Circumcising Men Reduces Their HIV Risk -- Study

NEW YORK (Reuters Health) - It has long been noted that circumcised men appear to be less likely to become infected with HIV, but whether there's a benefit to actively circumcising adults for this purpose has been an open question.

Now, investigators in France and South Africa report that circumcising men does afford them some protection against HIV.

Dr. Bertran Auvert, from Hopital Ambroise-Pare in Boulogne, France, and colleagues conducted a clinical study to test this prevention strategy. They randomly assigned 1,546 uncircumcised, HIV-negative men ages 18 to 24 years residing in South Africa to be circumcised and 1,582 to a wait "control" group.

Those who underwent circumcision were instructed to abstain from sex for 6 weeks after the procedure.

During 21 months of follow-up, 20 cases of HIV infection occurred in the circumcision group and 49 in the control group, the team reports in the medical journal PLoS Medicine

The researchers suggest several possible ways that circumcision may protect to some extent against HIV infection: "keratinization of the glans when not protected by the foreskin, short drying after sexual contact, reducing the life expectancy of HIV on the penis after sexual contact with an HIV-positive partner, reduction of the total surface of the skin of the penis, and reduction of target cells, which are numerous on the foreskin."

Auvert's group recommends male circumcision for reducing the risk of HIV infection in areas where the disease is rampant. However, they also caution men not to think circumcision gives them total protection. "If perceived as full protection, it could lead to reduction of protection of men who, for example, decrease their condom use or otherwise engage in riskier behavior."

SOURCE: PLoS Medicine, November 2005.