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December 25, 2009
Doctor's world impact
Circumcision is shown to help prevent HIV/AIDS.
RHONDA SPIVAK
Research spearheaded by Dr. Stephen Moses of the University of Manitoba, which has found that circumcision among men who participate in heterosexual sex greatly reduces the risk of contracting HIV/AIDS, has received special recognition nationally.
Moses' research has been named one of the top Canadian achievements in health research by the Canadian Institute of Health Research (CIHR) and the Canadian Medical Association Journal for 2008/2009.
Although scientists had suspected that circumcision was a method of HIV prevention, Moses' randomized clinical trials have offered conclusive experimental proof to support this claim. His project, originally staged in 2001 in Kenya, where HIV infections have been widespread, involved more than 2,700 men and was ongoing for five years. The findings showed that men who had been circumcised had 55 percent less chance of being infected with HIV/AIDS while having heterosexual intercourse, as compared to uncircumcised men. The clinical trials ended early when it was determined that the results were already so compelling that it was unethical to continue the trials without offering the control group the protection of circumcision.
The 57-year-old Moses said in an interview, "Since foreskin on the male penis has many receptor cells, circumcision makes it less likely that HIV will be contracted. HIV has to attach to a receptor cell and, by removing the majority of them, it is much less likely to be able to establish an infection."
Moses' study, in conjunction with two other studies, were earlier named in 2007 as one of the year's top medical breakthrough by Time magazine.
Moses' findings will have the greatest impact in regions where HIV infection rates are high and rates of male circumcision are low, such as several countries in eastern and southern Africa.
"In these areas, it could take as few as 19 circumcisions to prevent one person from contracting HIV," Moses, a Toronto native, said. "Doing more male circumcisions over a period of years in those countries ... could result in a reduction in HIV prevalence in the general population by as much as 67 percent," he added.
Moses, who moved to Winnipeg in 1989, noted that the group of U of M researchers (which he joined when he was in Kenya that year) was already interested in the topic of male circumcision and HIV infection.
Digvir Jayas, vice-president of research at U of M, in a statement: "Not only has Dr. Moses improved our understanding of this disease, but these findings have already been put into action, and have encouraged many countries in eastern and southern Africa to increase male circumcision services, in their battle against HIV and AIDS."
Following the results of Moses' study, male circumcision was endorsed as a preventive measure by the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS).
In March 2007, these organizations wrote, "The efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt." They went on to recommend: "Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men."
Moses told the Independent that, "already this year, in one area in Kenya where circumcision is traditionally not practised, there have been 50,000 circumcisions. The goal is to do 100,000 circumcisions there a year for the next few years."
Moses is now working with the government of India and state governments there to try to mitigate the impact of HIV in India and prevent the spread of the virus. His work is largely based in the southern state of Karnataka, where the aim is to enhance care for people living with HIV. For the past three years, Moses has been travelling back and forth between Bangor, India and Winnipeg.
Rhonda Spivak is a Winnipeg freelance writer.
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