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Over 15 years ago, studies published
in leading medical journals on AIDS in Africa, found that
uncircumcised men were about 3 times as likely as were
circumcised men to be infected with the human immunodeficiency
virus (HIV). These findings have been confirmed in more
than 40 separate studies. Currently almost 40 million
people worldwide are infected with HIV, mostly in sub-Saharan
Africa and 22 million have died of AIDS. The AIDS epidemic
is rapidly spreading in Asia and Eastern Europe. Professor
Malcolm Potts (Lancet. 2000) of the University of California
estimated that if all HIV-exposed men in Sub-Saharan Africa
and Asia had been circumcised there would have been 8
million fewer deaths from AIDS; 6 million fewer in Africa
and 2 million fewer in Asia. In a review article in a
leading British journal (Halperin, Lancet. 1999) alluded
to the lack of response of the international community
to the knowledge of the effect of circumcision on preventing
HIV infection in spite of these convincing figures. Public
knowledge in Africa of the protective effect of circumcision
against HIV infection, has resulted in private store-front
clinics offering adult circumcision under suboptimal conditions.
Governmental involvement is required in order to assure
that these circumcisions are properly performed by qualified
personnel. It should also be emphasized that circumcision
itself is most effective when used in association with
condoms.
In the U.S. there has been some official
recognition of the protective effect of circumcision against
HIV. Dr. Anthony Fauci, head of the HIV Research Division
of the NIH, stated that "the link between male circumcision
and lower HIV infection rates is now absolute fact."
In March 2002 a group of internationally reknowned scientists
concluded that affordable, safe, voluntary circumcision
should be developed to help fight the AIDS epidemic and
that "such efforts must commence now, lest the opportunity
for a potentially important prevention measure be further
delayed." Randomized controlled trials are now under
way in Africa, supported by the NIH, the Canadian and
the French governments, on the effectiveness of adult
medical circumcision in preventing HIV transmission.
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