Uncircumcised men have higher HIV risk - study
LOS ANGELES, Oct 9 2003 (Reuters) - Uncircumcised men are
eight times as likely to become infected with HIV than circumcised men,
according to a study of nearly 2,300 men in India released on Thursday.
A researcher at Baltimore's Johns Hopkins University School of Medicine
suggested that the inner surface of the foreskin does not have the same
protective layer as the outside, and is potentially more vulnerable to
HIV. Male circumcision is common in North America and elsewhere
for religious and cultural reasons and to help prevent urinary tract
infections and penile cancer. The procedure involves removal of the foreskin, which covers the tip of the penis, and is typically done shortly after birth.
In the United States, some two-thirds of male infants are circumcised
annually. Worldwide, the rates vary widely, depending on culture and
religion. In many countries, including India, circumcision is uncommon.
"It's important that we offer measures to help curb the spread of AIDS,
particularly in developing countries, where it continues to grow at an
alarming rate," Dr. Steven Reynolds, post-doctoral fellow in the
division of infectious diseases at Johns Hopkins and a study
investigator said in a statement. The American Academy of
Pediatrics has said it no longer recommends routine circumcision
because -- despite some medical benefit -- there can be complications.
Johns Hopkins also studied the risk of other sexually transmitted
diseases among circumcised and uncircumcised men. Although the
incidence of diseases like syphilis, gonorrhea and genital herpes was
slightly higher among uncircumcised men, the difference was not
statistically significant. The research was part of a larger
study investigating risk factors for HIV infection based on men
attending one of three sexually transmitted disease clinics in Pune,
India between 1993 and 2000. Demographics, sexual risk behaviors
-- including having sex with a prostitute -- and condom use were
similar between both groups, Reynolds said. He added that there
are methods uncircumcised men may be able to use to protect themselves
against HIV, including condoms and, in the future, a potential topical
microbicide product that might be applied to the foreskin before sex.
"Circumcision as a potential prevention strategy requires confirmation
by randomized clinical trials," Reynolds said. There currently are
clinical trials underway in Uganda, Kenya and South Africa. Results of the study were presented at a San Diego meeting of the Infectious Diseases Society of America.