Expert says circumcision makes sex safer

By Carol Nader
February 16, 2005
Roger Short holds a PlastiBell, a circumcision device. Professor Short says men who are circumcised are seven times less likely to contract HIV.
Photo: Rebecca Hallas

Every Australian parent should consider circumcising their son to reduce his chances of contracting HIV, the virus that causes the deadly AIDS, according to an expert on the disease.

Roger Short, from the Royal Women's Hospital obstetrics department and Melbourne University, told a medical conference yesterday that men who are circumcised are seven times less likely to contract HIV. And women who have a circumcised partner are at half the risk of developing cervical cancer.

Professor Short said the human papilloma virus (HPV), which caused cancer of the penis and cervical cancer, resided in the foreskin.

Circumcised men were much less likely to harbour HPV: they were protected because HIV entered the penis through the inner part of the foreskin, and circumcised men had no foreskin.

But Professor Short said being circumcised did not mean men could forgo using a condom. Previously, some have argued that encouraging circumcision as a means of protection against sexually transmitted infections undermines condom use.

"It would be wrong to say you're absolutely safe," Professor Short said. "Instead of just relying on a belt, it's giving you a belt and braces."

Most hospitals contacted by The Age yesterday said they did not do the procedure. Professor Short said until five years ago, he also believed circumcision was outdated and could not see the medical benefits in it. He said every parent should be enlightened so they could make up their own mind.

But he said there was no point in doing the procedure on grown men who were already sexually active - "you're shutting the stable door after the horse has bolted".

The Royal Australasian College of Physicians last year issued a statement on circumcision, stating that "on current evidence routine neonatal circumcision cannot be supported as a public health measure".

The college acknowledges that circumcision may be of benefit with urinary tract infections, HIV and cancer of the penis. But it says urinary tract infections affect up to 2 per cent of boys and penile cancer affects about 1 per 100,000 people in developed countries.

Circumcision has a complication rate of up to 5 per cent. Possible consequences include infection, bleeding and damage to the penis. Serious complications such as bleeding, septicaemia and meningitis may occasionally cause death.

The college's president of pediatrics and child health, Professor Don Roberton, said: "When HIV rates are low in our population, the risk that might come from universal circumcision is one that I think most pediatricians would be significantly concerned about."

Less than 20 per cent of infants are routinely circumcised, but it remains an important ritual in some religious groups, particularly Jewish and Muslim communities.

Rabbi Philip Heilbrunn said the importance of circumcision to the Jewish community dated back to biblical days. Abraham was circumcised at the age of 99, and in later generations it was made a basis for God freeing the Israelites from slavery in Egypt. Jewish baby boys are usually circumcised when they are eight days old.

"A lot of research has indicated that being circumcised is a pretty healthy way to be, and it avoids various infections and conditions that can arise because of what can happen under the foreskin during natural life," Rabbi Heilbrunn said.