Circumcisions urged as AIDS weapon

JOHANNESBURG, South Africa — The World Health Organization (WHO) on Wednesday urged nations with rampant AIDS epidemics to begin offering free or subsidized circumcisions in hopes of preventing millions of new infections and deaths.

The new recommendations, endorsed also by the United Nations AIDS agency, came in response to growing evidence that removing a man's foreskin lowers his risk of contracting HIV by 60 percent — a higher rate of protection than that offered by many vaccines.

Circumcision campaigns could prevent 5.7 million new infections in Africa over the next 20 years, the WHO said in a statement issued from Geneva.

"The recommendations represent a significant step forward in HIV prevention," Kevin De Cock, director of the HIV/AIDS department of the World Health Organization, said in the statement. "Scaling up male circumcision in such countries will result in immediate benefit to individuals. However, it will be a number of years before we can expect to see an impact on the epidemic from such investment."

The announcement capped a gradual reversal in attitudes about circumcision's benefits. A small group of researchers has been touting the value of the procedure for more than a decade, producing dozens of studies showing that regions with high HIV rates generally have low rates of circumcision. Three experiments, including two that reported results in December, have largely quelled debate in the scientific community over the value of circumcision.

Recent discussions have focused on how to increase the number of circumcisions performed, especially in sub-Saharan African where HIV rates are highest and public health systems generally are rudimentary.

Wednesday's announcement says circumcision should be part of prevention programs that also include counseling, HIV testing and providing condoms. It also urges nations to prioritize circumcision for adult men most at risk of contracting HIV, rather than infants.

Most traditional African societies historically have circumcised boys during rituals signifying the arrival of manhood, but those rites have declined amid rapid modernization, especially in Eastern and Southern Africa. Regions that continue to circumcise widely, including most of West Africa, have much lower rates of HIV.