Circumcision against AIDS: A new program being developed by the World Health Organization (WHO) is attempting to suggest ways and principles for holding a mass circumcision in HIV-infected countries, particularly African countries.
Research has found that the removal of the foreskin, an act which is carried out during the circumcision ceremony, reduces the chances of being infected or infecting people with the HIV virus.
The issue was discussed in Jerusalem at the beginning of the week, in a meeting between WHO representatives, 20 Israeli physicians and Jewish and Muslim circumcisers.
WHO-JAIP workshop in Jerusalem – Israeli and WHO experts (left to right): Dr. Benny Gesundheit, Dr. Tim Farley, Prof. Khalil Abu-Dalu and Dr. Inon Schenker), standing next to a poster from Swaziland promoting male circumcision for HIV prevention (Photo: Keren Manor)
"The initiative was born because Israel
is one of the only countries in the world with so much experience in circumcising children, as well as adults," explained Dr. Inon Schenker, an HIV-AIDS prevention specialist from the Jerusalem AIDS Project (JAIP).
According to Dr. Schenker, the joint workshop was aimed at hearing the opinions of the Israeli experts before deciding on the clinical indications for carrying out the circumcision.
Dr. Schenker presented data which show that almost all men in Israel have been circumcised, apart from a small percentage among adult new immigrants.
"In a country like Israel, in which about 100 percent of men have been circumcised, there is great significance in stressing the message that circumcision reduces the risk of being infected with HIV, but does not fully guarantee that. One must not be complacent."
Dr. Yoram Mor, chair of Pediatric Urology at the Sheba Medical Center at Tel Hashomer, was one of the experts who took part in the conference and commented on the document.
According to Dr. Mor, "The World Health Organization's documents mainly contains technical details which have to do with the training of circumcisers, the surgical technique, how to deal with complications, and which physical tests should be carried out. The Israeli team of experts received the draft document and commented on it."
The issue which was of natural interest to the WHO representatives dealt with circumcision of adults (new immigrants, for example).
"If circumcision reduces the chances of being infected with HIV, then it is a life-saving operation," Dr. Mor said.
The WHO program will only mature after the findings of additional research on the issue of circumcision are received, and in any case it will only serve as a recommendation to the authorities in African countries.
Dr. Schenker noted that two countries, Zambia and Swaziland, have already started suggesting to their residents to be circumcised as part of an experimental service aimed at examining the public's response to the issue.
A study conducted in Africa and published more than a year ago has shown that the chances of men who have been circumcised to be infected with HIV during sexual intercourse with a woman carrying the virus are 70 percent lower than that of men who have not been circumcised.
Another study held in Uganda revealed that circumcision also protects women from being infected with AIDS. According to the research findings, the chances of partners of men who have been circumcised and infected with the HIV virus to be infected are 30 percent lower than the chances of partners of men who have not been circumcised.