A study by epidemiologist Robert Bailey, PhD, MPH, along with two other studies conducted in African countries, has shown that medical circumcision dramatically reduces a man’s risk of acquiring HIV from an infected woman. In fact, in December
2006, the National Institutes of Health halted Dr. Bailey’s clinical trial of male circumcision after an interim review of the data showed that the procedure dramatically reduced transmission of HIV and recommended that all men enrolled in the study who remained uncircumcised be offered circumcision due to the clearly protective effect. Details of those studies were published in The Lancet.
In the two randomized trials, which included 7,780 HIV-negative men in Rakai, Uganda, and Kisumu, Kenya, researchers found that medically circumcised men were at approximately 60 percent less likely than uncircumcised men to acquire HIV during sex with women. The editors of The Lancet called the discovery “a new era for HIV prevention.” This discovery, that circumcision can prevent HIV transmission, was ranked as the #1 medical breakthrough for 2007 by TIME magazine.
Since 1995, Dr. Bailey and his colleagues have conducted research on male circumcision and HIV infection in eastern and southern Africa. His most recent clinical trial showed that medical circumcision reduces a man’s risk of acquiring HIV during heterosexual intercourse by 59 percent. The results of this and two additional trials, Bailey said, “led to a major policy shift to provide circumcision services widely throughout eastern and southern African.” Since 2008, with assistance from Dr. Bailey and his collaborators, Kenya has achieved 440,000 circumcisions, which will likely prvent nearly 100,000 new HIV infections over the next ten years.
Dr. Bailey's discovery that circumcision can dramatically reduce transmission of HIV was ranked as the #1 medical breakthrough for 2007 by TIME magazine.
Recently, Dr. Bailey completed a study on men who have sex with men (MSM) in Kisumu. In Kenya, males who are discovered to be homosexual can face up to 14 years in jail and are therefore a highly stigmatized and vulnerable population. This can make it difficult for these men to be identified, offered HIV testing and counseling and treated for sexually transmitted diseases. Over 415 men enrolled in the study, which found very high rates of HIV in the MSM population and learned that more than half of MSM sell sex for money or goods. Two thirds of them also have high risk sex with women. Because of the stigma against homosexuality in the community, 60 percent of these men have expereinced violence and most are rejected by their families and neighbors. In part due to the findings of Dr. Bailey’s study, a center has been established to support MSM in Kisumu, and these men now have access to affirming clinical and counseling services, and HIV positive MSM are getting care and appropriate drug treatment. The male circumcision program has now trained over 1,900 clinicians and has built capacity all over Kenya. They have also conducted a pilot on infant circumcision, but this is still not popular and requires more education. Right now, they are still focusing on men 18-30 years old who are at highest risk, because circumcising this age group will have the most immediate impact of the HIV epidemic.
Dr. Bailey is part of the leadership for the Chicago Developmental Center for AIDS Research. In its fourth year, the Chicago D-CFAR is a consortium of the University of Illinois at Chicago, Rush University Medical Center, and Cook County Health and Hospitals System. The three work together to develop new interdisciplinary collaborations that will further AIDS research and ensure that research findings are accessible to affected people regionally and nationally. Dr. Bailey serves as Codirector of Chicago D-CFAR.