USAID

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USAID

In a February 2009 report produced by USAID, a U.S. government agency, researchers found that circumcised men were more likely to have HIV in 10 of 18 (African) countries with data available.[1] The report found condom use, not circumcision, to be correlated with HIV status. Despite this report, USAID is listed as a contributing partner and a sponsor for the "Clearinghouse on Male Circumcision for HIV Prevention."[2][3]

Circumcision Scale-Up

USAID has studied the "scale-up" of circumcision in Africa and shows support for circumcision in numerous places on its website.[4][5][6][7]

Accelerated Saturation Initiative

In November 2010, USAID issued a "technical brief" on male circumcision as HIV prevention. In the report, USAID states that it is supporting Swaziland's "Accelerated Saturation Initiative" for circumcision by providing "implementation support together with the [U.S.] Department of Defense, the Peace Corps, and the U.S. Centers for Disease Control and Prevention (CDC)." The report goes on to say that USAID, along with UNAIDS, is providing technical and financial assistance in the studying circumcision programs in 14 African countries.[8]

Voluntary Male Medical Circumcision

USAID's support of what they call the "Voluntary Medical Male Circumcision program: VMMC" also focused on Kenya.[9] USAID funded a VMMC based circumcision campaign propaganda video to air on television in South Africa.[10]

C-Change

A USAID-funded organization called "C-Change" in Kenya is supporting "Male Circumcision Communication Toolkits" with the stated goal of "Creating demand for VMMC (circumcision)" and "facilitating a scale-up of materials" and capacity to perform more circumcisions from the government of Kenya. One of the ways C-Change is creating demand is by spreading information stating that "VMMC" prevents STI's.[11][12]

One issue of C-Change's publication included a study measuring media coverage of circumcision as HIV prevention and strategies for keeping media reports positive.[13]

PEPFAR

In September 2010, USAID, funded by the U.S. President's Emergency Plan for AIDS Relief program, along with a partner, also donated 5,000 male circumcision kits to Zimbabwe.[14]

Medical evidence shows circumcision is ineffective at preventing HIV infection

Levels and Spread of HIV Seroprevalence and Associated Factors: Evidence from National Household Surveys
There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.[15]

Circumcision does not prevent HIV infection

Population-based studies

September 2021 saw the publication of two huge population studies on the relationship of circumcision and HIV infection:

  1. Mayan et al. (2021) carried out a massive empirical study of the male population of the province of Ontario, Canada (569,950 males), of whom 203,588 (35.7%) were circumcised between 1991 and 2017. The study concluded that circumcision status is not related to risk of HIV infection.[16]
  2. Morten Frisch & Jacob Simonsen (2021) carried out a large scale empirical population study in Denmark of 855,654 males regarding the alleged value of male circumcision in preventing HIV and other sexually transmitted infections in men. They found that circumcised men have a higher rate of STI and HIV infection overall than intact men.[17]

No association between lack of circumcision and risk of HIV infection was found by either study. There now is credible evidence that the massive, expensive African circumcision programs have not been effective in preventing HIV infection.

Two African surveys

The previously reported studies were from developed Western nations. Now we have information from Sub_Saharan Africa.

French scientist Michel Garenne, Ph.D. has published two reports in 2022 comparing the incidence of HIV infection in circumcised and intact men.

In his first report, Garenne presented the findings from a study in Lesotho, the enclave in South Africa. He reported:

In couple studies, the effect of circumcision and VMMC on HIV was not significant, with similar transmission from female to male and male to female. The study questions the amount of effort and money spent on VMMC in Lesotho.[18]

In his second report, Garenne (2022) presented information from six Sub-Saharan African nations (Eswatini, Lesotho, Malawi, Namibia, Zambia, Zimbabwe). He reported:

"Results matched earlier observations made in South Africa that circumcised and intact men had similar levels of HIV infection."[19]

Criticism

The VMMC Experience Project has published a massive, illustrated 153-page report on VMMC in Africa for the United Nations.[20]

