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By Rhonda J Spivak, B.A., L.L.B.

Research spearheaded by Dr. Stephen Moses of the University of Manitoba, which has found that circumcision among men who participate in heterosexual sex greatly reduces the risk of their contracting HIV/AIDS, has received special recognition nationally.

Moses’s research recently has been named one of the Top Canadian achievements in Health Research by the Canadian Institute of Health Research (CIHR) and the Canadian Medical Association Journal (CMAJ), for 2009.

Although scientists had suspected that circumcision was a method of HIV prevention, Moses’s randomized clinical trials have offered conclusive experimental proof to support this claim.

Moses’s project, originally staged in Kenya in 2001 where HIV infections have been widespread, involved over 2,700 men, and was ongoing for 5 years. The findings of the study showed that those circumcised had a 55% less chance of being infected with HIV/AIDS while having heterosexual intercourse, as compared to uncircumcised men. Moses’s clinical trials ended early when it was determined that the results were already so compelling it was unethical to continue the trials without offering the control group the protection of circumcision.  

Moses, who is a physician, a medical microbiology professor, and a public health specialist, collaborated with researchers from the United States and Nairobi to conduct his study. 

The fifty-seven year old Moses, told the Winnipeg Jewish Review that “Since foreskin on the male penis has many receptor cells, circumcision makes it less likely that HIV will be contracted.  HIV has to attach to a receptor cell, and by removing the majority of them, it is much less likely to be able to establish an infection,” he said. 

Moses’s study  in conjunction with two other studies showing  that circumcision reduced the chances of HIV infection were earlier named in 2007 as one of the years’s top medical breakthrough by Time Magazine.

Moses’s findings will have the greatest impact in regions where HIV infection rates are high and rates of male circumcision are low, such as several countries in eastern and southern Africa. 

“In these areas, it could take as few as 19 circumcisions to prevent one person from contracting HIV,” Moses, a native of Toronto, said.
 "Doing more male circumcisions over a period of years in those countries … could result in a reduction in HIV prevalence in the general population by as much as 67 per cent,” he added. 

When asked by the Winnipeg Jewish Review whether his being Jewish played a factor in his taking an interest in studying the connection between  circumcision and HIV, Moses answered, “No, not really.  It was more that I was with a research group from U of M, which I joined while I was in Kenya in 1989.” 
Moses, who moved to Winnipeg in 1989, noted that that group of researchers was already  interested in the topic of male circumcision and HIV infection when he joined.

Digvir Jayas, vice-president of research at U of M, in a statement “Not only has Dr. Moses improved our understanding of this disease, but these findings have already been put into action, and have encouraged many countries in eastern and southern Africa to increase male circumcision services, in their battle against HIV and AIDS.”

Following the results of Moses’s study, male circumcision was  endorsed as a preventive measure by the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS).

In March 2007, these organizations wrote that "The efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt.” They went on to recommend that "Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men."

Moses told the Winnipeg Jewish Review that “already this year in one area in Kenya where circumcision is traditionally not practiced, there have been 50,000 circumcisions. The goal is to do 100,000 circumcisions there a year for the next few years."

When asked about HIV rates and the Jewish community, Moses said that within the Jewish community of North America, those most likely to become infected with HIV are “gay men and intravenous drug users.”

He added that “Among North American Jews, circumcision really doesn’t play a factor [in HIV transmission].”

When asked about the rates of HIV infection in Israel, Moses noted that there, “gay men and intravenous drug users” make up over ¾ of the cases of people who are infected with  HIV.
Moses is now working with the government of India and state governments there to try to mitigate the impact of HIV in India, and prevent the spread of the virus. His work is largely based in the southern state of Karnataka, where the aim is to enhance care for people living with HIV. For the past three years Moses has been travelling back and forth between Bangor, India and Winnipeg.

Versions of this article will be appearing in the Canadian Jewish News and the Vancouver Jewish Independent.


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Rhonda Spivak, Editor

Publisher: Spivak's Jewish Review Ltd.

Opinions expressed in letters to the editor or articles by contributing writers are not necessarily endorsed by Winnipeg Jewish Review.