But now, studies conducted in Africa show that circumcision reduced the rate of HIV transmission. In fact, the data are so compelling that researchers decided, for ethical reasons, they must discontinue the study and circumcise any study participant who requested the procedure. Is circumcision HIV prevention an effective way to combat HIV?
What is Circumcision?Circumcision is a surgical procedure during which all or part of the foreskin (the fold of skin covering the head of the penis) is removed by making a surgical cut around the head of the penis. The procedure is often performed prior to a newborn baby being discharged from the hospital, but it can be done on boys and men of any age.
Why is Circumcision Done?As mentioned earlier, there are several reasons why circumcision is performed. They include:
- Health and Hygiene – in some cases there is a problem with the foreskin that makes removal necessary. For example, if the foreskin is excessively narrow at the tip it can increase the risk of local irritation or infection. Bacteria can collect around an uncircumcised foreskin, leading to urinary tract infections. Finally, in boys with kidney abnormalities, circumcision can limit kidney infections that would further impair kidney function.
- Family, Culture, or Religion – some religions view circumcision as an act of religious dedication. For instance, in Judaism, circumcision represents the covenant made by God with Abraham, while Islam views the practice as a Prophet Tradition. There are cultures in which circumcision is a tradition among members of the community.
Earlier Studies Weren't ConclusiveOver the last few years, observational studies hinted that circumcision may offer some protection against HIV transmission. While early studies provided positive data, they did not account for cofactors that may have affected the observational studies. For example, was it circumcision that decreased the risk of HIV transmission, or do members of certain cultures have fewer sex partners or engage in less risky sexual practices, both of which could also decrease HIV transmission? A review by the Cochrane Collaboration in 2003 looked at circumcision observational studies around the world and found that none of them fully considered cofactors such as religious and sexual practices.
In response, controlled trials were done in Africa to support the observational trials that had been done. These trials involved randomly circumcising men and waiting for two years to circumcise others. Recently, the Chicago Sun-Times reported that the results of these studies also showed circumcision did indeed offer some protection against HIV transmission.
How Does Circumcision Help Prevent HIV Transmission?The majority of men who are HIV positive become infected through the penis during sexual contact. Recent studies have proven conclusively that uncircumcised men are at a much greater risk of becoming infected with HIV than men who are circumcised. In some studies, infection rate was 50 percent less in circumcised men. Experts offered several possible reasons why circumcision offers protection against HIV infection:
- the inner surface of the foreskin has a very high concentration of cells containing HIV receptors that act has a portal into the body when exposed to HIV-infected bodily fluids such as semen.
- the foreskin traps HIV in a moist environment near the surface of the penis, allowing the HIV to live longer
- small foreskin tears that may occur during intercourse provide an entryway for the virus.
An Important Fact Men Need to KnowSome experts have expressed concern that this data may lead to a false sense of security; circumcised men may feel condoms and other precautions are unnecessary. While the data have proven circumcision appears to reduce the risk of HIV infection, it does not eliminate the risk. Circumcision should not be viewed as a substitute for safer sex methods. In other words, circumcised or not, condoms are a must with each and every anal, vaginal, or oral sexual contact.
How Will this New Data Be Put to Work in the HIV BattleWhile the impact these studies will have in the Western World may not be monumental, it will make a big difference in those areas ravaged by the HIV epidemic. Throughout Africa, circumcision can be used to lower the risk of HIV infection. Some experts feel that circumcision alone could prevent millions of new infections, in turn saving thousands of lives. In fact, in some parts of Africa, non-physicians are being taught the procedure so it can be offered in more areas while keeping the cost down.
Sources: 2. Hyde, Janet, DeLamater, John.Understanding Human Sexuality. 9th. Ed. 2006. McGraw - Hill Higher Education. 3. Merck Source.Dorland's Illustrated Medical Dictionary. Ed. 2004. WB Saunders / Harcourt Health Sciences. 4. Moss, Aron."Judaism 101." . Chabad.org. 17 Dec 2006. 5. Muller, Siegfried."Male circumcision for prevention of heterosexual acquisition of HIV in men." The Cochrane Collaboration. 09 Apr 2003. 6. Ritter, Jim."Studies find circumcision reduces chance of HIV." Chicago Sun-Times. . Morning Edition. 14 Dec 2006
. 7. Szabo, Robert, Short, Roger."How Does Male Circumcision Protect Against HIV?." BMJ. 320: 1592-1594: 10 Jun 2000. 8. The Baby Center Circumcision: What You Need to Know." 19 Dec 2006.
1. Deam, John."Circumcision." 1 Dec 2005. NetDoctor.co.uk. 19 Dec 2006.
2. Hyde, Janet, DeLamater, John.Understanding Human Sexuality. 9th. Ed. 2006. McGraw - Hill Higher Education.
3. Merck Source.Dorland's Illustrated Medical Dictionary. Ed. 2004. WB Saunders / Harcourt Health Sciences.
4. Moss, Aron."Judaism 101." . Chabad.org. 17 Dec 2006.
5. Muller, Siegfried."Male circumcision for prevention of heterosexual acquisition of HIV in men." The Cochrane Collaboration. 09 Apr 2003.
6. Ritter, Jim."Studies find circumcision reduces chance of HIV." Chicago Sun-Times. . Morning Edition. 14 Dec 2006 .
7. Szabo, Robert, Short, Roger."How Does Male Circumcision Protect Against HIV?." BMJ. 320: 1592-1594: 10 Jun 2000.
8. The Baby Center Circumcision: What You Need to Know." 19 Dec 2006.