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Sunday 20th May 2018

Benefits of male circumcision

21st August 2008

Circumcision is a cost effective way to reduce the risk of human papillomavirus (HPV) infection, as well as helping prevent the transmission of HIV.


Male circumcision programmes were economically feasible in Sub-Saharan Africa, according to a team of researchers who presented a mathematical model at the International AIDS Conference in Mexico City.

The programmes could slash the bill for antiretroviral therapies in the long term, even though they looked costly to initiate at around US$900 million dollars.

Bertran Auvert, professor of public health at France's national biomedical institute INSERM, said calculations suggest that US$2 billion could be saved from health budgets over a 20-year period.

He said an important side-effect of such programmes was a 40% reduction in HPV infections in men, on top of a 60% reduction in HIV transmissions.

Such a result would have a knock-on benefit in women, who were less likely to get cervical cancers caused by certain HPV strains.

Alvaro Bermejo, executive director of the International HIV/AIDS Alliance, said studies in South Africa had already shown a high level of acceptance of male circumcision, with high uptake for the programme and long waiting lists.

Nonetheless, Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said the issue was a deeply cultural and social one, and expansion of the practice in Africa has still proved slow.

Warren said a traditional biomedical product like a pill would probably have been rolled out much faster.

In Kenya, for example, the Luo tribe elders say they won't endorse the procedure as it is against their culture, and they are not convinced it will prevent HIV transmissions. The Luo are a significant community in Kenya.

Meanwhile, Christians in Indonesia have been reluctant to get circumcised because the practice is associated with coming of age for Muslims.

Karen Houston Smith, deputy director of Family Health International, Indonesia, said Christians felt that circumcising their sons would cast doubt on the validity of their Christianity.

Male circumcision programmes needed broad-based dialogue and readily available information in communities if they were to be successful on a global scale, Bermejo said.

He also stressed that male circumcision should not be regarded as a substitute for a condom, because of the need to protect women from sexually transmitted infections.


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