The best way to prevent new HIV infections in the military is male circumcision, said the head of US anti-AIDS efforts to an assembly of top army brass from Africa, Eastern Europe and central Asia.
"We believe male circumcision is a highly significant, lifetime intervention. It is a gift that keeps on giving. It makes a lot of sense to put extraordinary resources into it," US global AIDS coordinator Eric Goosby told the 400 delegates.
AdvertisementThe meeting on AIDS and the military gathered officials from 80 countries, including most of Africa but also countries from Surinam to Georgia and Estonia.
Studies show that circumcision can dramatically reduce HIV infections. One study in South Africa last year found new infections fell by 76 percent after a circumcision programme was launched in a township.
In 2006, trials in Kenya, Uganda and South Africa found foreskin removal more than halved men's risk of HIV infection. Longer-term analysis has found the benefit to be even greater than thought, with a risk reduction of around 60 percent.
The United States is sponsoring programmes in several African countries with a goal of circumcising four million men by 2013.
Results so far are patchy. Although Kenya is close to reaching its target of 80 percent of sexually active men, Uganda has achieved less than five percent of its target.
"We need the military to take up some of these circumcisions," said Caroline Ryan of the US Global AIDS Coordinator's Office.
One issue she said, is that the surgery requires soldiers to recuperate for two to four days, meaning time off from the army.
Another concern, raised by South Africa, was how to marry traditional coming-of-age rites with the need for circumcisions to be carried out under surgical conditions.
"Traditional circumcision is part of the path to manhood. For us it is critical to be given strategies to deal with their concerns," South African Brigadier General Snowy Moremi.
Little data exists on HIV rates among soldiers. Few countries are willing to divulge statistics, fearing they will be perceived as weak.