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Circumcision Reduces HIV Infections 76% in South Africa, Researchers Find
研究人员发现包皮环切在南非降低HIV感染76%
Bloomberg News | Health care | Africa

Circumcision Reduces HIV Infections 76% in South Africa, Researchers Find

By Simeon Bennett - Jul 20, 2011 10:30 PM GMT+0800

A circumcision program in a South African township reduced the rate of new HIV infections among men who had the procedure by 76 percent, according to the first data to show the effect of circumcision in the nation with the most AIDS cases.

More than 20,000 circumcisions were performed between 2007 and 2010 in Orange Farm, near Johannesburg, according to findings presented at an AIDS conference in Rome today. The percentage of circumcised men from 15 to 49 years of age increased to 49 percent from 16 percent in the period, said Bertran Auvert, a public-health professor at the University of Versailles outside of Paris, who presented the results.

Today’s findings are the first evidence that circumcision is altering the course of the world’s deadliest infectious disease in the nation hit hardest by it. Botswana, Kenya, Swaziland, Tanzania and Zimbabwe are among 14 African countries promoting the procedure in an effort to expand the proportion of circumcised men in Africa to 80 percent from about 66 percent now, said Auvert.

“We are changing the social norms,” he said in an interview in Rome. “It’s the first time in the world that we have a successful intervention in a community to reduce the sexual transmission of HIV between adults.”

ircumcision is the surgical removal of a skin that covers the tip of the penis. Studies have shown the pocket between the foreskin and the tip of the penis gives viruses and bacteria a spot to grow, and circumcision eliminates it. The foreskin has been shown to be rich in cells that carry HIV into the body.

Transmission to Women

The researchers surveyed almost 1,200 men in Orange Farm in 2007 and the same number in 2010. There were 0.42 infections in every 100 circumcised men per year, compared with 2.86 among uncircumcised men, according to the study. After statistical adjustment, the decline worked out to 76 percent, Auvert said.

Among circumcised men in Orange Farm, 6.2 percent have HIV, compared with 20 percent of those whose foreskins are intact, today’s findings show. The researchers said they’re now collecting data to measure the effect of circumcision on the transmission of HIV from men to women.

Each circumcision costs about 750 rand ($108), said Dirk Taljaard, who participated in the study as a researcher with Progressus Research and Development Consultancy in Johannesburg. He’s now a program manager at the Centre for HIV and AIDS Prevention Studies, which operates a circumcision clinic in Orange Farm.

Preventing Infections

For every five circumcisions performed, one HIV infection is prevented in the next 10 years, and every dollar spent on circumcision will save about $15 that would need to be spent later on treating HIV infections, the researchers said.

South Africa’s government aims to have 4.5 million men, or 80 percent of the male population, circumcised within five years, Taljaard said.

“It’s really quite simple as an intervention,” Taljaard said. “It’s not something that you’re trying to get somebody to do every day of his life.”

Circumcised men were no more or less likely to use condoms than uncircumcised men, the study found.

About 500,000 men have been circumcised in Africa since 2008 in programs funded by the U.S. President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Malaria and Tuberculosis, Auvert said.

-- Editors: Phil Serafino, David Risser

To contact the reporter on this story: Simeon Bennett in Rome at sbennett9@bloomberg.net

To contact the editor responsible for this story: Phil Serafino at pserafino@bloomberg.net

Source:
http://www.bloomberg.com/news/print/2011-07-20/circumcision-reduces-hiv-infections-76-in-south-african-study.html


Bloomberg News | Health care | Africa

研究人员发现包皮环切在南非降低HIV感染76%

 

在南非的一个乡镇进行的一项男性包皮环切项目,在已接受包皮环切手术的男性中减少新艾滋病毒感染约76%,根据第一批数据,显示了包皮环切在这个拥有大多数艾滋病病例国家的影响。

 

根据今天在罗马举行的艾滋病大会上发布的研究结果,2007至2010年在约翰内斯堡附近的奥兰治农庄,有超过20,000名男性接受了包皮环切手术。在此期间,15岁至49岁男性的包皮环切比例从16%增加到了49%。巴黎郊外的凡尔赛大学公共健康教授Bertran Auvert在发布这个结果时说。

 

今天的结果是包皮环切改变世界上最致命的传染病在受灾最严重的国家的传染途径的第一个证据。Auvert说,博茨瓦纳、肯尼亚、斯威士兰、坦桑尼亚和津巴布韦是在非洲推进男性包皮环切从现在的66%左右的比例扩大到80%的14个非洲国家之中。

 

“我们正在改变社会规范”,他在罗马接受采访时说, “这在世界上是首次,我们有一个成功的社区干预,以减少艾滋病毒在成年人之间的性传播。”

 

包皮环切是手术切除覆盖阴茎头的皮肤。有研究表明,在包皮和阴茎头之间的口袋给病毒和细菌提供了生长的场所,包皮环切可以消除它。已被证明包皮上拥有丰富的能将艾滋病毒输送进入人体的细胞。

 

向妇女的传播

 

研究人员于2007年在奥兰治农庄调查了近1,200人,在2010年又调查了相同的人数。根据这项研究,每年每100名包皮环切的男性的感染率为0.42,相比,未包皮环切的男性的感染率为2.86。经过统计学调整后,包皮环切导致的感染率下降76%,Auvert说。

 

今天的结果显示,在奥兰治农庄包皮环切的男性中,有6.2%艾滋病毒阳性,而包皮都完好无损的男性有20%为艾滋病毒阳性。研究人员说,他们现在正在收集数据来测定包皮环切对艾滋病毒由男性向女性传播的影响。

 

约翰内斯堡Progressus研究及开发顾问项目的研究人员Dirk Taljaard参与了这项研究,他说,每例包皮环切手术的成本约为750兰特(108美元)。他现在在艾滋病毒和艾滋病预防研究中心担任项目经理,这个中心负责在奥兰治农庄经营包皮环切门诊。

 

预防感染

 

每进行5例包皮环切,在未来10年内就可以预防1例艾滋病毒感染,在包皮环切上花费的每一美元将为艾滋病毒感染后需要用于治疗的费用节省约15美元,研究人员说。

 

Taljaard说,南非政府的目标是450万的男性,或80%的男性人口,在5年内接受包皮环切。

 

“这的确是一种相当简单的干预方法”,Taljaard说。 “这不同于那种需要让别人每天都要做的事。”

 

研究发现,包皮环切的男性并没有比未包皮环切的男性更多或更少使用避孕套。

 

Auvert说,自2008年以来,在非洲大约有50万人已经在这个由美国总统艾滋病紧急救援计划和全球抗击艾滋病疟疾和肺结核基金资助的课程下接受了包皮环切。

 
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