Circumcision
urged in curbing AIDS spread

A U.S. health expert urged governments worldwide Tuesday to endorse circumcision to slow the spread of HIV, saying men without the procedure have a greater risk of contracting the virus from infected female partners.

Experts at an AIDS conference in Sydney, Australia, also warned that HIV infection rates were rising among men who have sex with men in developing countries because of discrimination and lack of access to health services.

The World Health Organization says male circumcision reduces the risk of female-to-male transmission of the disease by around 60%. But only 30% of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons.

Robert Bailey, a professor of epidemiology at the University of Illinois, said studies in Africa showed that uncircumcised men were 2 1/2 times more likely to contract HIV from infected female partners, though many health officials were still unclear about its benefits.

''If we had a vaccine that was 60% protective, we would be very happy and we would be rolling it out as fast as we can,'' Bailey told reporters at an International AIDS Society Conference in Sydney, Australia.

''The next step is to get the leaders of countries to actually come up with policy statements endorsing the practice,'' said Bailey, who has conducted circumcision-related studies in Africa and the United States.

Without local support, international agencies would be unlikely to encourage the procedure to avoid being seen as imposing foreign cultures or values, he said.

Circumcision, the removal of the foreskin from the penis, has long been suspected of reducing men's susceptibility to HIV infection because the skin cells in the foreskin are especially vulnerable to the virus.

In March, WHO urged heterosexual men to undergo the procedure because of compelling evidence that it reduces their risk of contracting HIV. However, it cautioned that male circumcision does not provide complete protection against HIV, and said men should still use condoms and take other precautions such as abstinence, delaying the start of sexual activity, or reducing the number of sexual partners.

''Circumcision could drive the epidemic to a declining state toward extinction,'' Bailey said. ''We must make safe, affordable, voluntary circumcision available now.''

Bailey also called on international agencies to ramp up funding for circumcision in countries hit hardest by the epidemic.

Michel Kazatchkine, the executive director of the Global Fund, a leading international health agency, also called for increased funding.

''I believe that the evidence is overwhelming for the efficacy of circumcision,'' Kazatchkine told the Associated Press on the sidelines of the meeting. ''And if countries come to us...I see no reason at all why we wouldn't fund that.''

Kazatchkine said his organization had not yet received any requests for funding for circumcision, and noted that the WHO advice on the topic was released fairly recently.

Also at the conference, a leading American AIDS research group said HIV infection rates among men who have sex with men were rising in Africa, Asia, and Latin America, citing figures from the Joint United Nations Programme on HIV/AIDS.

Studies also show that less than 5% of that group have access to HIV-related health care, according to the American Foundation for AIDS Research, or AmfAR.

''This is a massive failure of the HIV/AIDS response globally and I think one that needs to be addressed,'' said Kevin Frost, AmFAR's chief executive officer.

In Kenya around 40% of men who have sex with men are estimated to be HIV-positive, compared to a 6% rate in the country's overall population, AmFAR officials said. In Senegal nearly 22% are believed to be infected, compared to less than 1% of the general population.

In Uruguay and Mexico, 21% and 15% are estimated to have the disease.

Under an initiative launched at the AIDS Society Conference, AmFAR will seek to raise $3 million in the next three years to provide grants for AIDS education and research among men who have gay sex in developing countries. (Meraiah Foley, AP)