Routine Male Circumcision Should Be Considered in Areas of Africa With High HIV Prevalence, Opinion Piece Says
Routine male circumcision "must be considered" in areas of Africa with high HIV prevalence because the procedure is a "source of hope that could eventually save many lives," columnist Michael Gerson writes in a Washington Post opinion piece (Gerson, Washington Post, 6/1).
According to final data from two NIH-funded studies -- conducted in Uganda and Kenya and published in the Feb. 23 issue of the journal Lancet -- routine male circumcision could reduce a man's risk of HIV infection through heterosexual sex by 65%. In response to the findings, the World Health Organization and UNAIDS in March recommended the procedure as a way to help reduce the spread of HIV (Kaiser Daily HIV/AIDS Report, 5/10).
According to Gerson, there are "obstacles" to expanding male circumcision programs in Africa, including matters of cultural, religious and ethnic identity. However, surveys conducted in Africa "indicate an openness to the procedure among uncircumcised Christians," Gerson writes. There also are "practical obstacles," including a risk of infection from the operation and a lack of equipment and personnel to perform the procedure on an expanded scale, Gerson writes. Similar "arguments were made against the possibility of AIDS treatment" on the continent, Gerson writes, adding that a "concerted American and international commitment proved that pessimism to be unjustified." According to Gerson, the "main problem" is that circumcision is "partially protective" against HIV, which might give some men a "false sense of invulnerability."
According to Gerson, "health education will be required," African governments will have to consider both routine infant and adult circumcision, and international donors and European governments must "aggressively support" circumcision programs in Africa and provide new resources. Gerson writes that the benefits of circumcision to men are "increasingly undeniable" and a "matter of moral urgency." He concludes, "When it comes to AIDS, circumcision is the kindest cut" (Washington Post, 6/1).