Impact of male circumcision on the female-to-male transmission ofHIV

As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."


============================
Impact of male circumcision on the female-to-male transmission of HIV

Auvert B.1, Puren A.2, Taljaard D.3, Lagarde E.4, Sitta R.4, Tambekou J.4

1UVSQ - INSERM U687 - APHP, ST Maurice CEDEX, France, 2NICD,
Johannesburg, South Africa, 3Progressus CC, Johannesburg, South Africa,
4INSERM U687, St Maurice, France


Introduction: Observational studies suggest that male circumcision could
protect against HIV-1 acquisition. A randomized control intervention
trial to test this hypothesis was performed in sub-Saharan Africa with a
high prevalence of HIV and where the mode of transmission is through
sexual contact.


Methods: 3273 uncircumcised men, aged 18-24 and wishing to be
circumcised, were randomized in a control and intervention group. Men
were followed for 21 months with an inclusion visit and follow-up visits
at month 3, 12 and 21. Male circumcision was offered to the intervention
group just after randomization and to the control group at the end of 21
month follow-up visit. Male circumcisions were performed by medical
doctors. At each visit, sexual behavior was assessed by a questionnaire
and a blood sample was taken for HIV serology. These grouped censored
data were analyzed in an “intention to prevent” univariate and
multivariate analysis using the piecewise survival model, and relative
risk (RR) of HIV infection with 95% confidence interval (95% CI) was
determined.


Results: Loss to follow-up was 11%; 1% of the intervention group were
not circumcised and 2% of the control group were circumcised during
the follow-up. We observed 45 HIV infections in the control group and 15
in the intervention group, RR=2.77 (95% CI: 1.56 – 4.91; p=0.0005). When
controlling for sexual behavior, including condom use and health seeking
behavior, the RR was unchanged: RR=2.93 (p=0.0003).


Conclusions: Male circumcision provides a high degree of protection
against HIV infection acquisition. Male circumcision is equivalent to a
vaccine with a 63% efficacy. The promotion of male circumcision in
uncircumcised males will reduce HIV incidence among men and indirectly
will protect females and children from HIV infection. Male circumcision
must be recognized as an important means to fight the spread of HIV
infection and the international community must mobilize to promote it.

http://www.ias-2005.org/planner/Abstracts.aspx?AID=2675

The Pharma Satanic hymn, verse one:

Yes, AIDS is caused by HIV.
Yes, HIV exists.
No, there is no known cure for AIDS nor HIV.


"Briar Rabbit" wrote in message
...
As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."


============================
Impact of male circumcision on the female-to-male transmission of HIV

Auvert B.1, Puren A.2, Taljaard D.3, Lagarde E.4, Sitta R.4, Tambekou J.4

1UVSQ - INSERM U687 - APHP, ST Maurice CEDEX, France, 2NICD,
Johannesburg, South Africa, 3Progressus CC, Johannesburg, South Africa,
4INSERM U687, St Maurice, France


Introduction: Observational studies suggest that male circumcision could
protect against HIV-1 acquisition. A randomized control intervention
trial to test this hypothesis was performed in sub-Saharan Africa with a
high prevalence of HIV and where the mode of transmission is through
sexual contact.


Methods: 3273 uncircumcised men, aged 18-24 and wishing to be
circumcised, were randomized in a control and intervention group. Men
were followed for 21 months with an inclusion visit and follow-up visits
at month 3, 12 and 21. Male circumcision was offered to the intervention
group just after randomization and to the control group at the end of 21
month follow-up visit. Male circumcisions were performed by medical
doctors. At each visit, sexual behavior was assessed by a questionnaire
and a blood sample was taken for HIV serology. These grouped censored
data were analyzed in an “intention to prevent” univariate and
multivariate analysis using the piecewise survival model, and relative
risk (RR) of HIV infection with 95% confidence interval (95% CI) was
determined.


Results: Loss to follow-up was 11%; 1% of the intervention group were
not circumcised and 2% of the control group were circumcised during
the follow-up. We observed 45 HIV infections in the control group and 15
in the intervention group, RR=2.77 (95% CI: 1.56 – 4.91; p=0.0005). When
controlling for sexual behavior, including condom use and health seeking
behavior, the RR was unchanged: RR=2.93 (p=0.0003).


Conclusions: Male circumcision provides a high degree of protection
against HIV infection acquisition. Male circumcision is equivalent to a
vaccine with a 63% efficacy. The promotion of male circumcision in
uncircumcised males will reduce HIV incidence among men and indirectly
will protect females and children from HIV infection. Male circumcision
must be recognized as an important means to fight the spread of HIV
infection and the international community must mobilize to promote it.

http://www.ias-2005.org/planner/Abstracts.aspx?AID=2675

"Briar Rabbit" wrote in message
...
As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."


I don't think this is a good reason why people in the US should circumcise
their kids. There are better ways to prevent AIDS, like condoms.

