Newly circumcised Ogiek boys after coming out of
in the Mau forest.
Young men from communities that do not traditionally
up for the cut.
October 09, 2003
Rush for new
Young men go for
the 'cut', believing it reduces risk of infection
to establish if circumcision reduces HIV infections has attracted
many young men at Kisumu. offering themselves for circumcision in
a study that seeks to establish if the cut makes a man less
vulnerable to HIV infection.
last month, since the research started last year, 348 out of the
741 HIV-negative males enrolled in the study – which started
last year and targets the 18-25-year-old bracket – had been
them have withdrawn after they made what the researchers describe
as unreasonable demands.
Robert Bailey said the team had screened 1,339 young men for
circumcision by last month, 99 per cent of whom were accepted.
Between 4,500 and 5,000 are required as study samples. Just over
20 either declined or postponed the operation.
four, who were not circumcised, but used as part of the control
group (volunteers whose performance will be compared with results
from the circumcised group to test the method's efficacy) insisted
on being circumcised.
walked out when the researchers refused to do so and went to
private clinics. With more than 96 per cent of the young men
coming from communities that do not traditionally circumcise men,
the interest in the study is overwhelming.
is one of the few countries to launch such a study. Others are
South Africa and Uganda. The principal investigator, Prof Ndinya
Achola, says that no incentives are being given. The young men
only get free medical care. The results are expected in 2007.
scientists postulate that increased sexual pleasure for
circumcised men, good hygiene and the thought of protection from
HIV infection might be the factors driving the young men to the
the 13th International Conference on Aids and Sexually Transmitted
Infections in Africa (Icasa), some participants questioned the
ethics and the safety of carrying out such a research.
were concerned that, in some instances, men had died during
operations that went haywire. Some circumcised men have
unprotected sex under the false knowledge that they are insulated.
the researchers insist that the operations are safe since doctors
do it under the supervision of officials from the Data Safety
Monitoring team of Kenyan and American experts.
say the volunteers are counselled and advised against the mistaken
belief that circumcision will protect them against infection.
year, the study ran into trouble with the Kenyatta National
Hospital Ethics and Research board, which at one point even
board was concerned that specimens from many study subjects were
shipped abroad for further analysis.
the study has since picked up. Prof Bailey and his team say their
objective is to ascertain whether or not circumcision reduces the
risk of HIV infection.
studies to date have only compared HIV incidence in communities
that circumcise against those who do not, but do not offer strong
and conclusive evidence showing that circumcision lowers the risk
of HIV infection," he said.
the news of the study was first broken last December, Prof Achola
said the study wanted to provide empirical evidence on the
relationship between circumcision and HIV infection.
would justify or refute findings of other studies that have made
comparison between HIV and circumcision using untested data.
these studies are aimed at putting to rest bitter arguments
between doctors on whether or not circumcising men plays a role in
of the theory that circumcision prevents HIV infections say
circumcised men have low viral loads and are, therefore, less
likely to transmit the virus to female partners.
argued that the foreskin has a high density of cells known as
Langerhans, which, they think, represent a possible source of the
first conduct and one that provide an environment for HIV
Lancet No 8660 (1989), D. Cameron wrote that and others in their
paper Female to Male transmission of HIV type 1: risk factors for
seroconversion in men, claimed that the foreskin might provide an
environment enabling bacteria and viruses to survive long enough
to increase the likelihood of HIV infection.
note that the foreskin is susceptible to bruises that increase the
chances of contracting the virus.
scientists, however, scoff at these arguments, saying these
conclusions are not foolproof.
paper called "Male Circumcision: A role in HID prevention",
Dr. Die Vincent argues that " the evidence for an association,
at least from small-scale surveys, is doubtful and hence not
conclusive enough to qualify circumcision as an intervention."
others dismiss the existing studies outright, saying they do not
show evidence of a causal relationship between circumcision and a
reduced HID infection rate.
scientific arguments, certain economic, gender and cultural issues
question the supposed link between circumcisions and HID
scientists have expressed concern that, if the method is accepted
as a prevention against HID infection, the costs of mass
circumcision of males might increase dramatically and make it
example, Mutterer University lecturer Jams Matzo says the idea may
push governments into diverting money from other social needs to
circumcision, which would be counter-productive.
fear it would leave women more vulnerable to infection since some
circumcised men engage in unprotected sex thinking they are safer.
Horizons, a journal of the Population Council, cautions that
circumcised men are likely to use their status as a reason for not
avoiding condoms. Women, too, might be less inclined to insist on
scenario exposes women to more infection risk. Some argue that
increased cases of circumcision may encourage communities
practising Female Genital Mutilation (FGM) to continue with it,
thus intensifying another social problem.
critics say the research is likely to interfere with the cultural
practices of some communities – those who do not practise it –
and consequently elicit a negative reaction.
experts at Icasa and the International Aids Conference in
Barcelona, HIV experts called for studies to establish
circumcision acceptability by communities that do not practise it.
to this is the age at which a person needs to be circumcised. Past
research shows that circumcision as an HIV prevention is effective
if done soon after puberty.
by Kelly Kiwanuka on the age of male circumcision and risk of
prevalent HIV infection in Uganda found that men circumcised
before puberty had a much reduced risk of prevalent HIV infection.
the new research that targets those in late teens and early 20s
may not yield the best results.
- An AWC Feature
Link : http://www.nationaudio.com/News/DailyNation/Supplements/horizon/09102003/story09105.htm
Young Ogiek Initiates after circumcision. Increased
and the thought of protection from HIV
are driving the
men to the ritual.