External links

References

  1. REFnews USAID / Mishra Vinod / Amy Medley / Rathavuth Hong / Yuan Gu / Bryant Robey (2009)."DHS Comparative Reports 22", Macro International, Inc.. Retrieved 24 March 2011.
    Quote: Levels and spread of HIV seroprevalence and associated factors: Evidence from national household surveys
  2. REFweb Male Circumcision Clearinghouse: Partners and Contributors, Clearinghouse for Male Circumcision on HIV Prevention. Retrieved 24 March 2011.
  3. REFnews (July 2010)."National AIDS and STI Control Programme", Government of Kenya. Retrieved 24 March 2011.
    Quote: Progress Report on Kenya's Voluntary Medical Male Circumcision Programme
  4. REFweb Research: Male Circumcision and HIV Prevention, USAID. Retrieved 24 March 2011.
  5. REFweb Male Circumcision, USAID. Retrieved 24 March 2011.
  6. REFnews Clark, S. / I. Fua (May 2003)."Program and Policy Implications for HIV Prevention and Reproductive Health", USAID/AIDSMark. Retrieved 24 March 2011.
    Quote: Male Circumcision: Current Epidemiological and Field Evidence
  7. REFweb Fighting HIV with Circumcision, USAID. Retrieved 24 March 2011.
  8. REFnews (November 2010)."Technical Issue Brief", USAID. Retrieved 25 March 2011.
    Quote: Medical Male Circumcision and HIV Prevention
  9. REFweb Kenya / HIV/AIDS, USAID. Retrieved 25 March 2011.
    Quote: USAID/Kenya’s HIV/AIDS program is supported by the President’s Emergency Plan for AIDS Relief (PEPFAR). This five-year, $48 billion program, is led by the U.S. Global AIDS Coordinator, in conjunction with USAID, the Department of Health and Human Services (including the Centers for Disease Control and Prevention), the Department of Defense (DOD), the U.S. Peace Corps, and the Department of State.
  10. REFweb (December 2010). VMMC Soccer Videos from Kenya, VMMC.m4v. Retrieved 28 April 2011. Short video vignettes with a soccer theme that was field tested in communal video houses in Nyanza, Kenya during the 2010 World Cup Soccer broadcasts.
  11. REFweb C-Change Develops Male Circumcision Toolkit for Kenya, C-Change. Retrieved 25 March 2011.
    Quote: ...[Male Circumcision] reduces risk for men...
  12. REFweb (1 October 2010). Male Circumcision, C-Change. Retrieved 25 March 2011.
    Quote: VMMC Communication Toolkit in Kenya
  13. REFweb Wang Al a; Duke W b; Schmid GP b (December 2009). Bulletin of the World Health Organization: C-Channel Issue 15, C-Change. Retrieved 25 March 2011.
    Quote: Print media reporting of male circumcision for preventing HIV infection in sub-Saharan Africa
  14. REFweb Own Correspondent (12 September 2010). US donates 5 000 male circumcision medical kits, The Standard. Retrieved 25 March 2011.
  15. Levels and Spread of HIV Seroprevalence and Associated Factors: Evidence from National Household Surveys (February 2009)
  16. REFjournal Mayan M, Hamilton RJ, Juurlink DN, Austin PC, Jarvi KA. Circumcision and Risk of HIV Among Males From Ontario, Canada. J Urol. 23 September 2021; PMID. DOI. Retrieved 21 August 2022.
    Quote: We found that circumcision was not independently associated with the risk of acquiring HIV among men from Ontario, Canada.
  17. REFjournal Frisch M, Simonsen J. Non-therapeutic male circumcision in infancy or childhood and risk of human immunodeficiency virus and other sexually transmitted infections: national cohort study in Denmark. Eur J Epidemiol. 26 September 2021; 37: 251–9. PMID. DOI. Retrieved 16 January 2022.
  18. REFjournal Garenne M. Changing relationships between HIV prevalence and circumcision in Lesotho. J Biosoc Sci. 4 April 2022; online ahead of print: 1-16. PMID. DOI. Retrieved 7 November 2022.
  19. REFjournal Garenne M. Age-incidence and prevalence of HIV among intact and circumcised men: an analysis of PHIA surveys in Southern Africa. J Biosoc Sci. 26 October 2022; : 1-13. PMID. DOI. Retrieved 7 November 2022.
  20. REFdocument Fish, Max: Circumcision Campaigns: African experience and human rights: The U.N. Report PDF, VMMC Experience Project. (7 May 2019). Retrieved 15 May 2021.