NEWSFLASH: Circumcision May Cut Risk of HIV and HPV

According to an article published by Reuters last month, there is now evidence that circumcision, which is the process of surgically removing the foreskin covering the head of a man's penis (usually at birth), can protect men from HIV and human papillomavirus (HPV). HPV is the sexually transmitted virus that can cause cervical cancer in women, as well as genital warts. It is the most common of all sexually transmitted infections in the world.

Three studies were published in the Journal of Infectious Diseases presenting the evidence.

In the first report, Dr. Bertran Auvert of the University of Versailles in France and some colleagues in South Africa tested over 1200 men visiting a South African clinic. His team found that under 15% of the circumcised men as compared to 22% of uncircumcised men were infected with HPV.

"This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women," they wrote in their report.

The second study looking at U.S. men had less clear-cut results, but according to Carrie Nielson of Oregon Health & Science University and her colleagues, there was some indication that circumcision may protect men. The circumcised men were about half as likely to have HPV as the uncircumcised men, after adjustment was made for other difference between the groups.

The final study dealt with HIV. Lee Warner of the CDC and his colleagues tested Black men in Baltimore and discovered that only 10% of those at high risk of becoming infected that were circumcised had HIV, as compared to 22% of those were not circumcised.

"Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the U.S. context," they wrote.

Previously, studies supporting circumcision to reduce HIV transmission had all been done in Africa. Most of the U.S. studies had been unclear.

In commentary, Dr. Ronald Gray of Johns Hopkins University and a team of colleagues, who were encouraged by the findings, said the following:

"In the United States, circumcision is less common among African American and Hispanic men, who are also the subgroups most at risk of HIV....Thus, circumcision may afford an additional means of protection from HIV in these at-risk minorities."

But they highlighted the fact that the American Academy of Pediatrics does not recommend routine circumcision for newborns.

"As a consequence of this AAP decision, Medicaid does not cover circumcision costs, and this is particularly disadvantageous for poorer African American and Hispanic boys who, as adults, may face high HIV exposure risk," Gray and his colleagues wrote.

They also noted the fact that "circumcision rates have been declining in the U.S., possibly because of lack of Medicaid coverage."

For further information on HPV, visit http://www.cdc.gov/STD/HPV/STDFact-HPV.htm


Source: MSNBC

2 comments:

  Ji

January 7, 2009 at 9:17 AM

For safer easier and cheaper circumcisions, the aanswer is Tara KLamp Circumcision Device.


HIV: Tool to ease up male circumcision launched in Kenya
Article in The Standard newspaper in Kenya.

Thursday, 20th November 2008

Written by Edwin Nyarangi
Wednesday, 17 December 2008

Male circumcision has been made easier with the introduction of the Tara KLamp Disposable Circumcision Device in Kenya in May this year by the Bradmon Health Care (K) Ltd Director Otieno Oyoo.

The device was invented in 1995 by a Malaysian Dr Gurcharan Singh and it is now being used for Male circumcision in Sweden, Malaysia, Egypt, Morocco, South Africa, Botswana and Lesotho.
Oyoo said while launching the device at Nyangena Hospital in Kisii Town that the Tara KLamp disposable circumcision device will revolutionize male circumcision in the country since it can be used anywhere, anytime.
“Tara KLamp enables circumcisions to be performed not only safely and easily but also for the first time in surgical history in the country, enables circumcisions to be performed aseptically---at home, on the roadsides or out there in the bush as in an operating theatre,” Oyoo said.
He said the Tara KLamp is a pre-sterilized disposable device and is meant for single use only.
Tara KLamp is of unitary construction and does not require to be assembled before use such that even a para-medic can use it with ease requiring minimal training.
“Based on a concept of non-invasive surgery described for the first time ever in surgical history this device does not create an open wound, hence it does not require any sutures, ligatures or bandages” Oyoo said.
According to Oyoo, Tara KLamp Circumcision Device’’s benefits include protection against accidental amputation of glans penis and other injuries, requires minimal training, fast circumcision procedure as compared to normal method.
Oyoo said the simplicity of Tara KLamp circumcision device would easen congestion in hospital wards and allow operating theatres to be used for other surgeries where strict aseptic conditions are necessary.
The devise also avoids use of ancillary equipment since there is no need to prepare a separate tray of instruments for each circumcision and also no cauterizations or other harmful agents are necessary.
Oyoo said the procedure has got no age limit as it can be used on both infants and adults.
Oyoo says that the underlying surgical technique protects against cross infections between the circumciser and the patient during the surgery and that the patient can move about and may return to work immediately after circumcision and also that the patient may have a bath or shower immediately after circumcision.
“ The Tara KLamp circumcision device has good cosmetic results, when healed the circumcision leads to a uniformly and evenly cut and cosmetically pleasing appearance unlike in other procedures where too much or to little of the prepuce is cut leading to a not so pleasant look on the male organ,” said Oyoo.
The devise is to be distributed by the Bradmon Health Care (K) Ltd and would cost costs Sh1000 with additional costs depending on the hospital where the surgery is performed” he said.
During the launch of the Tara KLamp Circumcision Device at Nyangena Hospital in Kisii Town, two boys from the Keumbu Children’s Home Osano Mosoti aged 13 years and Jared Maraga aged 12 years underwent the cut at the expense of Bradmon Health Care (K) Ltd as part of the practical demonstration.
The surgeries were performed by Geophrine Musyoka of Darushifa Medical Centre in Umoja One Estate in Nairobi “ I am a Lab Technologist by profession and I became interested with the Tara KLamp circumcision the first time I came a cross it and I have been doing the surgeries since July this year” said Musyoka.

