CIHR-funded research in Kenya

Study shows circumcision reduces incidence of HIV

OTTAWA (December 13, 2006) – A CIHR-funded randomized controlled trial conducted in Kenya has demonstrated that male circumcision is an effective measure for reducing HIV incidence in young men. Dr. Stephen Moses from the University of Manitoba, along with Drs. J.O. Ndinya-Achola from the University of Nairobi in Kenya and Robert C. Bailey from the University of Illinois, presented their research results at the National Institute of Allergy and Infectious Diseases (NIAID), part of the US National Institutes of Health (NIH), Data Safety and Monitoring Board (DSMB) meeting in Washington on December 12.

The DSMB, which oversees the safety, validity and integrity of the trial, decided to stop the study prior to its completion because sufficient evidence had been accumulated to show that the surgical procedure reduces the risk of acquiring HIV. All men who were randomized into the non-intervention arms of the study will now be offered circumcision.

“Evidence has been accumulating that male circumcision may play an important role in explaining the substantial variations in the HIV epidemic in different parts of Africa”, said Dr. Stephen Moses, principal investigator for the University of Manitoba. “But now we have conclusive data demonstrating that male circumcision reduces the risk of HIV acquisition in men.”

The data presented in Washington showed a reduction in risk for HIV infection among circumcised men in the Kenyan trial of 53%. Over the course of the trial, there were 22 new HIV infections that occurred among the circumcised men versus 47 among the uncircumcised men. The annual incidence for HIV infection was approximately 1% among circumcised men versus over 2% among uncircumcised men.

“Effective strategies for HIV/AIDS prevention are urgently needed in countries with high prevalence rates, and such reliable data showing a protective effect will be of great value to health policy makers from around the world”, said Dr. John Frank, Scientific Director of the CIHR Institute of Population and Public Health. “This study is a clear example of Canadian excellence in health research working together with researchers in affected countries.”

The trial began in 2001and brought the expertise of researchers from three countries in a team-based approach. A total of 2,784 men between the age of 18 and 24 from the district of Kisumu in western Kenya were recruited to take part in the trial.

“Despite all efforts, rates of HIV remain high in many African countries. Although circumcision alone does not prevent someone from becoming infected with HIV, it clearly lowers the risk of becoming infected, and the results of this trial show that male circumcision can be considered an important HIV prevention strategy,” added Dr. Moses.

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The study was originally scheduled to end in mid-2007, but the DSMB concluded there was enough evidence to stop the trial prior to its completion. CIHR, under the Federal Initiative to Address HIV/AIDS and CIHR’s Randomized Controlled Trials Program, provided over $2.5 million in funding to this study. The US National Institutes of Health also supported the research.

The Kenya trial was one of two trials of adult male circumcision ended early by the NIAID. The other NIH-funded trial in Rakai, Uganda, showed that HIV acquisition was reduced by 48 percent in circumcised men.

NOTE TO EDITORS : Dr. Stephen Moses, Principal Investigator at the University of Manitoba, Dr. Alan Bernstein, President of CIHR, Dr. John Frank, Scientific Director of the CIHR Institute of Population and Public Health, and Dr. Bhagirath Singh, Scientific Director of the CIHR Institute of Infection and Immunity, are available to comment.

The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 10,000 health researchers and trainees across Canada.

The Federal Initiative to Address HIV/AIDS provides funding for prevention and support programs reaching vulnerable populations, as well as research, surveillance, public awareness and evaluation.
www.phac-aspc.gc.ca/aids-sida/fi-if/index.html

FURTHER INFORMATION:

Marie-France Poirier
CIHR Media Relations
(613) 941-4563
mediarelations@cihr-irsc.gc.ca

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