Kaiser Daily HIV/AIDS Report
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HIV TRANSMISSION: BENEFITS OF MALE CIRCUMCISION WIDELY IGNORED
Male circumcision could reduce the spread of HIV/AIDS in developing
countries, saving millions of lives, but the international health com-
munity remains "reluctant to publicize this fact," according to an edi-
torial in The Lancet. In his Salon.com column, Hank Hyena notes that
the editorial, written by Daniel Halperin and Robert Bailey, refers to
a decade-old study that found uncircumcised Kenyan men who frequently
visited prostitutes were eight times more likely to contract an infec-
tion than circumcised men.
In addition, Halperin and Bailey point to 27 studies that show a simi-
lar association between infection rates and circumcision. They theorize
that the foreskin "provides a vulnerable portal of entry to HIV and
other pathogens ... such as chancroid, syphilis and herpes, that are
known cofactors for HIV infection." In developing countries like Zambia
and India, Halperin and Bailey assert that circumcision "could provide
a huge barrier" to the AIDS epidemic. However, they charge that the in-
ternational health community has "disregarded information about the
probable link between circumcision and HIV/AIDS transmission." They
point to the Johns Hopkins Media/Materials Clearinghouse; none of its
30,000 AIDS- related listings discusses circumcision and transmission
rates.
Although they acknowledge that circumcision would be "counterproductive
if men believe that the procedure [alone] will protect them" from HIV,
Halperin and Bailey note that the procedure is gaining favor in eastern
and southern Africa. There, traditional healers are recommending the
procedure as "a way to alleviate chronic STD infection and AIDS." They
conclude The Lancet editorial with "a plea to the international health
community to assist the public with education, training and circumci-
sion services," while asking their colleagues "to assist them in this
mission" (Hyena, Salon.com, 2/28).
UNITED NATIONS: DEVOTES ECONOMIC AND SOCIAL COMMITTEE MEETING TO AIDS
The U.N. Economic and Social Committee devoted an entire session Tues-
day to the AIDS pandemic, marking the second time that the United Na-
tions has devoted a meeting to the topic, Newsday reports. U.S. Ambas-
sador to the United Nations Richard Holbrooke, who has argued that de-
ploying U.S. soldiers to areas such as Rwanda or the Congo without in-
forming them about the risks of HIV endangers their lives, said,
"Clearly and flatly, the U.S. will not support any peacekeeping mission
anywhere ... that does not support action on the issue." Accordingly,
the U.S. State Department Tuesday declared a "proclamation of war"
against AIDS in a memorandum distributed to its missions and embassies.
UNAIDS Director Dr. Peter Piot said, "Finally, finally we are seeing
changing gears in the international community ... Let's agree that
here, today, we put aside all the doom and gloom talk of AIDS in Af-
rica. Today we've got to go beyond that. We must spread a message of
hope." Other participants debated whether to focus on treating AIDS pa-
tients or preventing AIDS from spreading. Traditionally, the global em-
phasis has been on prevention rather than treatment of the disease, but
treatment has become the "most divisive issue" since the U.N. Security
Council's Jan. 10 declaration of war on AIDS. But activists have
charged that a war on AIDS that fails to address the needs of those who
are already infected means "that millions of people with HIV in Africa
are only good for the role of bugbears of the world contagion."
Failing to mention treatment for her nation's 2 million citizens esti-
mated to be infected with the virus, South African First Lady Zanele
Mbeki called for prevention programs. She said yesterday that the only
way to slow the spread of HIV in South Africa is to create economic
programs that give women control over their lives (Garrett, Newsday,
2/29). Disagreeing with Holbrooke, Indian representative Satyabrata Pal
turned the conversation to the economic toll of the disease. Arguing
that AIDS is not a security issue but a development problem, Pal called
for the council to commission an analysis on the full economic and so-
cial costs of AIDS and asked that the council "consider that discover-
ing a vaccine was less profitable than discovering a cure" (Presswire,
2/29).
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