« Uganda: Guinea is in West Africa | Main | Making it Official »
March 30, 2007
De Kock: Less Cock
The World Health Organization formally endorsed circumcision as an HIV prevention method, clearing the way for governments and NGOs to pay for the procedure. Read a news summary or The Boston Globe.
All along, some questions have dogged this idea and they're not going away quickly. (See this strategy paper.) Several recent studies show that circumcision can reduce transmission by 65 percent. But before we start waving this extraordinary number around, consider that it's comparing cut men with uncut men in heterosexual situations. It doesn't (necessarily) change a woman's chances of getting HIV from an infected man, so it doesn't mean that infected, cut men can be irresponsible. Poz summarizes.
The theory is that foreskin cells allow HIV easy entry into the body, and that the virus can live longer underneath the foreskin. So the procedure must be done under proper medical care to avoid bacterial infections. And men must wait until they are healed before having sex or else their risk may actually increase.
There is also worry that a wrongheaded belief of the protection this conveys could actually lead to an increase in risky behavior. As an opinion piece in a medical journal argues: "It is difficult to imagine a convincing public health message that effectively influences men to undergo circumcision and continue to consistently use condoms."
Also the not-insignificant cultural barriers to this practice all over the world. As one doctor told me last week, "Perhaps I'm naive but I just can't imagine a 20-year-old walking in and saying, 'Doc I'd like to have the end of my dick cut off.'"
Posted by Adam Graham-Silverman at March 30, 2007 11:10 PM