Aug. 1 (Bloomberg) -- On a typical day, Robert Bailey has 20 to 30 men waiting to be circumcised at his clinic in Kisumu, Kenya. The men are enduring the pain because they don't want to get AIDS.

Since a study by Bailey in 2006 found the operation drops the HIV infection rate in men by 60 percent, the procedure most often performed at birth has become a popular elective surgery among grown men in southern Africa. The push has been fueled by $16 million from the U.S. for clinics, personnel and procedures, funding expected to double this year, and $10.8 million from the Bill & Melinda Gates Foundation.

The operation, in which skin covering the end of the penis is removed, may help lower infections among men of the traditionally uncircumcised Luo tribe by more than two-thirds, to 5 percent, said Bailey in a telephone interview July 14 from the Nyanza Reproductive Health Society Clinic he runs. Widespread use could prevent 5.7 million African infections and 3 million deaths over 20 years, according to the United Nations.

``It sounds stranger than fiction,'' said Kevin DeCock, director of HIV/AIDS at the UN's World Health Organization in Geneva, in an interview last month. ``Surgery to protect against an infectious disease is such an unfamiliar concept.''

Researchers and advocates will discuss how to promote circumcision at the 17th International AIDS Conference in Mexico City next week, where more than 25,000 will gather.

Reducing Risk

AIDS experts are looking for cost-effective, reliable ways to reduce 2.7 million HIV annual infections. HIV vaccines and preventive gels have failed and some have even appeared to raise infection rates, and while condoms are effective, they work only when people have and use them, said Daniel Halperin, a Harvard School of Public Health researcher in Boston.

``Circumcision is a one-time investment, highly effective, and may make much more of an impact than any of these measures,'' he said in a telephone interview.

Bailey, a 61-year-old American, says he wants to overcome traditional ethnic views of circumcision. While the Luo Council of Elders, an advisory body that can sway public opinion on religious and cultural issues, doesn't oppose circumcision, it has said a campaign encouraging the procedure would be inappropriate.

``We need to emphasize that circumcision isn't being promoted for reasons of culture and religion, but just medicine and health,'' he said.

Ridicule in Entebbe

An anthropologist and epidemiologist at the University of Illinois at Chicago, Bailey endured 15 years of ridicule for his pet project, he said. People laughed openly when he gave a talk on the topic in Entebbe, Uganda, in 1998.

``I'd present my data and people would act like `That's a quaint idea, let's move on,''' he says. ``Now that we have the evidence that circumcision works, young men are actively seeking the services.''

The Luo tribe is Kenya's third-largest, with more than 3 million living in western Kenya. After opening his clinic in 1997, Bailey started charging about $5 for the service and now does it free. About 65 percent of young men in the region are unemployed, he said.

Nick Owuor, a 21-year-old Luo from Kisumu, said he had the 5-minute procedure in Bailey's clinic this month to ward off sexually transmitted infections.

``The pain was pretty severe for about an hour,'' Owuor said in a telephone interview. ``But it's worth it.''

Not `Foolproof'

Men should avoid sex during the six weeks the wounds take to heal, Bailey said. Erections can burst stitches, and men get over-the-counter drugs for pain.

The procedure protects men only partially and their female partners not at all. Having sex while the wound heals may increase the risk of HIV, studies have shown, and circumcised men who have condoms should use them.

``People need to understand that this isn't foolproof,'' said Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition in New York. ``But none of these are reasons not to move ahead with scaling up circumcision.''

In 1995, Bailey stumbled on a 10-year-old study suggesting circumcised men were less likely to catch HIV from prostitutes. Areas of Africa where circumcision is uncommon were most affected by the AIDS epidemic, another study showed.

Bailey spent years trying to prove a link.

He says he thinks it can save millions of men in Africa, where about 22 million of the world's 33 million people infected with the AIDS virus live.

`People Are Demanding It'

The pocket between the foreskin and the tip of the penis gives viruses and bacteria a spot to grow, and circumcision eliminates it. The foreskin has also been shown in studies to be rich cells that carry HIV into the body, said Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.

Since Bailey's 2006 study, more African health leaders are trying to raise circumcision rates, said Agnes Binagwaho, executive secretary of Rwanda's National Commission to Fight AIDS, in an interview last month at the UN in New York. Rwanda's population of about 8 million is dominated by the Hutu, Tutsi and Twa tribes.

``In our culture, there was no male circumcision,'' Binagwaho said. ``Now the information is out there and people are demanding it.''

To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net.

Last Updated: August 1, 2008 00:00 EDT