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Wednesday, August 23, 2006 - Page updated at 12:00 AM

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Circumcision foes doubt practice can halt AIDS spread

Seattle Times staff reporter

About the conference


The Ninth International Symposium on Circumcision, Genital Integrity and Human Rights will be held Thursday to Saturday at the University of Washington, 102 Johnson Hall. On-site registration is open to the public ($65/half-day, $110 full day; $250 full program). For more information: www.nocirc.org/.

Just when the genital-integrity advocates thought they were winning the battle against routine male circumcision, along comes research touting it as a way to stop the spread of AIDS — and reports that the world's best-known Bills (Gates and Clinton) are extolling its virtues.

Anti-circumcision activists from around the world, gathering tomorrow at the University of Washington for a three-day conference, were dismayed by news that circumcision had suddenly become the star of the show at last week's 16th International AIDS Conference in Toronto.

"This is an astonishing development," said John Geisheker, a Seattle attorney and executive director of Doctors Opposing Circumcision (DOC), one of the sponsors of the Ninth International Symposium on Circumcision, Genital Integrity & Human Rights. "We had hoped Bill Gates would remain an ally, or at least neutral and open to the science."

Preliminary research indicating male circumcision may significantly reduce the spread of HIV became a focus at the Toronto conference.

There, more than 20,000 doctors, public-health experts and others — including big-time funders like the Bill & Melinda Gates Foundation and big-time crowd-pleasers like former President Clinton — brainstormed about ways to stop the AIDS virus, which has infected 39 million people worldwide.

Bill Gates, addressing the conference, termed the circumcision research "promising" and "exciting."

Clinton said that if the research pans out circumcision could have a "staggering effect" on AIDS.

But even the Bills had some trouble with the idea of mass circumcision in regions hit hardest by AIDS, notably Africa.

Clinton, noting cultural and safety concerns, told those attending the conference: "Frankly, it would be a lot of trouble to get it done."

Gates said relying on circumcision to prevent AIDS has one big problem: It still "depends on a man," he said. "We need to put the power to prevent HIV in the hands of women."

For Geisheker, those problems are just a start. "Village or bush surgery in septic conditions, on millions of Africans against their will or with coerced or bogus consent, or upon children, where even clean water is a luxury — with the payoff 18 years from now? Really? Please!"

Some 150 anti-circumcision activists from more than 20 countries are expected to attend the Seattle conference.

Over time, hammering home the message that there is no "medical necessity" for routine infant circumcision, they have witnessed drastic drops in rates in many countries. Circumcision is the removal of the sheath of skin, called the foreskin, covering the head of the penis.

Now activists face a new challenge on the medical front. Conferees have drafted a petition to the Gates Foundation and other global-health powerhouses, urging them to resist efforts to push circumcision as an "HIV/AIDS panacea" in developing countries.

Such a scheme is "deeply flawed," would sustain troubling, "even cruel" practices and would violate human rights, the petition said.

"We've found over the years that whatever is the biggest scare at the moment, just be patient, and circumcision will be touted as its preventative," said Dr. Leonard Glick, a conference speaker and author of "Marked in Your Flesh," a history of circumcision.

Glick worries that large, well-funded organizations may now push the procedure. "Obviously, we're up against some really formidable opposition."

The research that engendered such excitement at the Toronto AIDS conference followed a study of South African men by Dr. Bertran Auvert, a French academic researcher, suggesting that circumcised men are 60 percent less likely to be infected by HIV.

An analysis of Auvert's results by an international team, published last month, calculated that routine circumcision of all men in Africa could prevent 2 million new infections and 300,000 deaths over 10 years.

Already, anti-circumcision activists are circulating a study disputing those findings.

In their petition, the conferees call circumcision a desperate strategy — a sort of HIV "Russian roulette."

Even if the claimed protective effect of 60 percent is true, it said, people still need to practice safe sex.

Two large studies of circumcision and HIV rates are now under way in Uganda and Kenya, with results expected next year.

Information from Seattle Times news services was used in this report.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com

Copyright © 2006 The Seattle Times Company

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