11 February 2007 - PANA. A study undertaken in Uganda went on to vindicate similar ones earlier done in Kenya and South Africa that discovered male circumcision as a potential tool that can be used to control HIV infection.
Judging from preliminary results of the study involving 4,996 HIV- negative Ugandan male volunteers between 15–49 years who offered to be circumcised- scientists have expressed optimism that the practice is a major step towards HIV prevention in Africa and rest of the world.
 
"Male circumcision is the first new, proven HIV prevention method in over a decade, reducing the risk of acquiring HIV infection by over 50 percent," Dr. Godfery Kigozi, Medical Officer in charge of the three-year long trial (August 2003–December 2006), told PANA Saturday.
"If the trial demonstrates efficacy, it will have profound implications for HIV prevention because a single surgical procedure may afford life- long HIV risk reduction for the man and his sexual partner," he said as he announced their findings at the Rakai Health Sciences Program, over 160-kilometers southwest of capital Kampala.
 
"This could be extremely cost effective intervention as the initial cost of surgery would be offset by the long-term prevention of disease, with no recurrent costs," said Dr. Kigozi.
"The foreskin has cells that are extremely vulnerable to HIV infection. It's also vulnerable to tear and ulcers that act as entry points for HIV, but once removed (circumcised), the risk of infection reduces by more than a half," he added.
"Once the surgical scar is healed, the new skin is covered with a protective lining called 'Keratin' that is less vulnerable to HIV infections and other sexually transmitted diseases," Dr. Kigozi explained.
 
However, he hastened to warn: "Men who practice unsafe sex put themselves at high risk of HIV, whether or not they are circumcised."
Dubbed 'The Rakai Male Circumcision Trial' and conducted in partnership with Uganda's leading University of Makerere, John Hopkins University (USA) and Columbia University, the study warns that circumcision is not a cure.
"Its important to note that male circumcision is not a cure–all," warned Dr. Ron Gray, one of the scientists who conducted the study that saw randomly picked volunteers divided in two groups of 2,500 each– one circumcised in 2003 and the other after two years.
 
"We find it provides partial protection, but cannot be sure protection will last after circumcision, although it's likely to be life-long," he told journalists.
According to Professor David Serwadda who led the all Uganda study, the beginning seemed to give negative results posing the risk of discouraging male circumcision, but the threat later faded out.
"Circumcision did not reduce HIV infection in the first six-months, but became progressively more protective after that time and has not yet rescinded," Professor Serwadda told journalists.
 
He further revealed that the study suffered some shortcomings with some volunteers getting infected in the process saying; "those who became HIV- positive during the trial are receiving access to primary healthcare and antiretroviral treatment".
According to Dr. Maria Wawer from the John Hopkins University, "Observational studies are not conclusive because risk behaviours and other characteristics differ between circumcised and uncircumcised men."
"For example, most circumcised men in Rakai are Muslims, and their lower infection rate may be due to cultural practices such as abstinence and post-coital genital cleansing. Therefore, clinical trials are needed to assess the potential for male circumcision as a means of HIV prevention before policies or programs can be implemented," she said.