Male circumcision - a defence against HIV?
Kaiser Daily HIV report
2005-07-06

Various studies have shown that circumcised men are less likely to contract HIV during intercourse than their uncircumcised counterparts.

At the dawn of the 21st century, circumcision may confer more than manhood to a new generation of African boys. It could help to determine whether or not they, their future wives and girlfriends, or their children will die of AIDS, according to an article posted recently on Salon.com. In 1998, American anthropologist Priscilla Reining charted the African cities with the highest HIV infection rates, discovering that the virus was spreading fastest in areas where male circumcision was not regularly performed. Of the 23.3 million people in sub-Saharan Africa believed to be infected with HIV, by far the greatest majority live in countries with low rates of circumcision, such as Botswana, Mozambique, Uganda and Zimbabwe. 

In the past 12 years, at least 45 additional studies have been performed to examine the link between HIV and circumcision, including one by Johns Hopkins University researcher Dr. Thomas Quinn, who for 30 months tracked 415 serodiscordant, rural Ugandan couples. The study results showed that of 137 uncircumcised men with HIV- infected partners, 40 eventually became infected themselves, while among 50 circumcised men with HIV-infected partners, not one contracted the virus. Another study demonstrated that men who were not circumcised ran between 2.3 and 4.5 times the risk of contracting AIDS as circumcised men. 

According to recent research, foreskin is particularly rich in a specialized white blood cell for which HIV has a high affinity - making the foreskin a port of entry for HIV infection. The more you look at AIDS, the more you can see that the circumcision hypothesis has a lot of explanatory power. Look at Nigeria, a country with a high level of sexually transmitted disease, but a low rate of HIV (4%). In Nigeria, they circumcise, Edward Green, an anthropological consultant with USAID, said. 

But anticircumcision advocates are angered by the recent push to promote the procedure in developing countries. The foreskin is not dangerous, Marilyn Milos, a nurse and founder of NOCIRC, a California-based nongovernmental organization. The scare tactics are always consistent with the dreaded disease of the times. There was penile cancer in the '30s; a cervical cancer scare in the '50s; and the sexually transmitted disease scare of the '60s. HIV is no different, she said. And author David Gollaher contends that the symbolic significance that circumcision plays in various African tribes makes it a poor candidate as a public health measure. The social and cultural meanings of [circumcision] are vastly more important than any single scientific argument, he said.
(Source: Kaiser Daily HIV/AIDS Report 5/7/05)