An American health official urged international agencies Tuesday to step up their promotion of circumcision to slow the spread of HIV, saying that men without the procedure face greater risk of contracting the virus from infected female partners.
The World Health Organization says male circumcision reduces the risk of female-to-male transmission of the disease by around 60 percent. But only 30 percent of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons.
Robert Bailey, a professor of epidemiology at the University of Illinois, said uncircumcised men are 2-1/2 times more likely to contract the virus from female partners, based on testing in parts of Africa hardest-hit by the epidemic.
Bailey told a major international AIDS conference in Sydney, Australia, that world health agencies should be aggressive in implementing the procedure in light of mounting evidence of its effectiveness in preventing new HIV infections.
"Circumcision could drive the epidemic to a declining state toward extinction. ... We must make safe, affordable, voluntary circumcision available now," he said.
"But no one stands to profit from male circumcision — no one but the 4,000 in Africa who will be infected tomorrow," said Bailey, who has conducted circumcision-related studies in Uganda, Kenya, Malawi, Zambia and the United States.
Circumcision, the removal of the foreskin from the penis, has long been suspected of reducing men's susceptibility to HIV infection because the skin cells in the foreskin are especially vulnerable to the virus.
The World Health Organization issued a statement in March urging heterosexual men to undergo the procedure because of compelling evidence that it reduces their risk of getting the disease.
However, it cautioned that male circumcision is not a complete protection against HIV, and said men should still use condoms and take other precautions such as abstinence, delaying the start of sexual activity and reducing the number of sexual partners.
Michel Kazatchkine, the executive director of the international health agency The Global Fund, said the organization had not received any requests for funding for circumcision, and noted that the WHO advice on the topic had only been released in March.
"I believe that the evidence is overwhelming for the efficacy of circumcision," Kazatchkine told The Associated Press on the sidelines of the meeting. "And if countries come to us ... I see no reason at all why we wouldn't fund that."
