HIV: circumcision, partner risk of incomplete healing

While circumcision would protect against infection with HIV, interim data from a study suggests instead an increased risk of transmission to the partner when the healing is not total risk, according to a statement released by the World Health Organization Health Organization (WHO).

Three studies in Africa have shown that circumcision decreased by about 50% to 60% risk of transmission of HIV from women to men, says WHO. Another test confirmed the reciprocal phenomenon, namely a lower risk of contamination of non-infected with HIV + man circumcised woman.

Because of their interest in terms of public health, these results have prompted the WHO and UNAIDS to develop recommendations to guide this practice. A meeting was held at WHO headquarters in Geneva between various specialists.

It was during this meeting that the U.S. and Ugandan researchers already involved in the matter, have released the interim results of a study conducted in Rakai (Uganda). However, these data suggest an increased risk of infection in female partners of HIV + men who did not wait for the healing to be complete risk.

According to data supplied by the Monitoring Committee (Data Safety Monitoring Board, DSMB) of the trial, three of the 12 men who resumed sexual activity before healing is evidenced have transmitted HIV to their partners against six of the 55 who have waited long enough.

The time to complete healing is about four weeks, according to WHO. The researchers had more "strongly advised" to patients not resume sexual activity before the certificate of a caregiver.

Although these results are not significant from a statistical point of view, the DSMB preferred closing inclusions, whereas the study would fail to demonstrate a short-term effect of circumcision, which was one of objectives of the study. The 997 men already enlisted meanwhile continue to be followed.

"While male circumcision has extraordinary potential for the prevention of infection, these new findings remind us that we must proceed with caution in order to develop strategies to extend [the practice] in Africa", considered the head of the department HIV / AIDS WHO, Kevin De Cock, echoed by the press.

Contacted by APM, a spokesman for the WHO indicated that these data were taken into account in the drafting of a document published on the WHO after the meeting.