an article talking about what works for AIDS prevention, and how we aren't really budgeting our monies in the best way.
One of the things that is working:circumcision
Over 45 observational, biological,
and other studies from the last 20 years
have shown that MC significantly reduces the
risk of heterosexual HIV infection . The population-level effect of widespread
MC is observed in west Africa, where HIV has
been present for many decades, yet prevalence
remains relatively low . All three
recent RCTs of MC in Africa were stopped
early for ethical reasons when initial findings
demonstrated at least 60% reduction in HIV
risk. The population-level impact, taking
into account “herd immunity,” could be
even greater if a large proportion of men
become circumcised . Unlike most
other interventions, MC is a one-time procedure
that confers lifelong protection. Modeling
suggests that MC could avert up to 5.7 million
new HIV infections and 3 million deaths over
the next 20 years in Sub-Saharan Africa, many
of these among women .
A dozen acceptability studies and on-theground
experience in many high-HIV-prevalence
African countries demonstrate that the
majority of uncircumcised men and their
female partners accept and want MC services
(typically for reasons of hygiene and sexual
pleasure). In Swaziland, men almost
rioted because circumcision services were not
available. Studies suggest that up to
80% in high HIV-prevalence countries like
Botswana and Swaziland would seek MC if it
were safe and inexpensive.
Over time MC, which
has been called a “surgical vaccine,” would
probably protect more women, albeit indirectly,
than nearly any other achievable HIV
prevention strategy.