French and South African AIDS researchers have called an early halt to a study of adult male circumcision to reduce HIV infection after initial results reportedly showed that men who had the procedure dramatically lowered their risk of contracting the virus.

The study's preliminary results, disclosed Tuesday by the Wall Street Journal, showed that circumcision reduced the risk of contracting HIV by 70 percent -- a level of protection far better than the 30 percent risk reduction set as a target for an AIDS vaccine.

According to the newspaper account, the study under way in Orange Farm township, South Africa, was stopped because the results were so favorable. It was deemed unethical to continue the trial after an early peek at data showed that the uncircumcised men were so much more likely to become infected.

All of the men in the study had been followed for a year, and half the men had been followed for the full 21 months called for in the original study design, according to the Wall Street Journal, which obtained a draft copy of the study.

Begun in August 2002, the experiment is one of three closely watched clinical trials in Africa to determine whether there is scientific merit to nearly three dozen less rigorously controlled studies showing that circumcised men were much less likely to become HIV-positive.

The hope is that, lacking a vaccine, the nearly 5 million new HIV infections occurring each year could be slowed by circumcision, the surgical removal of the foreskin -- a simple, low-cost and permanent medical intervention that is a common but controversial cultural practice in much of the world. In Africa, about 70 percent of men are circumcised at birth or during rite-of-passage ceremonies in early puberty.

Medical anthropologists began noticing as early as 1989 that the highest rates of HIV infection in Africa were occurring in regions of the continent where the predominant tribal or religious cultures did not practice circumcision. Adult HIV infection rates above 30 percent are found in Zimbabwe, Botswana, Swaziland and eastern South Africa, where circumcision is not practiced; yet HIV infection rates remain below 5 percent in West Africa and other parts of the continent where circumcision is commonplace.

Laboratory studies have found that the foreskin is rich in white blood cells, which are favored targets of HIV, the virus that causes AIDS. So the theory is that men who are uncircumcised are much more likely to contract the virus during sex with an infected woman, and that the epidemic spreads when these newly infected men have sex with other women within their network of sexual partners.

The lead investigators of the study, Dr. Bertran Auvert of the University of Paris and Adrian Puren of South Africa's National Institute for Communicable Diseases, are not talking. The results were expected to be discussed at an AIDS conference in Rio de Janeiro in three weeks. But word about the findings has been circulating among researchers searching for ways to slow the epidemic.

"I would be thrilled if it works, but we will also need the results of other trials,'' said Johns Hopkins University epidemiologist Ronald Gray, who is conducting, in Uganda, one of two other controlled clinical trials of male circumcision.

Gray's trial, which has completed enrollment of 5,000 men in the Rakai district of Uganda, is not scheduled to end until 2007.

A third trial, under way in Kisumu, Kenya, is still enrolling its quota of 2,700 volunteers and is also expected to be completed in 2007, according to the National Institute of Allergy and Infectious Diseases, which is sponsoring it.

All three trials were designed to compare the HIV infection rates of two groups of HIV-negative men, one-half of whom would agree to be circumcised, the other to be offered only counseling on AIDS prevention. The studies were designed to show whether or not circumcision provided a statistically significant protective effect of at least 50 percent.

The South African study -- if the results are confirmed -- suggests that the level of protection afforded is even higher.

Although the apparent protective effect of circumcision has been noted for more than 20 years, doubts linger as to whether circumcision itself is protective, or whether the lower risk may be the result of cultural practices among those who circumcise. HIV rates are low in Muslim communities, for example, which practice male circumcision but also engage in ritual washing before sex and frown on promiscuity.

E-mail Sabin Russell at srussell@sfchronicle.com.

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That's an ass-kicking post and a wealth of information! Thanks.

Been wondering where the hell you have been...

"Off with their heads!"

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Yes. informative post. Not so sure the Europe "dig" was called for.

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The idea of preventing AIDS by circumcision is illogical as preventing breast cancer by cutting off girls' breasts at birth.

The only reason this is an issue is because the Catholic Church and other anti-sex "Christian" groups have been obstructing the distribution of condoms in Africa for moral reasons.

I believe it is going against God's will to cut off the foreskins He gave us! (Even for Jews!) I have never forgiven the doctor who did it to me without my mother's consent.

BTW, previous studies on this subject were invalidated because they did not actually examine the foreskin (or partial lack thereof), but relied on self reports, which turned out to be very inaccurate. I wonder what this study has done to be more scientific.

