AIDS.
[B]Recently, Feachem received thousands of hate mails when he made a statement in Paris, backed by a study, that he expected the epidemic to grow faster among Hindus because they didn't practise circumcision. One sharp reaction had come from BP Singhal of the BJP.
"This is obnoxious. We are not going to tolerate such remarks made against Hindus," Singhal had said in protest against Feachem's remark.[/B]
Even health minister A Ramadoss received a letter from VHP leader Giriraj Kishore seeking to know whether India had commissioned a similar study.
"We did receive a letter from (him). We have also replied to him. No such tests are taking place in India," a ministry official said.
On condition of anonymity, officials also cited figures to show how Muslim countries, where circumcision is prevalent, have very low number of AIDS patients.
"We strongly believe that the AIDS figures in Muslim countries are extraordinarily low because of circumcision. While 0.92% of the adult population in India is HIV+, the number is 0.1% in Iran, Indonesia and Pakistan, 0.2% in Bangladesh and 0.4% in Malaysia. Circumcision can prevent six to seven out of 10 potential HIV infections," another official added.
Using caution, officials also pointed out that circumcision of men will not stop women from getting the disease. "At present, 40% of all AIDS patients are women. So Muslim men are still vulnerable."
The French agency circumcised about half of 3,000 subjects for the study, while the rest remained uncircumcised. After 21 months, 51 members of the uncircumcised group had contracted HIV while only 18 members of the circumcised group had the disease.
"There had always been theories that male circumcision prevented AIDS, but this was the first study using control trials. Though the Joint United Nations Programme on HIV/AIDS took considerable interest in the results of the trial, UNAIDS has said it is too early to encourage widespread circumcision as a way to prevent the spread of AIDS. Lately, there has been heightened interest in male circumcision from governments in a number of African countries," an official said.
[B]Researchers believe circumcision helps cut the risk of infection because the foreskin is covered in HIV 1 cells that the virus easily infects. At present, at least three more studies are underway to confirm the effectiveness of circumcision.[/B]
WHO is also working on guidelines for qualified medical personnel to conduct safe circumcision as demand for the operation has started to increase in the West. [/FONT]
2005-09-25 21:52 | User Profile
[I]Wall Street Journal also weighs in on the issue - this "meme" seems to have been spreading quickly last summer![/I]
[url]http://online.wsj.com/article/0,,SB112052891400077032,00.html?mod=todays_us_page_one[/url]
[FONT=Arial] [SIZE=5]Study Says Circumcision Reduces AIDS Risk by 70%[/SIZE] [SIZE=4] Findings From South Africa May Offer Powerful Way To Cut HIV Transmission[/SIZE]
[B]By MARK SCHOOFS, SARAH LUECK and MICHAEL M. PHILLIPS Staff Reporters of THE WALL STREET JOURNAL July 5, 2005; Page A1[/B]
In a potentially major breakthrough in the campaign against AIDS, French and South African researchers have apparently found that male circumcision reduces by about 70% the risk that men will contract HIV through intercourse with infected women.
Other than abstinence and safer sex, almost nothing has been proved to reduce the sexual spread of HIV, the virus that causes AIDS. World-wide, the major route of HIV transmission for many years has been heterosexual sex.
Vaccine developers have said they would consider an AIDS vaccine with just 30% efficacy useful. But so far, no effective vaccine against the disease has been developed, leaving AIDS workers desperate for another tool to help them stem the tide of new infections, estimated at almost five million last year.
The circumcision findings were so dramatic that the data and safety monitoring board overseeing the research halted the study in February, about nine months before it would have been completed, on the grounds that it would be immoral to proceed without offering the uncircumcised control group the opportunity to undergo the procedure. While men were directly protected from infection by circumcision, women could benefit indirectly because circumcision would reduce the chances their partners would be HIV-positive.
Researchers in the field have been aware of the study's basic findings, but they haven't been published, so most experts haven't evaluated them. The British medical journal the Lancet decided against publishing the study, but for reasons unrelated to the data and scientific content, according to people familiar with the matter. Lancet officials, following standard policy at the journal, refused to comment on why the study was turned down.
The fact that an independent board ordered the study halted is considered a strong sign that the science is sound. Bertran Auvert, the French researcher who headed the trial, declined to discuss the findings but is expected to present them later this month at an International AIDS Society conference in Brazil.
Still, the fact that the research hasn't yet been published makes experts in the field wary about commenting. "Confirm, confirm, confirm," said Seth Berkley, a veteran HIV researcher and president of the International AIDS Vaccine Initiative. But if the study holds up, said Dr. Berkley, who wasn't involved with the research, it would be "quite important" because circumcision would be "an intervention that works over a person's lifetime and could reduce HIV in a community setting."
Assuming circumcision is as effective as the new study shows, it would still require careful implementation. In particular, health experts are concerned that men understand that circumcision can't fully protect them and that they maintain other preventive measures, such as safer sex.
