Beschneidung und HIV: Unterschied zwischen den Versionen

Hrdy (1987) identified numerous African cultural practices other than circumcision or non-circumcision that would contribute to the spread of [[HIV]] infection. Such factors include:

* Female circumcision and [[infibulation]].

* Promiscuity.

* Homosexuality and anal intercourse.

* Practices resulting in exposure to blood.

* Practices involving the use of shared instruments.

* Contact with non-human primates.<ref name="hrdy1987">{{REFjournal

Carael et al. (1988) studied [[HIV]] transmission among heterosexual couples in Central Africa. No difference was found between couples in which the male was circumcised and in which the male was intact.<ref name="carael1988">{{REFjournal

de Vincenzi & Mertens (1994) reviewed the literature regarding the alleged role of the [[foreskin]] in [[HIV]] transmission. They concluded:

The potential public-health benefits of male circumcision have been greatly discussed in the past 50 years, often in a passionate and emotional manner. However, relatively few studies have been carried out and those that have, present conflicting results. The major criticism of most of the studies preformed to date is the lack of attention given to potential confounding factors, which could be related to both circumcision status and risk of sexually transmitted infections, such as sexual behaviour or differences in hygienic practices, or differential use of specific health facilities. As Poland [48] noted, "We must remember that circumcision is not performed randomly."

Therefore, further efforts are still required to quantify the relative risk associated with the lack of male circumcision. Some of this can be achieved by using observational designs which better address the limitations discussed above. Laboratory and primate research might also continue to provide useful information.

As the safety, expected benefits, feasibility and acceptability of mass circumcision are all questionable, neither public-health interventions nor intervention studies appear to be defensible options before there is stronger evidence from observational studies in different settings that show lack of male circumcision may be a genuinely independent risk factor for the transmission of [[HIV]].<ref>{{REFjournal

[[Robert Darby| Darby]] (2002) examined the claims that circumcision is preventive of infection with [[HIV]]. He tabulated the prevalence of circumcision and [[HIV]] infection in various nations. He found no connection between the prevalence of circumcision and [[HIV]] infection. Darby also compared the nineteenth century British attempts to control syphilis (then a dreaded and incurable disease) with male circumcision, which was equally unsuccessful.<ref name="darby2002">{{REFjournal

Thomas et al. (2004) studied the incidence of [[HIV]] in circumcision and intact men in a United States Navy population. A slightly higher incidence of [[HIV]] infection was found in circumcised men (84.9%) as compared with intact men (81.8%). The authors concluded:

Although there may be other medical or cultural reasons for male circumcision, it is not associated with [[HIV]] or STI prevention in this U.S. military population.<ref name="thomas2004">Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA. [http://www.cirp.org/library/disease/HIV/thomas1/ Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. Navy population]. Abstract no. TuPeC4861. Presented at the XV International [[AIDS]] Conference, Bangkok, Thailand, July 11-16, 2004.</ref>