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Studies Show Male Circumcisions May Reduce the Spread of AIDS

by Jason St. Amand
National News Editor
Tuesday Jan 31, 2012
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Three studies have reported that circumcising heterosexual men may be one of the best ways to reduce the spread of AIDS. The studies show that the risk of infecting someone with the deadly disease can be reduced by 60 percent or more. Now, public health officials are trying to implement methods that would make the circumcision process safe and efficient, the New York Times reported.

Circumcision can reduce the spread of AIDS because the foreskin has several Langerhans cells, which "pick up viruses and ’present’ them to the immune system, which HIV attacks," the New York Times writes.

Officials want to circumcise 20 million African men by 2015 but currently, only about 600,000 have undergone the procedure. Several countries in Africa suffer from a lack of surgeons, so health experts from the World Health Organization (WHO) are considering new tools and methods of circumcision, including an innovative new procedure called PrePex.

PrePex was invented in 2009 and was approved by the Food and Drug Administration three weeks ago. The device is said to be faster and less painful than similar products on the market. It uses a simple rubber band that compresses the foreskin against a plastic ring, which causes the foreskin to die in a few hours due to lack of blood. In a week, the skin falls off or can be clipped off. The company’s chief executive officer, Tzameret Fuerst, compared the process to the clipping a fingernail and "the stump of an umbilical cord shriveling up and dropping off a few days after it is clamped."

AIDS-prevention expert Mitchell Warren said that the WHO also is looking into the Shang Ring, which was developed in China to treat foreskin that becomes too tight and prevents men from urinating. The device is a plastic two-ring clamp but it requires the circumciser to use anesthetics, requiring the circumciser to have training in minor surgery.

"The Shang is not as fast, but it’s faster than full-fledged surgery," Warren said. "And it hasn’t submitted as much safety data."

Said data from PrePex is sourced from Rwanda’s health ministry. The ministry’s scientists used PrePex on 590 men and only two had "moderate" complications that were easily fixed. It was also reported that the two nurse teams could finish a procedure in three minutes.

Dr. Jason Reed, an epidemiologist in the global AIDS division of the Centers for Disease Control and Prevention, said that having three two-nurse PrePex teams would equal to about 400 circumcisions a day.

Although circumcision could reduce the spread of AIDS, several individuals and organizations object to the procedure. In July 2011, a group of "inatactivists" (people who believe baby boys have the right to not be circumcised) pushed for a measure that would criminalize circumcision in San Francisco. The city’s Superior Court Judge Loretta Giorgi, however, ruled that it would not appear on the November ballot.

The measure proved controversial, with Jews and Muslims claiming discrimination. Both religions require male infant circumcision. One of the spear headers of the San Francisco initiative produced an anti-circumcision comic book that was widely repudiated for its purported stereotypical imagery.

The San Francisco activists did manage to force the hand of the State Legislature, which passed a bill that prevented local jurisdictions from banning the practice, thus making local referenda on the subject impossible. The votes were 37-0 in the State Senate and 67-2 in the House.

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