» When students become patients: TB disease among medical undergraduates in Cape Town, South Africa » Screening for gestational diabetes mellitus in a South African population: Prevalence, comparison of diagnostic criteria and the role of risk factors » Cytomegalovirus retinitis in Cape Town, South Africa: Clinical management and outcomes » Characteristics and outcomes of gunshot-acquired spinal cord injury in South Africa » Training and support to improve ICD coding quality: A controlled before-and-after impact evaluation I thank the above authors, all acknowledged HIV/AIDS experts, for their robust responses.
South Africa and the SA HIV/AIDS research community have indeed been at the forefront of the global effort to better understand and to contain the HIV/AIDS epidemic, and there is no gainsaying the motive of the VMMA proponents to control and ultimately to eradicate the disease.
The debate is about what the evidence means and what its role should be in the greater HIV prevention strategy.
UCT’s Myers and Myers have cautioned that ‘given the epidemiological uncertainties, and the cultural, ethical and logistical barriers, it seems neither justified nor practicable to roll out male circumcision as a mass anti-HIV/AIDS intervention’.
The reported side effects include Guillian Barré Syndrome (paralysis lasting for years, or permanently — sometimes eventually causing suffocation), lupus, seizures, blood clots, and brain inflammation. ’About eight in every ten women who have been sexually active will have HPV at some stage of their life,’ Harper says.However, this evidence seems to have acquired considerable interpretation creep along the way, with inferences of ‘lifelong protection’, and of benefits of neonatal circumcision that are not self-evident from the RCTs.Clark [my emphasis] neonatal male circumcision is an effective therapy that has minimal risks, is cost efficient and will save human lives.That said, the envisaged mass roll-out of a surgically invasive prophylactic intervention is without historical parallel, and it is only appropriate that the VMMC project is deliberated within the medical profession beyond the immediate circles of the panels and committees driving the initiative.The significance of the evidence from the three African randomised controlled trials (RCTs) is not at issue.