The Kindest Cut

We don’t yet have a cure for AIDS, although we now have medicines that can keep people alive for much longer. But we do have a prevention, and it turns out to be something that has been around for thousands of years: circumcision.

A new study shows that male circumcision significantly reduces the risk of acquiring HIV in young African men. Researcher Robert Bailey conducted a clinical trial of almost 3,000 HIV negative, uncircumcised men between 18 and 24 years old in Kenya, where an estimated 26% of uncircumcised men are HIV infected by age 25. The majority of the men in the study were Luo, an ethnic group that does not traditionally practice circumcision. Half the men were randomly assigned to circumcision and half the men remained uncircumcised for two years. The clinical trial found that 47 of the 1,391 uncircumcised men contracted HIV, compared to 22 of the 1,393 circumcised men.

Bailey worries that circumcised men may feel they are protected from becoming HIV infected and may be more likely to engage in risky behavior. He says, “Circumcision is by no means a natural condom. We do know that some circumcised men become infected with HIV. But we did find that the circumcised men in our study did not increase their risk behaviors after circumcision. In fact, all men in the trial increased their condom use and reduced their number of sexual partners.”

But circumcision needs to be done by someone who knows how to do it. The rabbis who do Jewish circumcisions are not doctors, but they are carefully trained. However, in third world countries, where AIDS is the most prevalent, circumcision may be performed by an untrained person during a tribal ceremony. A study in Turkey evaluated 48 cases of severe complications of circumcisions in patients ranging from 5 months to 24 years, with the mean age of 14 years. These circumcisions were performed at various centers or during religious ceremonies in environments other than health facilities.

The researchers concluded that while circumcisions are routine, they may be associated with serious complications. They felt that experience played a major role and that when circumcisions are performed, they should be done by educated, experienced personnel.

Art credit: freeimages.co.uk

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