23 February 2007United Nations health agencies have convened an international meeting of AIDS experts for early March to examine the latest findings that male circumcision cuts the risk of HIV infection in men in heterosexual relations by up to 60 per cent. “The consultation will address a range of policy, operational and ethical issues that will help guide decisions about where and how male circumcision can be best implemented, promoted and safely performed,” the UN World Health Organization (WHO) and the Joint UN Programme on HIV/AIDS (UNAIDS) said in a statement today. “Male circumcision has major potential for the prevention of HIV infection,” WHO HIV/AIDS Department Director Kevin De Cock added. “These findings are a very important contribution to HIV prevention science.” The detailed findings of two trials undertaken in Kenya and Uganda to determine whether male circumcision has a protective effect against acquiring HIV infection were published today in the British medical journal The Lancet. Funded by the United States National Institutes of Health, the trials support the results of the South Africa Orange Farm Intervention Trial, funded by the French National Agency for Research on AIDS (ANRS), published in late 2005. Together the three studies, which enrolled more than 10,000 participants, provide compelling evidence of a 50 to 60 per cent reduction in heterosexual HIV transmission to men, the statement said. When preliminary results were published in December showing a 50 per cent reduction, UN agencies gave a guarded welcome, warning that circumcision should never pre-empt other preventive measures such as the use of condoms. Proper guidelines “will be necessary to prevent people from developing a false sense of security and, as a result, engaging in high-risk behaviours which could negate the protective effect of male circumcision,” they said then, noting that circumcision does not provide complete protection, and circumcised men can still become infected and, if HIV-positive, infect their sexual partners. They also stressed that any recommendations would have to take into account cultural and human rights considerations; the risk of complications from the procedure performed in various settings; the potential to undermine existing protective behaviours and strategies; and the fact that the ideal and well-resourced conditions of a randomized trial are often not replicated in other settings.
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