Politics and Policy of HIV/AIDS

“Properly planned” male circumcision programs should be part of efforts supported by the Group of Eight industrialized nations and the President’s Emergency Plan for AIDS Relief to curb the spread of HIV/AIDS worldwide, a Los Angeles Times editorial says. Rates of male circumcision — which is “relatively inexpensive and can drastically reduce the transmission of [HIV/]AIDS,” — “are exceptionally low in many areas where HIV is dangerously prevalent,” including India, Asia and southern Africa, according to the Times. One-quarter of men globally have undergone circumcision, the editorial says (Los Angeles Times, 2/10). A study published in the November 2005 issue of PLoS Medicine of men living in South Africa finds that male circumcision might reduce the risk of men contracting HIV through sexual intercourse with women by about 60%. (Kaiser Daily HIV/AIDS Report, 10/26/05). Male circumcision might also reduce the risk of HIV transmission from HIV-positive men to their female partners, according to a study of couples in Raiki, Uganda, presented on Wednesday at the 13th Conference on Retroviruses and Opportunistic Infections in Denver (Kaiser Daily HIV/AIDS Report, 2/9). Some countries including Botswana and Swaziland have begun instituting adult and infant male circumcision programs following the 2005 South African study, the editorial says. There are growing waiting lists at clinics performing the procedure, the editorial says, adding that this might lead men seeking circumcision to rural doctors where they risk “dangerous and even deadly infections.” If preliminary findings from two circumcision trials in Kenya and Uganda are similar to those in the South African study, the U.S. and other donor countries “should help increase access to a safe and affordable procedure that has gone out of favor in most of the world,” the editorial says. The Times adds that information reinforcing the importance of safer sex also should accompany any male circumcision program, as there is concern that men who are newly circumcised may engage in “risky behavior” (Los Angeles Times, 2/10).