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Routine Circumcision Does Not Protect Against HIV For Men Who Have Sex With Men, CDC Study Finds
July 29th, 2010
Although previous research in African countries has shown that circumcision helps reduce a man’s risk of contracting HIV through heterosexual intercourse, a new study from the Centers for Disease Control and Prevention suggests the procedure does not provide protection for men who have sex with men — one of the groups most at risk for the virus in the U.S. — the AP/Miami Herald reports. According to the AP/Herald, the study — presented Tuesday at an HIV/AIDS conference in Atlanta — likely will influence new government recommendations on male circumcision, which currently are being developed and will not be finalized until 2010 following a public comment period.
For the study, CDC researchers surveyed about 4,900 men who had anal sex with HIV-positive men. The study found that the infection rate among the men was about 3.5% in both the men who were circumcised and those who were not. Although the study found that circumcision “is not considered beneficial” in preventing the spread of HIV among MSM, CDC still might recommend the procedure for other groups, including male infants and high-risk heterosexual men, according to Peter Kilmarx, chief of epidemiology for CDC’s division of HIV/AIDS Prevention.
Kilmarx noted that the definition of high risk is still being discussed. He added that circumcision is “seen by many as more than just a medical procedure” because of the procedure’s cultural and religious associations. He added that CDC might just recommend improved education for doctors and parents about the risks and benefits associated with male circumcision.
According to the AP/Herald, various global health organizations like UNAIDS have been promoting male circumcision as a way to reduce the spread of HIV/AIDS in other countries. However, the same level of promotion has been largely absent in the U.S., where nearly 80% of men already are circumcised. More than half of new HIV cases in the U.S. each year occur among MSM, who account for about 4% of the U.S. male population (Stobbe, AP/Miami Herald, 8/25).
Editorial Calls for Clear CDC Recommendations
“Three large studies in Africa have shown that male circumcision can reduce the transmission of HIV/AIDS from women to men by up to 60%,” a Boston Globe editorial states, adding that this has prompted CDC “to consider promoting circumcision of infant boys in this country. Such a tactic makes sense against a virus that infects more than 50,000 Americans each year.”
The protection provided by male circumcision “is not complete, however, and the organizers of the African studies still advised all participants, circumcised or uncircumcised, to use condoms,” the editorial continues. In addition, although there is no “evidence that circumcision protects against male-to-male transmission of the virus, or from men to women,” a “technique that reduces the prevalence of the disease will ultimately benefit all groups,” according to the editorial.
“While a majority of U.S. parents already circumcise their babies, rates are lower among two groups that suffer disproportionately from HIV/AIDS: African-Americans and Hispanics,” according to the editorial. “No one should be forced to circumcise a son,” but “where the health benefits are clear, the CDC should be equally clear in its recommendations. Circumcision is no panacea, but it deserves the CDC’s support,” the editorial concludes (Boston Globe, 8/26).
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
The Biamba Marie Mutombo Hospital and Research Center (BMMH), in Kinshasa, Democratic Republic of the Congo and BD (Becton, Dickinson and Company) today launched two Centers of Excellence - an Immune System Monitoring Laboratory and an Occupational Safety Centre for Health Workers - at the state of the art medical facility founded by NBA legend Dikembe Mutombo. The safety center will train more than 300 clinicians, and the new laboratory will improve monitoring and treatment of patients living with HIV/AIDS.
Mr. Mutombo was joined at the opening ceremonies by UNICEF Executive Director Ann M. Veneman, BD Executive Vice President Gary Cohen, and the DRC Minister of Public Health, Mwami Mopipi Mukulumany. The Center is an expansion of the BMMH, an acute care hospital which opened in 2007 and provides care to thousands of patients each year in a region of the world where over five million people have died from violence, hunger and disease since 1998.
“The doctors and nurses at the Biamba Marie Mutombo Hospital are saving lives every day and helping improve health care in the DRC which has been ravaged by more than a decade of war and disease,” said Mr. Mutombo. “These Centers of Excellence are an important milestone in improving the quality of life for those who live with HIV/AIDS and in training new health care workers to help prevent the spread of disease.”
The new Centers will provide laboratory equipment, reagents and training to improve immune system monitoring, an essential component of treating people living with HIV/AIDS. To help ensure the safety of healthcare workers at the facility, DMF will develop a Department of Occupational Health and a Regional Training Center at the BMMH. BD, in collaboration with the University of Virginia, will help implement the Exposure Prevention Information Network (EPINet™) surveillance system to monitor occupational injuries at BMMH. BD will also provide a range of safety-engineered injection and safety-engineered blood collection devices as well as laboratory and occupational safety training for at least 330 healthcare workers.
“The problems of pandemic disease prevalence and occupational risks to health workers exist throughout sub-Saharan Africa, but pose particular challenges in countries emerging from conflict,” said Mr. Cohen. “We are proud to partner with Dikembe Mutombo, and to support his efforts to provide essential medical care to the people of Kinshasa and DRC, his home country.”
The World Bank estimates that nearly 70 per cent of the population of the DRC is living on $1.25 or less a day. Around half a million children under the age of five die every year in the DRC. Most of these deaths are from largely preventable causes, such as diarrhea, pneumonia, malaria, tuberculosis and malnutrition and measles. Over one million people in DRC are living with HIV/AIDS. Sexual violence of the most brutal form has been carried out against tens of thousands, over half of them children.
“The Democratic Republic of Congo remains one of the poorest countries in Africa with poverty, conflict and disease contributing to a public health crisis for the country’s most vulnerable people,” said Ms. Veneman. “Partnerships such as the one we recognize today are addressing this devastating situation and help provide an infrastructure for expanded care and services to those who otherwise would not have access to these life-saving resources.”
The UNICEF Executive Director also commended Mr. Mutombo for his dedication and commitment to his home country.
“It is such an honor to be here today at the hospital founded in the memory of Dikembe’s mother,” said Ms.Veneman. “He is a true friend of UNICEF and his dedication for his home country is an inspiration to us all. Dikembe continues to give a voice to the voiceless people of Democratic Republic of the Congo.”
Through the work of a broad collaboration of partners including UNICEF, government, the private sector, NGOs, religious leaders and communities, progress is being made in the DRC but much work remains to be done, especially in reaching the “hard-to-reach” given the size and the limited infrastructure of the country. Community based integrated health programs are providing life saving interventions that include: vaccination of 5 to 7 million children each year against polio, measles and other diseases; vitamin A supplementation for 11 million children aged between 6 and 59 months: insecticide treated mosquito nets to protect against malaria; nutritional treatment for 320,000 acutely malnourished children, including 60,000 affected to a severe degree in 2008; de-worming tablets for 9 million children; access to clean drinking water in rural communities; and HIV/AIDS prevention and treatment.
Attn broadcasters: VNS and b-roll is available at: http://www.thenewsmarket.com/unicef
About the Dikembe Mutombo Foundation
The Dikembe Mutombo Foundation is dedicated to improving the health, education and quality of life for the people of the Democratic Republic of the Congo. The Foundation strives to accomplish this goal not only by providing comprehensive health care at the Biamba Marie Mutombo Hospital, but also through an emphasis on primary health care and disease prevention, the promotion of health policy, health research and increased access to health care education for the people of the Congo. http://www.dmf.org
About BD
BD is a leading global medical technology company that develops, manufactures and sells medical devices, instrument systems and reagents. The Company is dedicated to improving people’s health throughout the world. BD is focused on improving drug delivery, enhancing the quality and speed of diagnosing infectious diseases and http://www.bd.com
Source
UNICEF