AIDS risk lower than thought for circumcised
By Donald G. McNeil Jr
New York Times News Service
Copyright © 2007, Chicago Tribune
Published February 23, 2007
Circumcision may provide even more protection against AIDS than was realized when two clinical trials in Africa were stopped two months ago because the results were so clear, according to studies being published Friday.
The trials, in Kenya and Uganda, were stopped early by the National Institutes of Health, which was paying for them, because it was apparent that circumcision reduced a man's risk of contracting AIDS from heterosexual sex by about half. It would have been unethical to continue without offering circumcision to all 8,000 men in the trials, federal health officials said.
That decision, announced Dec. 13, made headlines around the world and led the two largest funds for fighting AIDS to say they would consider paying for circumcisions in high-risk countries. But the final data from the trials, to be published Friday in the British medical journal The Lancet, suggest circumcision reduces a man's risk by as much as 65 percent.
Re-evaluating the data, excluding a few men whose HIV status was misdiagnosed during the trial and combining the results of three trials--those in Uganda and Kenya as well as one in South Africa that was stopped in 2005 when the protective effect became apparent--yields an apparent protection rate of about 65 percent.
"This is a one-time, permanent intervention that's safe when done under the appropriate medical conditions," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "If we had an AIDS vaccine that was performing as well as this, it would be the talk of the town."
He said President Bush's $15 billion AIDS initiative and the World Health Organization were considering paying for circumcisions in high-risk countries but must work out what training and equipment circumcisers would have to have.