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Please Answer Q. about Circumcision
Mar 8, 2004

Dear Doctor, I wrote to you before regarding the risk of being uncircumcised and I hope you answer me this time. I recently received unprotected oral sex from a sex worker for about 15 sec., after which she gave me a hand job. I called various helplines and was told only to test for HIV to relieve my anxiety as the risk for HIV was virtually nonexistant. However on reading the John Hopkins website it claims that being uncircumsized can increase the chance of infection. I was slightly worried and confused by this, I am Irish and we do not circumcize in general however no Irish or European websites indicate that being uncircumsized is a risk factor for HIV infection. I still do not believe that I need to be tested unless you feel that being uncircumsized increases my risk. Thank you for your help and the wonderful resource you provide.

Response from Dr. Frascino

Hello,

I agree with the advice you've been given your risk of HIV transmission from 15 seconds of insertive oral sex is essentially nonexistent, whether you are circed or uncut.

The circumcision story is still unfolding (so to speak). Preliminary research in Africa a few years ago suggested that cut guys were less likely to be HIV-positive than those who never had a visit from the mohel. It has been suggested that the foreskin, and perhaps glans of the uncut man, may be more prone to infection. Additional studies presented at the XII International AIDS Conference in Durban, South Africa gave additional evidence showing HIV transmission rates were lower in cities where circumcision was more common. In one large cohort study of over 5,000 African men, cut guys had an HIV incidence rate of 1.1 per 100 men per year compared to 1.6 per 100 men per year for uncut guys. It was pointed out that circumcision probably helps reduce sexually transmitted bacterial infections, which might also contribute to HIV transmission.

More recently, there was a study reported last year from India that suggested cut guys had an eight-fold reduction in HIV-1 compared to uncut guys in Pune, India. The study followed 2,300 men, and also found, somewhat surprisingly, that syphilis, gonorrhea, and genital herpes were only slightly higher among uncut guys (statistically not significant). Clinical trials are presently underway in Kenya, Uganda, and South Africa to further examine the possible protective effect of circumcision.

All of this is just for informational purposes, Irish-guy, and not applicable to the 15 second lick on your all-day sucker. OK?

Stay safe and stay well.

Dr. Bob



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