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Male circumcision overstated as prevention tool against AIDS

e to hi gher AIDS prevalence as previously speculated. In a frequently cited academic paper, Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development and one of the world’s leading advocates for male circumcision, weighted results from individual countries by their population. When this artificial weighting was removed Talbott found that circumcision was no longer statistically significant in explaining the variance in AIDS infection rates across the countries of the World.

Second, to date, there has not been an adequate explanation as to why Africa as a continent is experiencing an AIDS epidemic far in excess of any other region of the world with some African countries’ prevalence rates exceeding 25% of the adult population and tens of millions dying from the disease on the continent. Talbott’s new study suggests that the reason is that Africa as a whole has four times as many prostitutes as the rest of the word and they are more than four times as infected. Some southern Africa countries have as many as 7% of their adult females infected and working as prostitutes while in the developed world typically this percentage of infected prostitutes is less than .1%. If these 7% of infected prostitutes in Africa sleep with five men in a week that means they are subjecting 35% of the country’s male population to the virus weekly. The virus is not easy to transmit heterosexually, b ut over time with multiple exposures, infection is inevitable. These men then act as a conduit to bring the virus home to their villages, their other casual sex partners and to their wives.

The study has important policy implications. Several international AIDS organizations have begun to provide funding for male circumcisions as a deterrent to AIDS. While male circumcision may indeed reduce the risk of transmission by some 50% to 60% in each sexual encounter, reducing single encounter transmission rates alone cannot control the epidemic. The
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Source:Public Library of Science


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