Study raises questions about circumcision in AIDS

WASHINGTON, Mar 7 (Reuters) Circumcision helps protect men from getting the AIDS virus but may make an already-infected man more likely to infect a woman if he does not let his penis heal completely, researchers said.

Researchers working in Uganda released early findings from a study of 997 HIV-infected men. It indicated that women who had sex with a man who did not wait to heal fully after circumcision seemed to have a higher risk of infection than through sex with an uncircumcised infected man.

Intercourse might cause tiny tears in the surgical wound, which in turn could put HIV-infected blood into the woman's vagina, the researchers speculated.

They found no apparent increased risk for female sex partners of infected men who waited until a doctor certified that the wound had completely healed.

''We thoroughly agree that this should not be used to discredit the incredible value of male circumcision for the prevention of HIV acquisition in men,'' Dr Maria Wawer of Johns Hopkins University in Baltimore, who leads the study, told reporters yesterday.

Women make up the majority of HIV-infected people in Africa, where HIV largely is spread through heterosexual sex.

The wounds from circumcision take about four weeks to heal. The findings emphasized the importance for men to abstain from sex until fully healed, said Dr Ron Gray of Johns Hopkins.

The study will be completed in two years. The preliminary findings were issued in Switzerland as UN health officials consider circumcision policy recommendations.

Public health leaders think circumcision may be a powerful way to reduce HIV infection in Africa, the continent hardest hit by AIDS.

Three previous African studies showed circumcised men are 50 to 60 percent less likely to become infected with the human immunodeficiency virus.

Experts say the lower risk may be because cells on the inside of the foreskin, the part of the penis cut off in circumcision, are particularly susceptible to HIV infection. HIV also may survive better in the warm, damp environment beneath foreskin.

'PARADOXICAL SITUATION' ''The data shows a paradoxical situation,'' Dr Kevin De Cock, director of the World Health Organization's Department of HIV/AIDS, said in a conference call with reporters.

De Cock said the new findings were preliminary, incomplete and statistically insignificant because of how few people were involved.

He said when the study is completed, it might even show circumcision can protect a man's female sex partner.

The team at Johns Hopkins, the Rakai Health Sciences Program and Makerere University in Uganda said they viewed circumcision as important in AIDS prevention efforts.

The researchers tracked infection rates of 113 previously uninfected female partners of infected men. Of 12 women who had sex with infected men before the circumcision wound was fully healed, three became infected within six months.

Of 55 female partners of infected circumcised men who waited to resume sex until the wound healed, six became infected. That was similar to the infection rate of female partners of uncircumcised infected men -- four of 46.

Of the 39.5 million people worldwide infected with HIV, 24.7 million are in sub-Saharan Africa. About 25 million people have died from AIDS since it was first identified a quarter century ago.

Reuters SY DB1001