Call to rethink opposition to circumcision

November 4, 2003

Australia needed to rethink its opposition to male circumcision amid growing evidence the practice offered significant health benefits for both men and women, a medical conference was told yesterday.

Recent studies showed circumcision protected men against HIV and lowered the risk of cervical cancer in their female partners, Roger Short of Melbourne University told the Fertility Society of Australia's Annual Scientific Meeting in Perth.

Australia had an "unduly negative" attitude towards male circumcision and needed to do a major rethink, Professor Short said.

"Evidence shows male circumcision reduces by two to eight-fold a man's risk of becoming HIV positive," he said.

He said several studies demonstrating this had been published in the past three years.

The most recent research, based on a study of Indian men beginning in 1993, showed an eightfold reduction of HIV in those who had been circumcised, Professor Short said.

Another study by the London School of Hygiene and Tropical Medicine, which analysed existing literature, found a man's risk of being HIV positive was halved if he was circumcised.

The reason for these findings was simple, Professor Short said.

"The main site by which HIV enters the penis is through the inner aspect of the foreskin, where there's no keratin covering which normally keeps the virus out and there's a very high concentration of cells with receptors for the virus that internalise it," he said.

"If you take the foreskin away you remove most of the receptor sites for HIV, so you drastically reduce risk."

He said other studies had shown that circumcised men were also less likely to be infected with the human papilloma virus.

Professor Short said more studies were needed "before we say the world should be circumcised".

However, he said, circumcision could be considered a cheap and effective protective measure in places such as Africa where HIV is out of control and where there is a lack of access to medicines.

The Royal Australasian College of Physicians advises that there is no medical reason for the routine circumcision of boys.