New data from study roll-out provides further evidence that male circumcision is effective in preventing HIV in men
ROME/GENEVA, 20 July 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes new results confirming that scaling-up adult male circumcision works to prevent HIV in men. The study, which was carried out in the township of Orange Farm in South Africa, resulted in a 55% reduction in HIV prevalence and a 76% reduction in HIV incidence in circumcised men.
The results were announced today in Rome at the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention by the French National Agency for Research on AIDS and Viral Hepatitis. It is the first time a study has shown that male circumcision roll-out is effective at community level in preventing HIV.
“Science is proving that we are at the tipping point of the epidemic,” said Michel Sidibé, Executive Director of UNAIDS. “Urgent action is now needed to close the gap between science and implementation to reach the millions of people who are waiting for these discoveries. Scaling up voluntary medical male circumcision services rapidly to young men in high HIV prevalence settings will help reach the 2015 goal of reducing sexual transmission of HIV by 50%.”
During the study, free circumcision services offered to all men over 15 years of age resulted in 20 000 circumcisions over a three-year period. From 2007 to 2010 the percentage of circumcised men increased from 16% to 50% among men between the ages of 15 and 49 years, peaking at 59% in young men aged 15 to 24 years. Community-based surveys reveal no changes in sexual behaviour. The total population of the township of Orange Farm is estimated to be around 110 000.
Many African countries are strongly supporting the scale-up of male circumcision. Kenya has taken the lead, providing voluntary male circumcision to 290 000 men over the past three years, mostly in the province of Nyanza. As reported today at the Rome conference, the men who were circumcised did not increase their risk behaviour. In Tanzania, where the government announced plans to circumcise at least 2.8 million men and boys between the ages of 10 and 34 over a five-year period, a rapid results campaign in early 2011 saw more than 10 000 boys and men circumcised over six weeks.
His Majesty King Mswati III of Swaziland, together with the Swazi Ministry of Health and the US President’s Emergency Plan for AIDS Relief, has recently launched a plan to provide voluntary medical male circumcision to the 152 800 men living in Swaziland between the ages of 15-49 years. Swaziland has the highest HIV prevalence rate in the world, estimated at 26% of adults aged 15-49 years. A statement released by the US Embassy in Swaziland estimated that the circumcision plan could avert nearly 90,000 new HIV infections and save more than US$ 600 million over the next decade.
These results and announcements follow other recent scientific breakthroughs in HIV prevention: the HPTN 052 trial announced in May showed that early initiation of antiretroviral therapy can reduce the risk of transmission to an uninfected partner by 96%; the Partners PrEP and TDF2 studies announced last week show that a daily antiretroviral tablet taken by people who do not have HIV infection can reduce their risk of acquiring HIV by up to 73%; in November 2010, the iPrEx trial among men who have sex with men reported a 44% reduction in HIV acquisition among HIV negative men who took a daily antiretroviral tablet; and the CAPRISA gel study results announced in July 2010 showed that an antiretroviral gel—when used as a vaginal microbicide—was 39% effective in reducing a woman’s risk of becoming infected with HIV during sex.
UNAIDS stresses that despite the recent scientific discoveries there is still no single method which is fully protective against HIV. To reach UNAIDS vision of Zero new HIV infections, UNAIDS strongly recommends a combination of HIV prevention options. These include correct and consistent use of male and female condoms, waiting longer before having sex for the first time, having fewer partners, medical male circumcision, avoiding penetrative sex and ensuring that as many people as possible in need of antiretroviral therapy have access to it.