Circumcision to Fight HIV Transmission

Voluntary male circumcisions (VMMC) in high-risk areas reduce HIV acquisition among men by approximately 60%, for only about $6 per treatment. The evidence is strong enough that the treatment has gotten heavy hitters like the CDC, WHO, the Gates Foundation, and the White House (at least the last one …) onboard.

Kenya made it its long-term goal to circumcise 80% of its male population in 2008. In the first couple years, they circumcised almost 400,000 people. Since then, 13 African countries have followed suit, getting 3 million done from 2008 to 2012, and doubling from 2011 to 2012.

Image Credit: UN AIDS Global Report 2013


Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa.
Public Library of Science

 

Kenya’s 4-year VMMC target is to circumcise 860,000 (80%) of uncircumcised males aged 15–49 years by 2013. During 2008–2011, trained clinicians performed 391,383 VMMCs for HIV prevention in Kenya, of which 340,958 (87.1%) were conducted in 260 MOH sites supported by CDC-funded partners, from which the data were obtained
The CDC

 

“Providing men with information about male circumcision and HIV risk can encourage safer sexual behavior among uncircumcised men, and fears that information will lead to riskier behavior among circumcised men may be overstated. The 2008 information campaign led uncircumcised men to adopt safer sexual behavior one year after a short information session, suggesting that VMMC information can have longer-term effects on sexual behavior.”
Jameel Poverty Action Lab

 

While challenges persist in preventing new infections, opportunities to dramatically lower HIV incidence have never been more promising. In recent years, evidence has emerged that antiretroviral therapies can reduce the risk of HIV transmission by as much as 96%, voluntary medical male circumcision by approximately 60% […]
The UN

 

The number of those responding positively is below the ages of 18. Maybe this is due to peer pressure. Once school children are circumcised, they tend to influence others to undergo the procedure. I think there is need to teach everyone a lot about these programmes.
VOA Zimbabwe

Walking Barefoot in Human Poop Held the American South Back for Centuries

Hookworm is a parasite that causes lethargy and lower performance. It is transmitted when human waste (used as a fertilizer on fields) comes into contact with human feet (barefoot field workers) in climates where it can survive (the American South).

Almost half of the American South was infected with this parasite as of 1910, causing stereotypes about lower-class Southern people being lazy and dumb. It was only around then, after centuries of lives held back from their potential, that someone thought to figure out why and discovered hookworm.

Despite some pushback from Southerners who were offended by the accusation that they were all infected by parasites, improving conditions and a big campaign by the Rockefeller Foundation eventually wiped out the parasites, but only in the mid 20th century.

Image Attribution: Marion Post Wolcott [Public domain], via Wikimedia Commons


[…] as recently as the 1950s, hookworms were an intimate and ever-present threat for those living in the South. It was nearly impossible for the rural poor—the majority back then—to avoid hookworms […] Because iron is critical for brain function, hookworm infection could also lead to irreversible cognitive and intellectual defects. A 1926 study of Alabama school children found that the greater the number of worms that students harbored, the lower their IQ. 
PBS

 

Areas with higher levels of hookworm infection prior to the RSC experienced greater increases in school enrollment, attendance, and literacy after the intervention. This result is robust to controlling for a variety of alternative factors […]
The NIH

 

Hookworms live in the small intestine. Hookworm eggs are passed in the feces of an infected person. If the infected person defecates outside (near bushes, in a garden, or field) of if the feces of an infected person are used as fertilizer, eggs are deposited on soil. They can then mature and hatch, releasing larvae (immature worms). The larvae mature into a form that can penetrate the skin of humans. Hookworm infection is mainly acquired by walking barefoot on contaminated soil.
The CDC

 

Southerners initially distrusted RSC efforts. Many were offended by accusations of infection and refused to accept testing and the treatment of Epsom salts and thymol. Others believed that the disease simply did not exist. Regional newspaper editorials also strongly criticized RSC employees and viewed them as a Northern imposition.
The Rockefeller Foundation