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Study advises voluntary circumcision for older men to stop ‘vicious HIV cycle’

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A greater proportion of uncircumcised men test HIV-positive with increasing age, according to a study presented at the eighth South African Aids Conference in Durban yesterday.

It was hoped that the information gathered in the study would be used to further attract older men to undergo HIV testing by offering voluntary medical male circumcision (VMMC) to interrupt the “vicious HIV cycle”.

The study was conducted by the Perinatal HIV Research Unit (PHRU) at Chris Hani Baragwanath Hospital in Johannesburg, using routinely collected data at five VMMC clinics in three provinces between 2010 and 2015.

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Picture: Phando Jikelo

The study found that at the age of 22, there was a rise in HIV-positive results and, from age 40, there was a rapid rise, however, neither of these groups was particularly big.

Although further investigation was needed, the reasons for circumcision by age was thought to be related to a transition to manhood in the young, while older men sought out VMMC because they feared they might have been exposed to HIV.

VMMC is known to reduce the risk of HIV. In 2007, the World Health Organisation recommended the upscaling of the practice as part of efforts in HIV prevention.

In South Africa, 2.4 million men underwent VMMC between 2012 and 2016, with targets for 2017 to 2022 sitting at 2.5 million.

According to the study, the focus was on getting men to be tested before circumcision and before their debut sexual practice.

VMMC would not be denied to anyone applying for the procedure, even if they were found to be HIV-positive, according to the study.

Circumcision was not seen as an emergency procedure. The onus was thus to get the men who tested HIV-positive to the appropriate facilities and on treatment to increase their CD4 count. Following this, they would be admitted for VMMC.

According to Aids charity Avert, it is recommended that VMMC be included as part of a comprehensive HIV prevention strategy comprising HIV testing and counselling, treatment for sexually transmitted infections, the promotion of safer sex practices and the distribution of condoms as well as their correct use.

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