Circumcision to fight HIV

Public health officials are considering promoting routine circumcision (surgical removal of the foreskin of the penis) for all baby boys born in the United States to reduce the spread of HIV, the virus that causes AIDS.

The topic is a delicate one that has already generated controversy, even though a formal draft of the proposed recommendations, due out from the Centers for Disease Control and Prevention by the end of the year, has yet to be released.

Experts are also considering whether the surgery should be offered to adult heterosexual men whose sexual practices put them at high risk of infection. But they acknowledge that a circumcision drive in the United States would be unlikely to have a drastic impact: the procedure does not seem to protect those at greatest risk here, men who have sex with men.

Recently, studies showed that in African countries hit hard by AIDS, men who were circumcised reduced their infection risk by half. But the clinical trials in Africa focused on heterosexual men who are at risk of getting HIV from infected female partners.

For now, the focus of public health officials in this country appears to be on making recommendations for newborns, a prevention strategy that would only pay off many years from now. Critics say it subjects baby boys to medically unnecessary surgery without their consent.

Clinical trials in Kenya, South Africa and Uganda found that heterosexual men who were circumcised were up to 60 percent less likely to become infected with HIV over the course of the trials than those who were not circumcised.

Members of Intact America oppose circumcision on broad philosophical and medical grounds, Ms. Chapin argued that the studies in Africa found only that circumcision reduces HIV infection risk, not that it prevents infection. “Men still need to use condoms,” Ms. Chapin said.

In fact, while the clinical trials in Africa found that circumcision reduced the risk of a man’s acquiring HIV, it was not clear whether it would reduce the risk to women from an infected man, several experts said.

“There’s mixed data on that,” Dr. Kilmarx said. But, he said, “If we have a partially successful intervention for men, it will ultimately lower the prevalence of HIV in the population, and ultimately lower the risk to women.”

Circumcision is believed to protect men from infection with H.I.V. because the mucosal tissue of the foreskin is more susceptible to HIV and can be an entry portal for the virus. Observational studies have found that uncircumcised men have higher rates of other sexually transmitted infections like herpes and syphilis, and a recent study in Baltimore found that heterosexual men were less likely to have become infected with HIV from infected partners if they were circumcised.

source: The New York Times

picture by S H HO urology and laparoscopy center

Capacity Building for Armenia’s health sector

This August, in collaboration with the Yerevan Women’s Resource Center, Lory Hovsepian (Ph.D. candidate in Public Health, Université de Montréal) and Apraham Niziblian (Lobbying and advocacy specialist) will facilitate a three-day conference, supported by the Canadian International Development Agency (CIDA) entitled: Capacity Building for Armenia’s health sector. This project will focus on developing community capacity in Armenia’s health sector, specifically regarding the promotion of sexual/reproductive health and the prevention of HIV/sexually transmitted infections in Armenia. Community organizations working in Armenia on these issues have been invited, with the hopes of knowledge transfer and capacity building, culminating in the creation of a collaborative effort to maximize effective promotion of key sexual health issues within the Armenian public.
In recent years, our experience with various civil society groups working in the Armenian health and social sectors has suggested that although there are many community organizations working either in the realm of sexual health or with vulnerable groups, these organizations often work independently and collaborative efforts on common projects are rare. Moreover, prior fieldwork and needs analysis have indicated need for common spaces where these organizations can come together, share experiences and expertise, learn from each other, all in a collaborative spirit. This situation has led us to believe that there is a need to create such a space and to facilitate concerted action in the area of sexual health. This common space will allow for needs analysis and knowledge transfer, following which it is our hope that the organizations present will pursue the steps, and that the process will culminate into the possible creation of a form of partnership – whether it be in the form of a consortium, coalition, or ‘table de concentration’ (the outcome, of course, will be left to the actors/stakeholders involved, reflecting their needs/interests in such collaborative efforts). Such collaborative efforts can only be beneficial to the attainment of the objectives set forth in the realm of sexual health in Armenia.

Invitation
Given our belief that it is through concerted, intersectoral and multi-level action that change can be brought forth, such a process cannot be successful without the inclusion and implication of all representatives of the health sector, including representatives of academic, health and governmental institutions. In this respect, we invite "PINK" NGO to participate in this conference. It is through the collaborative effort of organizations such as "PINK Armenia" that we can create the needed concerted effort in the Armenian health sector. In an effort to be as inclusive as possible, we would like to request your help in reaching out to other organizations that may be interested in participating in this conference.
The conference will consist of three half-day workshop sessions between August 12 and 15, 2008. The August 15 session will be followed by a networking event. During this event, representatives from various groups and institutions (e.g. Ministry of Health, health sector practitioners and researchers) will be invited to discuss possible venues of collaboration in the short and long term.