South Africa: Hopes That More Circumcisions Can Cut HIV Figures
Business Day (Johannesburg)
August 22, 2006
Even a modest expansion of circumcision in SA could prevent a
significant number of new HIV infections and save money, said studies
presented at the 16th International AIDS Conference last week.
Many AIDS experts are hopeful that circumcision could prove to be a
powerful addition to the options already available for preventing HIV
Studies under way in Kenya and Uganda confirm the protective effects
of circumcision revealed in an Orange Farm, SA, study published last
year. The study found that young circumcised men were 60% less likely
to contract HIV than those not circumcised.
This week, Microsoft chairman Bill Gates and former US president Bill
Clinton called for an increase of the practice. "If research shows it
saves lives, we have to be prepared to deal with it," Clinton said.
Although policy makers such as the World Health Organisation and the
Joint United Nations Programme on HIV/AIDS are urging caution until
the results are received from the Kenyan and Ugandan studies,
scientists yesterday urged implementation of programmes to encourage
more men to be circumcised.
Using a mathematical model based on epidemiological data from
Gauteng, University of California researcher James Kahn calculated
that every 1000 circumcisions would avert 308 HIV infections, two-
thirds of them among men and the remainder among women.
Such a programme would cost the health system about R1086 per HIV
infection averted, but since there would be fewer AIDS patients, the
savings would be considerable - about R14400 for every infection
averted, he said.
The cost effectiveness of a circumcision programme was largely
independent of its scale, said Kahn.
Yale researcher Kyeen Mesesan modelled the impact of male
circumcision on HIV prevalence in Soweto, and predicted that a 10%
increase in the 35% circumcision rate among young men could avert
32000 HIV infections over the next 20 years. The reduction in HIV
transmission would lead to a decline in overall prevalence in the
population from 17% to14%.
Such programmes could provide substantial health benefits to both men
and women, and should be implemented immediately, said Mesesan.
A small study reported by Walter Reed Army Medical Centre researcher
Douglas Shaffer, which compared HIV infection among circumcised and
uncircumcised men in Kenya, found a 69% protective effect.