Study: Adult Circumcision Minimally Effective at Controlling U.S. HIV Transmission

by Kilian Melloy
Thursday Jul 22, 2010

Circumcision would not significantly reduce the spread of HIV in the United States, a new study suggests.

The study, carried out in San Francisco, indicated that circumcision as a tactic for reducing HIV transmission would only be minimally effective, reported an article posted at Scientific Computing.

Although studies in Africa have indicated that circumcision might help reduce the spread of HIV in straight men by removing foreskin cells that are vulnerable to the virus, the new study--which focuses on gay American men--does not arrive at the same conclusion, in part because circumcision is already so prevalent in the U.S. Moreover, only a very small minority of men surveyed for the study said that they would undergo circumcision even if it were proven to reduce their risk of contracting HIV.

"Our study indicates that any potential benefit may likely be too small to justify implementing circumcision programs as an intervention for HIV prevention," said Chongyi Wei, a post-doc with University of Pittsburgh Graduate School of Public Health, which carried out the study, and an author of the paper on the results, which was presented at this week's International AIDS Conference in Vienna.

Previous studies have also indicated that gay men do not benefit from circumcision the way heterosexuals seem to when it comes to HIV transmission. One study by the U.S. Centers of Disease Control and Prevention showed that circumcision seemed to make no difference in HIV transmission rates when it came to anal sex, an AP story from Aug. 26, 2009 reported.

That article also noted that circumcision is more than a medical procedure, freighted with religious, political, and social significance. It is part of some religious traditions, but also excoriated by some political groups. One anti-circumcision group, Intact America, views the procedure as a violation: "It's removing healthy, functioning, sexual and protective tissue from a person who cannot consent. You're mutilating a child," Intact America's executive director, Georgeanne Chapin, told the AP.

Last year, the CDC floated the controversial idea of recommending circumcision as a standard part of neonatal care as part of an effort to combat HIV in the United States. The proposal anticipated that the next generation will include more uncircumcised males than the current generation. Moreover, more Hispanics and African Americans are choosing not to have their make babies circumcised; studies indicate that those populations are harder hit by HIV and AIDS than are Caucasians. Worldwide, only about 30% of all men are circumcised.

Although circumcision is commonplace in some parts of Africa, it is often not conducted until adulthood. A June 30 AP article reported that the traditional circumcision rite, which is not typically performed by physicians or carried out in a sterile environment, can result in potentially fatal infections.

Elsewhere in Africa, circumcision is not so commonplace, partly because there are too few qualified medical professionals to carry out the procedure. However, a new medical device, called a ShangRing, simplifies the procedure and reduces discomfort and pain to a minimum, the AP reported last Feb. 16. Use of the ShangRing reportedly involves a much lower incidence of infection or other complications.

Kilian Melloy serves as EDGE Media Network's Assistant Arts Editor. He also reviews theater for WBUR. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.


  • , 2010-07-22 15:39:14

    Condoms and safe sex, not circumcision, prevent HIV transmission. Men who have been circumcised are more reluctant to use condoms, perhaps because they’ve lost half the nerve endings in their penises and are understandably reluctant to deaden sensation even further. Let’s not give circumcised men any more excuses to avoid condoms!

  • , 2010-07-22 17:23:28

    What would we think of "resarchers" who were trying to legitimize FEMALE circumcision? What would we think of them if they were proposing governments take up "mass female circumcision" campaigns? I think they would be immediately dismissed. One needs to wonder HOW anyone up at the WHO could let this happen. What are they smoking? How much were they paid? We need to put professional medical organizations and medical journals to task; the "study" of trying to connect male circumcision to the "prevention" of whatever disease has been raging on since it was first introduced into western medicine over 100 years ago. I think it’s time we ended the "study" of trying to vilify a perfectly healthy and normal part of the human body. Medical "research" that focuses on seeking to necessitate a destructive procedure is backwards. Imagine "research" that focuses on finding the "benefits" blood-letting and trephination. The time has come we have treated circumcision "research" accordingly.

  • , 2010-07-22 17:32:45

    "...studies in Africa have indicated that circumcision might help reduce the spread of HIV in straight men by removing foreskin cells that are vulnerable to the virus..." - Actually, HOW circumcision is supposed to protect against HIV is never explained. The "studies" were performed on the unproven hypothesis that the Langerhans cells found in the foreskin are the "prime point of entry for HIV." DeWitte found that the Langerhans cells actually DESTROY the HIV virus. The "studies" continue to be purported, but their basis has never been thoroughly established. There’s only been a "correlation" between circumcision and a lowered risk of HIV, that’s it, that’s all. But this correlation fails to appear in other studies, and in other realities, such as in the US, and Israel, where the majority of the men have been circumcised. In the US, 80% of the male population is already circumcised, yet we have the highest HIV transmission rate in the developed world. In Malaysia, 60% of the population is Muslim and circumcised. Yet, 72% of the HIV positive male population is circumcised. Let’s have "studies" explain THAT one.

  • , 2010-07-23 11:28:16

    "partly because there are too few qualified medical professionals to carry out the procedure" ... and partly because men don’t want the most sensitive 10,000+ nerve endings in their penis cut off. Lets go with condoms and safe sex education, not risky surgery which may cause men to "feel protected".

  • , 2010-07-23 15:10:32

    Circumcision is a dangerous distraction in the fight against AIDS. There are six African countries where men are *more* likely to be HIV+ if they’ve been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men. If circumcision really worked against AIDS, this just wouldn’t happen. We now have people calling circumcision a "vaccine" or "invisible condom", and viewing circumcision as an alternative to condoms. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms". The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw. ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.

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