Author: Valiere Alcena
Position: Physician/Professor
Institution: Albert Einstein College of Medicine
E-mail: DRALCENA@AOL.COM
Additional Authors: None
Submitted Date: October 16, 2006
Published Date: October 19, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Twenty years ago, I wrote a short article entitled 'AIDS in Third World countries' by way of a letter to the editor of the New York State Journal of Medicine, vol.86, August 1986. In that short article I proposed the hypothesis that the lack of male circumcision in Africa is partly responsible for spreading the AIDS virus in that continent and in other third world countries of the world. I gave the example of balanitis, phimosis, and paraphimosis, represented entry point for the AIDS virus to transmit from female to male during sexual intercourse. I was the first one in the world to propose this idea.

Since that time, many authors have picked up on the idea, have evaluated it using different research models in Africa, and have found it to be indeed true and credible. In the issue of JAMA, August 16 2006, vol.296, No7, Bridget M Kuehn wrote, "Routine circumcision of all men in Africa could prevent 2 million new HIV infections and avert 300,000 deaths over the next ten years." However, interestingly no one has ever mentioned my name in his or her writing as being the first physician to have given birth to this most important idea.

The letter to the N Engl J. Med. 1986 Oct 30; 315(18):1167 by Fink suggesting that the foreskin increased infection by HIV was based on my idea. It was colleague from the Royal College of Physicians in London England who wrote to me alerting me that some one was taking my idea as his own because he had read my article and became aware that Fink wrote his letter to the New England J of Med. I wrote a letter of protest to the editor of the N Engl J. Med. in 1986; I was ignored and received no response. Please note that my article came out in August of 1986 while his came out in October of 1986.

The end result is that over these many years Fink continued to get credit for an idea that was never his. I have copyrighted this idea so as to prevent further discrepancies.

I read with great interest the articles published by McCoombe SG and Short RV. AIDS.2006; 20:1491-1495, Williams BG et al. PLoS Med. 2006; 3:e262, Auvert B et al. PLoS Med. 2005; 2:e298, and Kuehn BM.JAMA Aug 16, 2006-Vol 296, No. 7,755.

I am indeed extremely pleased to know that, this most important contribution, that I made to the literature twenty years ago, is being used today and no doubt will continue to be used to help save lives in the difficult fight against AIDS. I ask that you publish this letter in PLoS Med. so that the well-deserved and long over due credit can be given to me.

Valiere Alcena M.D., F.A.C.P.
Clinical Professor of Medicine
Albert Einstein College of Medicine
Bronx New York

And

Adjunct Professor of Medicine
New York Medical College
Valhalla, New York.
37 Davis Avenue
White Plains N.Y. 10605
Phone: 914-682 8020
Fax: 914-682-8266
Email Dralcena@AOL.COM

References:
1. Alcena, Valiere MD, 'AIDS in third world Countries', New York State Journal of Medicine, Vol. 86, August 1986 (attached)
2. Kuehn, M. Bridget, 'Routine Male Circumcision Could Prevent Millions of HIV Infections in Africa', JAMA, August 16 2006 - Vol. 296, No7
3. Auvert B et al. PLoS Med. 2005; 2:e298
4. Williams BG et al. PLoS Med. 2006; 3:e262
5. McCoombe SG and Short RV, AIDS, 2006; 20:1491-1495