Jeff

Jeff wrote:

"Briar Rabbit" wrote in message
...

As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."



I don't think this is a good reason why people in the US should circumcise
their kids.


Who is asking them to? All that has been stated is the efficacy of male
circumcision in reducing the risk of HIV infection. Why do you rush
towards an "anti-circumcision" position? Have you an interest in this
issue which you should share with the group?

_____________________
Quote:
"I'm not sure which upsets me mo that people are so unwilling to
accept responsibility for their own actions, or that they are so eager
to regulate everyone else's." --Kee Hinckley

On Sun, 07 Aug 2005 05:58:22 +0200, Briar Rabbit wrote:

As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."
[cut]

Cultural blinders caused you to miss this study, Briar? Female circumcision
reduces HIV risk:

http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138

What's good for the goose is good for the gander, right?

On Sun, 07 Aug 2005 14:58:27 GMT, Jeff wrote:

I don't think this is a good reason why people in the US should circumcise
their kids. There are better ways to prevent AIDS, like condoms.

Children shouldn't be circumcised anywhere to prevent HIV. They have a
right not to be second-guessed about their future sexual practice.

As far as U.S. goes here's a study that has a lot more relevance since it
was not performed in the developing country with very low hygiene standard
and 37% HIV infection rate among women.

"Prevalence of male circumcision and its association with HIV and sexually
transmitted infections in a U.S. navy population"

http://www.iasociety.org/abstract/sh...act_id=2176002

Lack of circumcision was not found to be a risk factor for HIV or other
STDs. Risk factors found were irregular use of condoms (2.6 higher risk),
having anal sex (6.2 times higher risk), being african-american (3 times
higher risk) and being single or divorced/separated (3.5 times higher
risk).

"Briar Rabbit" wrote in message
...
Jeff wrote:

"Briar Rabbit" wrote in message
...

As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."



I don't think this is a good reason why people in the US should
circumcise their kids.


Who is asking them to? All that has been stated is the efficacy of male
circumcision in reducing the risk of HIV infection. Why do you rush
towards an "anti-circumcision" position?

I have no anti-circumcision position. Personally, I think the decision
should be left up to the family.

Have you an interest in this issue which you should share with the group?

Yes, I have I performed several circumcisions in the past, as a physician.

Jeff

Jeff wrote:

"Briar Rabbit" wrote in message
...

Jeff wrote:


"Briar Rabbit" wrote in message
...


As the conclusions state: "Male circumcision is equivalent to a vaccine
with a 63% efficacy."



I don't think this is a good reason why people in the US should
circumcise their kids.


Who is asking them to? All that has been stated is the efficacy of male
circumcision in reducing the risk of HIV infection. Why do you rush
towards an "anti-circumcision" position?


I have no anti-circumcision position. Personally, I think the decision
should be left up to the family.


Have you an interest in this issue which you should share with the group?


Yes, I have I performed several circumcisions in the past, as a physician.

Jeff




As neonatal male circumcision is the majority practice in the US this
base is covered.

The results of the RCT should be read in conjunction with a previous
study relating to the younger the age at circumcision the greater the
protective effect of circumcision against HIV infection.

Age of male circumcision and risk of prevalent HIV infection in rural
Uganda.
http://www.ncbi.nlm.nih.gov/entrez/q..._uids=10199231

LarryW wrote:

On Sun, 07 Aug 2005 14:58:27 GMT, Jeff wrote:


I don't think this is a good reason why people in the US should circumcise
their kids. There are better ways to prevent AIDS, like condoms.


Children shouldn't be circumcised anywhere to prevent HIV. They have a
right not to be second-guessed about their future sexual practice.



You are entitled to your opinion. The majority view however is that male
circumcision is a perfectly acceptable parental decision as a result of
religious, cultural or medical considerations.



As far as U.S. goes here's a study that has a lot more relevance since it
was not performed in the developing country with very low hygiene standard
and 37% HIV infection rate among women.

"Prevalence of male circumcision and its association with HIV and sexually
transmitted infections in a U.S. navy population"

http://www.iasociety.org/abstract/sh...act_id=2176002

Lack of circumcision was not found to be a risk factor for HIV or other
STDs. Risk factors found were irregular use of condoms (2.6 higher risk),
having anal sex (6.2 times higher risk), being african-american (3 times
higher risk) and being single or divorced/separated (3.5 times higher
risk).


Yes and that must be considered in the greater scheme of things.

Here's another from the US:

Sexual risk, nitrite inhalant use, and lack of circumcision associated
with HIV seroconversion in men who have sex with men in the United States.
http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15851918

There are at least three other studies amongst gay men which find the
lack of circumcision to be a factor in HIV infection.

The heterosexual aspect is covered in the Fischl study:

Seroprevalence and risk factors associated with the heterosexual
transmission of HIV in a sexually active non-drug abusing population.
http://www.aegis.com/aidsline/1992/dec/m92c3474.html