UIC School of Public Health
2005 Sponsored Activities Annual Report

FACULTY PROFILE

Robert Bailey, PhD, Professor
Epidemiology and Biostatistics

The UNIM Project is a collaboration between the Universities of Nairobi, Illinois and Manitoba to investigate the protective effect of male circumcision against HIV acquisition in 18 to 24 year-old men in Kisumu, Kenya. Over 40 studies have shown that men who are not circumcised are at between twice and eight times greater risk of HIV infection. However, the international health community has not been willing to promote male circumcision as an HIV prevention strategy since there have been no clinical trials of this intervention. Recently, a clinical trial in South Africa was stopped because the protective effect of circumcision was found to be so large – between 60 and 76% of new infections were prevented in circumcised compared to uncircumcised men – that it would be unethical to continue the study without offering circumcision to the control group.

Working with a team of approximately 50 devoted Kenyans, we have established a male reproductive health clinic with a well-equipped laboratory and surgical theater in Kisumu, Kenya, an area where 18% of men and 27% of women are living with HIV. We have recruited 2800 young men into a randomized controlled trial of circumcision. We have provided voluntary counseling and testing (VCT) for HIV to over 6700 young men. Men who were found to be sexually active and HIV negative were asked to enroll in the study and, if they agreed, they were randomly assigned to be circumcised right away, or to wait until they complete 24 months of participation in the study. Men enrolled in the trial receive diagnosis and treatment for sexually transmitted infections (STI), intensive counseling to lower risk of HIV infection, and free medical care for two years. At the end of the study, in September 2007, we will be able to show definitively whether heterosexual men who are circumcised have lower incidence of HIV infection. We will also be able to see if circumcision has a protective effect against other STI, including chlamydia, gonorrhea, genital herpes and human papilloma virus (HPV), which is associated with penile cancer in men and cervical cancer in their sex partners.

Working with the Kisumu community, we have also established a support group for people living with HIV/AIDS (PLWHA), called the Youth Empowered to Succeed (YES) Club. YES provides treatment to PLWHA for opportunistic infections, individual and group counseling, and training in income-generating activities, and its members are leading the effort to lower stigma and raise awareness for the tens of thousands of men, women and children infected and affected by HIV in western Kenya.

This project is funded by the National Institute for Allergy and Infectious Diseases and the National Cancer Institute at the NIH and by the Canadian Institute of Health Research.

Copyright 2006 Contact jckong@uic.edu for questions