Nonetheless, I believe the theory that it is easy to transmit HIV through the foreskin is probably true and it would be interesting to know if it is true. Uncut guys should be warned about this extra risk if it is true.

But I still think circumcision would be a stupid way to stop new infections. With the billions we are spending, we could give away condoms to everybody who wanted them. It would be much easier and cheaper than cutting off the sex organs of every male.

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I'm glad SOMEONE out there knows the Mind Of God.

I've always wondered what He thought about circ.

Now I know.

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I'm no Doctor, but simple science has always dictated that dark, moist places are a breeding ground for bacteria and infection. That said, I'm not surprised at this and have heard this years ago actually in regards to HIV infection.

I'm all for reducing HIV infections, yet, this study seems a bit skewed. 70% is a huge contrast and what's up with a vaccine targeted for only a 30% reduction risk? Being in the Social Science field I'm pretty well versed in research methods and know that statitistics are very grey and are almost always skewed towards the agenda of a given issue being measured. Looks like in this case we have science battling religion.

As for circumcision, I consider that genital mutilation and don't think it should be mandatory for anyone. However, nowhere in Cutguys post indicates that as an option so I'll leave it at that.

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Im with you scruffy!!!

Welcome back Dr. Danny.....we have speculated on where you were! We figured some nice european vacation spot.

__________________
40 something, 6' 175 brn/brn hairy looking for other married wm or younger guys to play.

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Frankly, I have always been amazed and amused by God's apparent obsession with the penis and foreskin. Hell, maybe I really am made in his image.

__________________
"Men never do evil so completely and cheerfully
as when they do it from religious conviction."
-Blaise Pascal

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As for my absence: has anyone noticed how pathetic this BB has been of late???

Anyone notice Scruffy has been missing? I had to make it look as if he is me...

Teva, I wasn't thinking about you when this was posted. BUT, these are recent, well conducted studies. I like my guys cut, I make no bone (ouch) about it. But as an MD, I do have to face the reality of how "artificial" lopping off a little boys foreskin really is. And I know that the main reason was to stop Victorian boys from jacking off. I ain't Victorian (or English for that matter), and heaven knows, it didn't help me one bit. But 70% reduction in HIV transmission is nothing to be sneezed at.

To have a study this large stopped for ethical reasons says a hell of a lot. America was in the forefront of the AIDS epidemic, and HIV/AIDS is one hell of a minor problem here compared to the rest of the planet. And as we all know, it is pretty rare to find an uncut guy in any locker room here in the States. These studies clearly show that it is NOT a coincidence.

When adults come to me professionally asking about getting circumcised, I almost always discourage it. Now however, if an adult gay man were to come to me and asked about elective circumcision, I honestly think it would be immoral on my part not to encourage him to proceed. So as far as I'm concerned, you guys can rage against your parent's evil intentions, the injustice and how horribly you've been mutilated, but if it saves you just that one time when you got drunk and bare backed that beauty, well, nuff said. Your folks made the RIGHT decision, albeit for the wrong reason! You may not be happy about it, but I'm glad you got mutilated.

As for God's thinking, that is pretty straight forward. (I'm not God, I just stand in for him in real life, and no, I never stay at a holiday inn...) You want to be among the chosen, your dick gets clipped on the eighth day, not a minute sooner. No ifs, ands, or butts. (Actually, the Torah is pretty clear that if an uncle had a bleeding disorder, it was forbidden to circumcise the nephews. Bit of trivia for you, plus an interesting take on medical genetics, circa 3000 BC)

And no, haven't been to Europe for about 3 months, but will be going back for Labor Day. I love the place, even if their politics, strikes, newspapers, and unemployment rates are pathetic. And I've been reading that circumcision is becoming the in thing to do in Germany. Perhaps it's time for me to do a little field research. Any suggestions?

Danny

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...like a cut dick and a condom should keep you safe! If you're cut, be sure to have the condom, too. If you're not cut, use the condom only. You get the idea. In Africa, condoms are often not available or used, so there is a rate of infection that can support studies like this.

I'm not in favor of removing the foreskin (can't spell circum..., & there's no spell check here!). However, with the Catholic Church and other the American Ayatollahs ending the promotion of condoms in Africa (the US will be next, if they get their way!), we may need to go with clipping Africans for now, anyway. It's sad that the one tool we know works is not widely used.

I do wonder, though, what role hygiene plays. Again, I wouldn't count on washing my dick to keep safe, but... As a cut guy, I'm only vaguely aware of proper foreskin maintenance,but I do know it can be done!