Musyoka said that with the intensive campaign now to promote male circumcision in order to curb the spread of HIV/AIDS, he has fully adopted to using Tara KLamp due its effectiveness.
The two boys who underwent the cut at the Nyangena Hospital looked relaxed and as they walked out of the operation room someone could not easily tell what they had undergone.
“I am really grateful to the Bradmon Health Care(k) Ltd and Nyangena Hospital for this amazing circumcision method which does not require hospitalization,“ said Pastor Abel Onchari the Director of Keumbu Childrens Home.
Abdul Wako, a Harambee Estate Resident in Nairobi who recently took his 9 years old son Idris Galgalo a pupil at the Mary Immaculate Educational Complex in Bahati Estate for the Tara KLamp Circumcision procedure has a lot of praise for the new invention.
“I had previously taken my son for circumcision last year at a Nairobi clinic and for the three consecutive days I visited it the surgeon who works in a government hospital besides running the clinic claimed that the nurses had forgotten to sterilize the surgical tools.

This led me to abandon the exercise altogether” says Wako.
Wako says that he learnt of the Tara KLamp method recently from a relative and he decided to take his son Idris for the operation.
“I liked the way the staff handled my son who had developed a negative attitude towards male circumcision. In a few minutes the operation was over and immediately we reached home my son went straight to the computer and started playing computer games” he said.
Dr David Momanyi Orwenyo, the Manager of the Nyangena Hospital where the Tara KLamp Circumcision method was launched said that his staff were well trained to perform circumcision using the new method.
“My hospital will be charging Sh2 000 for the surgery and I will highly recommend it to parents since it does not hinder their children from going on with their normal lives unlike other methods,” he said.
During the occasion Gibbon Ogada a Sales Executive with Bradmon Health Care (K) Ltd took the visitors through the processes involved in the performance of circumcision using the new method.

  Mark Lyndon

January 25, 2009 at 1:44 PM

Circumcision can only possibly help men who have unsafe sex with HIV+ partners, so why this bizarre obsession with genital surgery when we know that ABC works better than circumcision ever could? (ABC=Abstinence, Being Faithful, Condoms).

The studies which allegedly show a reduction in HIV among circumcised men are highly questionable. Not one of them was finished, despite the protective affect appearing to decline well below the oft-reported 65%, and several of the subjects disappeared. The fact that one study described circumcision as "equivalent" to a "vaccine of high efficacy" seems to show clear bias. They appear to have been seeking a certain result. One has to wonder how many of the people promoting circumcision in Africa are themselves circumcised. Some of them have been promoting circumcision for decades.

Other epidemiological studies have shown no correlation between HIV and circumcision, but rather with the numbers of sex workers, or the prevalence of "dry sex".

The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circed men than intact men, yet they've just started a nationwide circumcision campaign. Rwanda has more than nine million people, but only one doctor for every 50,000 people and one nurse for every 3,900 people, so why would they want to waste their medical resources operating on intact Rwandan men who are less likely to be HIV+ than circumcised Rwandan men? Other countries where circumcised men are *more* likely to be HIV+ than intact men are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives.

Circumcised male virgins are more likely to be HIV+ than intact male virgins, as the operation sometimes infects men.

The latest news is that circumcised HIV+ men are more likely to transmit the virus to women than intact HIV+ men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised.

Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that.

If people were really interested in fighting HIV, rather than promoting circumcision, they would be focussing on ABC. The level of knowledge about HIV in some African countries is quite frightening. In Malawi for instance, only 57% know that condoms protect against HIV/AIDS, and only 68% know that limiting sexual partners protects against HIV/AIDS. There are people who haven't even heard of condoms. It just seems really misguided to be hailing male circumcision as the way forward. It would help if some of the aid donors didn't refuse to fund condom education, or work that involves talking to prostitutes. There are African prostitutes that sleep with 20-50 men a day, and some of them say that hardly any of the men use a condom. If anyone really cares about men, women, and children dying in Africa, surely they'd be focussing on education about safe sex rather than surgery that offers limited protection at best, and runs a high risk of risk compensatory behaviour.