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Malawi rules out circumcision for AIDS prevention

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By RAPHAEL TENTHANI
The Associated Press
Thursday, September 16, 2010; 8:49 AM

BLANTYRE, Malawi -- Malawi will not officially promote male circumcision as an HIV-prevention strategy, two officials said Wednesday, citing a lack of evidence to support the practice.

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"We have no scientific evidence that circumcision is a sure way of slowing down the spread of AIDS," said Dr. Mary Shaba, a top HIV/AIDS official in Malawi.

Shaba said she had seen studies that showed a comparatively low rate of HIV/AIDS in countries where circumcision is encouraged or mandated. But she said she believed circumcision may not be the only reason for this.

Chairman of the National AIDS Commission and Anglican Bishop Emeritus Bernard Malango said studies in Malawi raised doubts about the effectiveness of circumcision in preventing HIV.

"If you go to areas where circumcision is practiced, you still find a good number of people that are HIV-positive," he said.

The U.N. said last year that studies show universal male circumcision in sub-Saharan Africa could prevent 5.7 million new infections and 3 million deaths over 20 years.

Circumcision is common among Muslims and some tribes in Malawi, but is not universally practiced. But since reports emerged that circumcision may slow the spread of HIV, an increasing number of men have flocked to hospitals for the procedure.

"We have seen an increase in people seeking the service, but it's mostly for hygiene reasons," Malango said.

Strong evidence suggests that voluntary male circumcision can reduce the risk of men becoming HIV-positive by about 60 percent, said Marcus Low, a researcher at Treatment Action Campaign, a Cape Town, South Africa-based advocacy group for people living with HIV.

He said his organization "fully supports the responsible rollout of voluntary medical male circumcision services in South Africa and the region. It is one of the few effective prevention tools we have, and not making use of it presents a major missed opportunity in the struggle against HIV."

The United Nations' AIDS agency recommends that male circumcision be recognized as an additional intervention to reduce the risk of heterosexually acquired HIV infection in men.

The U.N. says some 930,000 Malawians - nearly 12 percent of the population - have HIV.

South African Health Minister Dr. Aaron Motsoaledi said last year that the government would consider how strongly it should endorse circumcision as a means of preventing AIDS. South Africa does not currently have a policy on male circumcision.

South Africa, a country of some 50 million, has an estimated 5.7 million people infected with HIV, the virus that causes AIDS, more than in any other country.

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Associated Press Writer Jenny Gross contributed to this report from Johannesburg.



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