And you think Europe's politics are screwed up? They may have given us Kafka, but only the US could produce Billy Graham!

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Much as I like to agree with our resident MD here, and much as I absolutely could not care less, if my partner happens to be UC or C, I am afraid, he got it very wrong this time.

Little first-hand experience and possibly a few road trips (or an extensive search) will show that the USA/Canada have a very comparable standard of living, real purchasing power per capita, etc. to Western and Central Europe. Equally so, relatively very few males in Western and Central Europe happen to be cut, in contrast to the number of cut guys in Northern America. Since 'Again America gets it right, Europe gets it wrong', wouldn't we all agree that the prevalence rates of infection in Western and Central Europe must be higher than the prevalence rates in Northern America?

Ouups, we shouldn't agree that hastily! Sure, the Europeans got it all wrong and the Americans got it all right. That's why the prevalence rates in Western and Central Europe range between 0.2% and 0.3%. The North American prevalence rates, I mean the 'right ones' are 0.3% to 1%. So the UNAIDS concluded that the average prevalence rate in Western and Central Europe for 2002-2004 stays at 0.3%, whereas the average prevalence rate in Northern America for the same period stays at 0.6%. Damned Europeans, who got it all wrong and have half the prevalence rates compared to the right Americans. Go, figure...

The truth is that Western and Central European governments, NGOs, etc. have spent much more resources on educating the general public. Over the years, that work and that investment have richly paid off.

For more, go to:

[url=http://www.unaids.org/wad2004/EPIupdate2004_html_en/epi04_03_en.htm#TopOfPage]

Just my 2 cents...

KD

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As the social scientist say. Statistics do not lie, but statisticians do. There are many variables that would have to be answered to determine the validity of the study.
Some unofficial ones that come to mind:

For how long did the adult men that obtained circumcisions refrain from sex after surgery?
Was there a change in their sex partnering patterns?
Was there an increase in condom availability post surgery ? You get the picture.

The practice of foreskin removal in N. American has political and religious historical origins, not clinical ones.

Although I do not have a preference in my partners foreskin status, the process just seems unnatural. Besides there are many nerve endings in the foreskin which can add to sexual pleasure.

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Thinking that America always gets things right and Europte always gets them wrong is a result of American nationalism and an unfimiliarity with European history resulting in xenophobia. A good example of that is how the Bush administration is refusing to give money for AIDS research to Africa, and other countries, if birth control and abortion are even mentioned. They are also moving to deny Federal economic support to states and local govs that teach sex education, except abstinance. I don't need to cite this because it is general information easily found. In conclusion, if that is "getting it right" then "right" has a new definition.

__________________
Will meet with discreet men w/large erections, true 7"+ & hard. Will sit down on your hard-on while you stroke me, or get on my hands and knees, reach back and massage your balls while your cock's up my asspipe. Like prostate massages and sucking. I always have enema before playing. Very clean only. No kissing or hugging, etc. Just sex.


If your cock is big and hard, I'm truly interested.

Northern California, Coos Bay, Ashland, Medford in Oregon, and other places.

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With such deep insight and so many facts at your fingertips, it is no wonder you guys just keep losing elections! (Thank heavens!)

Why we contribute a dime to that hell hole is beyond me, but be that as it may, ol' W had dumped MORE $$$ into Africa than Bill the rapist. Check on line for NIH funding.

And why should my very hard earned tax dollars go to support Mugabe in Zimbab, who steals white land, then proceeds to wreck his economy, or to So Africa, whose brilliant post aparthied president STILL denies that AIDS is a result of infection with HIV. Hell, it's my money, and my family needs it more than they do. I don't need Chirac's hand in my pocket

Now how much did you say France and Germany have contributed to that garden of eden?

Off with their foreskins!

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I have been puzzled how some good but very limited evidence has been again turned into a political snotfest. Let's look at the evidence here:

1) 70% reduction in transmission in 1.5 years is all fine, but if you extend the timeframe beyond that you're still talking about a lot of people with HIV. I don't see how this obviates condoms in favor of snipping the foreskin.

2) The study finds that uninfected men who insert are less likely to contract the disease; that's nice, but it doesn't give much hope to women who will continue to contract the disease from HIV-infected men. The only possible beneficiaries here are uninfected uncut men who start severely curtailing their partners.

3) It's virtually irrelevant to the epidemic in European and American men because they are getting infected as receptive partners. Anyone who starts barebacking with cut guys thinking they are lowering their risk are foolish.

If you keep your eyes on the science, there's some good stuff here. If you turn it into a political football, everybody loses.

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