Circumcision appears to offer some protection against HIV, but not other sexually transmitted diseases (STDs), according to a new study. The results support the idea that HIV interacts with the foreskin so unlike those of other STDs.
Previous studies have suggested that circumcised men have a lower risk of contracting HIV. But these studies also found that circumcised men had a lower risk of other STDs as well, suggesting that they can just participate in fewer sexual risk behaviors than uncircumcised men, possibly because of differences between cultures that encourage circumcision and those who do not. To determine if circumcision leads to a specific protection to HIV epidemiologist Robert Bollinger of Johns Hopkins University in Baltimore collaborated with scientists at the National Research Institute on AIDS in Pune, India.
The team followed nearly 2,300 men who visited STD clinics in India and were without HIV. About 10% of men were circumcised. The researchers determined the rates at which men became infected with HIV, gonorrhea or syphilis. Control of risky sexual behavior, the researchers found that men have contracted gonorrhea and just about syphilis the same rate, regardless of the circumcision, but circumcised men were six to seven times less likely to contract HIV, they reported in the Lancet March 27. Bollinger said the specificity of circumcision to reduced HIV infection "provides a clue" as to why it works "Other studies have shown that the foreskin has cells that are magnets for HIV." Removing the foreskin may hinder other STDs but not HIV, he said.
"It is a good study," said epidemiologist Stephen Moses from the University of Manitoba, Winnipeg. But it is still not convinced that circumcision protects against HIV infection. "Circumcision is a procedure surgical, it removes the natural tissue and can cause damage, "he said, so that the evidence must be strong before doctors recommend. He said the debate will be decided by three tests in which men are grouped at random to receive circumcision or not, then followed to determine if the procedure protects against HIV.
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Robert Bollinger
Research Institute of the National AIDS India
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