Science of Circumcision

          

          Gerald N. Weiss, MD 

                                               DABS, FACS, FICS                        

 

Science of Circumcision

 Additional information 

 Latest 2009 data concerning UNAIDS at below site--- click finger pointer to enter:

http://www.unaids.org/en/default.asp

 Then see the "Circumcision" report an excellent updated report at:  http://www.unaids.org/en/PolicyAndPractice/Prevention/MaleCircumcision/

Sex Transm Infect. 2003 Dec;79(6):495-6.

Sex Transm Infect. 2003 Oct;79(5):427-8.


Male circumcision: an acceptable strategy for HIV prevention in Botswana.
Kebaabetswe P, Lockman S, Mogwe S, Mandevu R, Thior I, Essex M, Shapiro RL.

The Botswana-Harvard AIDS Institute Partnership, Private Bag BO 320, Bontleng, Gaborone, Botswana.

BACKGROUND: Male circumcision is known to reduce the risk of acquiring HIV, but few studies have been performed to assess its acceptability among either children or adults in sub-Saharan Africa. METHODS: We conducted a cross sectional survey in nine geographically representative locations in Botswana to determine the acceptability of male circumcision in the country, as well as the preferred age and setting for male circumcision. Interviews were conducted using standardised questionnaires both before and after an informational session outlining the risks and benefits of male circumcision. RESULTS: Among 605 people surveyed, the median age was 29 years (range 18-74 years), 52% were male, and >15 ethnicities were represented. Before the informational session, 408 (68%) responded that they would definitely or probably circumcise a male child if circumcision was offered free of charge in a hospital setting; this number increased to 542 (89%) after the informational session. Among 238 uncircumcised men, 145 (61%) stated that they would definitely or probably get circumcised themselves if it were offered free of charge in a hospital setting; this increased to 192 (81%) after the informational session. In a multivariate analysis of all participants, people with children were more likely to favour circumcision than people without children (adjusted odds ratio 1.8, 95% CI 1.0 to 3.4). Most participants (55%) felt that the ideal age for circumcision is before 6 years, and 90% of participants felt that circumcision should be performed in the hospital setting.

CONCLUSIONS: Male circumcision appears to be highly acceptable in Botswana. The option for safe circumcision should be made available to parents in Botswana for their male children. Circumcision might also be an acceptable option for adults and adolescents, if its efficacy as an HIV prevention strategy among sexually active people is supported by clinical trials. 

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Male Circumcision Could Cut Millions Of Future HIV Infections 

Main Category: HIV / AIDS News
Article Date: 11 Jul 2006 - 10:00am (PDT) in Medical News Today

Circumcision reduces HIV infection risk by 60% in heterosexual men, it could reduce the number of HIV infections in sub-Saharan Africa by over six million over the next two decades, says an international team of researchers led by Catherine Hankins, Chief Scientific Adviser, United Nations Programme on HIV/AIDS (UNAIDS). Over three million lives could be saved in sub-Saharan Africa alone, they say.You can read about this study in the journal PLoS Medicine.

Data from studies in 2005 was used to calculate HIV infection rates among areas where most men are circumcised and areas where most men are not. The information was then used to predict future infection rates and totals. By using a mathematical model, the researchers then predicted how many men in Sub-Saharan Africa would be infected with HIV over the next twenty years if they were all circumcised.
If all men in Sub-Saharan Africa were circumcised, they calculated that…

During the first 10 years:
300,000 deaths would be avoided
During the second ten years:
2,700,000 more deaths would be avoided
3,700,000 infections would be prevented

Although men would benefit the most, women would also benefit as a consequence, say the scientists.
        Catherine Hankins said "The big message from the paper is that there is a tremendous potential for male circumcision to have an effect on the HIV epidemic, particularly in sub-Saharan Africa. Safety, acceptability and cost of male circumcision will also be important beyond just modelling this impact, because if you do not get increased uptake you will not see any of these effects."  According to Hankins, prevalence of male circumcision is high in west and central Africa and low in southern and eastern Africa. Prevalence of HIV/AIDS is lower in west and central Africa and high in southern and eastern Africa.
           It is crucial, say many experts, that before embarking on any voluntary circumcision campaign, that people understand there is still a serious risk of infection. The best way to avoid infection is either by abstaining or using a condom.
     The Potential Impact of Male Circumcision on HIV in Sub-Saharan Africa
             PLoS Medicine
Brian G. Williams, James O. Lloyd-Smith, Eleanor Gouws, Catherine Hankins, Wayne M. Getz, John Hargrove, Isabelle de Zoysa, Christopher Dye, Bertran Auvert
                Funding
The work of JOLS and WMG was supported by NIH-NIDA grant R01-DA10135 and a James S. McDonnell Foundation 21st Century Science Initiative grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Written by: Christian Nordqvist
Editor: Medical News Today

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http://www.bbc.co.uk/science/horizon/2000/valley_hiv.shtml

 Clicking at above site will reveal BBC report as to why circumcision effective in reducing AIDS in Africa

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Commentary of scientific data in relationship to HIV/AIDS transmission & Cancer of the Cervix in Females by the uncircumcised [CIRCUMCISION ON LINE NEWS].. Click pointer at above area to retrieve.

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Circumcision: Frankly Speaking

by Gerald N Weiss MD and Andra Harter

 A Book Review by Anton Shaw at:

  http://www.gilgalsoc.org/b_reviews/frankly.html 

The book by Weiss and Harter entitled Circumcision: Frankly Speaking (ISBN: 0-9667219-0-X)  is available from Amazon.com.

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A TEXTBOOK OF TROPICAL SURGERY, the first of its kind ever published, appeared in 2004. It was edited by renowned former International College of Surgeons Presidents Refaat Kamel of Ain Shams University, Cairo, Egypt and John S.P. Lumley of the University of London, United  Kingdom. The 1332 page text has included Gerald N. Weiss, M.D. in its list of 263 distinguished worldwide authors.  Asked to contribute a subject of his interest, he chose a study of circumcision (Chapter on "Circumcision" in Section 2, #155). Discussed is the history, prevelance and rationale for prophylactic circumcision for a procedure practiced since antiquity.

Weiss concluded,  "NEONATAL CIRCUMCISION IS A PROVEN SECULAR PROPHYLACTIC HEALTH MEASURE FOR PROMOTING AND MAINTAINING QUALITY GENITAL HEALTH FOR MALES OF ALL AGES

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