'Surgical vaccine': Delegates at the International AIDS Conference 2008 in Mexico City.
Credit: International AIDS Society/Mondaphoto
Circumcision has emerged as one of the few bright areas of progress in the AIDS crisis, after the Orange Farm and Kisumu trials.
The discovery has sparked talk in some circles of a "surgical vaccine" – a cheap, safe method for shielding men from HIV, especially in sub-Saharan Africa, home to two-thirds of the 33 million people with HIV.
But this enthusiasm has also been tempered by worries that circumcision may face a backlash on cultural, religious or sexual grounds, or may prompt men to abandon use of the condom.
HIV entry point
Other work at the conference, closing Today, suggested, though, that circumcision was widely accepted by men, some of whom believed that it enhanced sexual pleasure, and did not prejudice safe-sex practices.
According to French researcher Bertran Auvert, who led the original South African study, circumcision could avert up to 3.8 million infections and half a million deaths in sub-Saharan Africa between 2006 and 2016, and up to 5.8 million deaths by 2026.
The theory behind the effectiveness of circumcision is that the inner foreskin is an easy entry point for HIV. It is rich in so-called Langerhans cells, tissue that the AIDS virus finds particularly easy to latch onto and penetrate.
Other questions surrounding a circumcision campaign are the need to ensure that operations are done hygienically and with the full knowledge and consent of the male. Also unclear is what benefit, or otherwise, male circumcision has on women.
Fargo
Circumcision is an obvious mutilation of the human body. This point has not been mentioned. On the one hand it may be the case that circumcision affects the speed-spread of AIDS. But on the other hand this form of mutilation does not prevent AIDS from speading if other precautions are ignored. If this is true, then circumcision is not as helpful as one may believe. By reviewing the article I can see that circumcision may become a mandate for some societies.