"These preliminary results are quite interesting and we look forward to examining the data more closely, to looking at the technical aspects of the study and public-health implications if these results are confirmed by other trials," said Cate Hankins, chief scientific adviser to the United Nations AIDS agency, UNAIDS.
More than 30 previous studies have suggested a relationship between circumcision and lower rates of HIV infection. In Kenya, for example, HIV prevalence is much higher among the Luo people, who don't practice circumcision, than among the Kikuyu, who do.
And there are strong biological theories as to why. For example, a type of cell that HIV targets, called the Langerhans cell, lies close to the delicate underside of the foreskin, whereas the head of a circumcised penis tends to develop a thick layer of outer skin that may armor it against HIV. Another theory: Rather than acting against HIV itself, circumcision may help prevent other sexually transmitted diseases that are known to facilitate the acquisition of HIV.
Despite these theories, no study until now has been able to prove that circumcision reduces the chances of contracting HIV. Longtime advocates of the benefits of circumcision note that performing such a study has always faced resistance because of the sensitive cultural issues involved as well as the challenge of persuading a significant number of men to undergo the procedure.
The new research was designed to test the hypothesis by the most rigorous possible method: a randomized, controlled clinical trial.
It was conducted with more than 3,000 HIV-negative men ages 18 to 24 in a South African township called Orange Farm. Half of the men were randomly assigned to be circumcised and the other half to remain uncircumcised as controls. The study, headed by Dr. Auvert, a researcher at the French National Institute of Health and Medical Research and at the University of Versailles Saint-Quentin, originally planned to follow the men for 21 months. But after all the men had been followed for a year -- and about half of them for the full 21 months -- the data showed the circumcised group fared far better. For every 10 uncircumcised men in the study who contracted HIV, only about three circumcised men did so, according to two people familiar with the research and a draft of the study reviewed by The Wall Street Journal.
Stopping trials is common when an intervention is clearly shown to be effective. Indeed, the result of the South African trial is likely to spark discussion of whether to halt or modify two other major studies of circumcision and HIV under way in Kenya and Uganda, funded by the National Institutes of Health.
Ronald Gray, lead researcher on the Uganda trial, said, "It would be extremely unwise" to stop the Kenya and Uganda trials at this stage because "medicine has been burned in the past when policy is based on a single trial."
It isn't clear how the new study, if confirmed, would influence U.S. policy. Circumcision wouldn't affect IV drug users who get infected by sharing syringes, a group that accounts for a large proportion of American HIV cases. Also, the South Africa study didn't evaluate whether circumcision would offer any protection to gay men, who make up another large proportion of American cases. Any direct benefit to gay men would almost certainly be restricted to the insertive partner in anal intercourse, not the receptive partner.
In countries where male circumcision is uncommon and heterosexual HIV rates are high or rising rapidly, the procedure could be a powerful way of reducing the spread of the disease, the new study shows.
Even so, researchers warn of potential pitfalls in trying to put the findings into practice. First, circumcision doesn't make a person immune to infection. Indeed, if men abandon safer sex practices because they think the surgery completely protects them, then HIV transmission could rise.
"It will not take very much of an increase in risk behavior to overcome the benefit from circumcision," said Carolyn Williams, an American researcher involved in the Kenya circumcision study. AIDS experts insist that circumcision will have to be accompanied by intensive counseling.
Secondly, AIDS researchers worry that circumcisions performed in unsanitary conditions could lead to dangerous complications.
And while many Africans come from cultures that practice circumcision, many others don't. Would large numbers of men in noncircumcising cultures consent to go under the knife simply to reduce their risk of acquiring HIV?
"It's a surgical procedure on an organ that, you know, conjures up a lot of feelings in people," said Robert Bailey, the principal investigator in the Kenya study. "It's not just a shot in the arm."[/FONT]
2005-09-26 04:11 | User Profile
I can assure you that the statistics you posted aren't correct, I'v seen several other statistics that is much higher, at least 2500 people die of aids per day in this country, and definitively more than half the pregnant woman are infected. Look I live in South Africa, I know, it is not uncommon to lie about statistics here, remember the communists are in control.
2005-09-26 08:58 | User Profile
I can easily believe that South African statistics are unreliable, but what do you think about this circumcision-prevents-AIDS theory?
Petr
2005-09-26 17:21 | User Profile
[QUOTE=Petr]I can easily believe that South African statistics are unreliable, but what do you think about this circumcision-prevents-AIDS theory?
Petr[/QUOTE] I am trying to fathom how circumcision prevents transmission of microbes during unprotected sex via semen and / or blood, or other precious bodily fluids.
Sorry, this smells to high heaven. A mis placed cause and effect relationship, and I am more likely to believe that a behavioral difference between Muslims and animists is a more likely root cause of the infection's difference.
Behavior is the best preventative for most STD's.
AE