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For the past 15 years, George Karambuka, a Pentecostal pastor and health worker, has fought against HIV/AIDS. Like many Kenyan church leaders, Karambuka believed premarital abstinence and marital fidelity were the key to preventing new infections.

But Karambuka, fellow African pastors, and other religious leaders have recently joined a new, controversial effort to stem the deadly virus: circumcising adult African men, by the tens of millions. About 70 percent of men in Africa are already circumcised. So an estimated 20 million uncircumcised adult men, many of them living in sub-Saharan Africa, could potentially benefit from this surgery.

Though skeptics remain, recent research indicates that circumcision helps prevent the transmission of HIV from women to men. Edward C. Green, the renowned HIV/AIDS researcher and author of Broken Promises: How the AIDS Establishment Has Betrayed the Developing World, is one champion of voluntary medical male circumcision. In an interview, Green said, "From a purely public health standpoint circumcision is beneficial, especially in southern Africa where infection rates are the highest.

"We talk about a perfect storm of factors. There are more men and women having multiple and concurrent sex partners in southern Africa than any other place in the world. You have high rates of uncircumcised men, and a couple other factors that together make the perfect storm for high HIV rates."

Green has encouraged religious leaders to support adult male circumcision. "The evidence is so strong and the church is so powerful. It's essential. If more than half of the male population of a country becomes circumcised, and certainly if it went up to closer to 80 or 90 percent, ...

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