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MALE CIRCUMCISION (HIV + MALE CIRCUMCISION)
Aug 11, 2008

Hey Dr. Bob,

Does circumcision of HIV+ guys reduce their risk of transmitting HIV to their female partners?

Thanks...

Hanging Chad

Response from Dr. Frascino

Hello,

So far there has been only a single randomized controlled study looking at the safety and efficacy of male circumcision in HIV-positive men. This study was never completed, because the data safety and monitoring board recommended the trial be halted. The board stated the trial would not be able to produce a statistically significant answer. This is known as a "futility finding." Additional analysis of the partially completed study noted a trend toward increased (rather than the hoped-for decreased) rates of HIV infection in the women partners of circumcised HIV-positive men. This was apparently due to resuming sex before complete wound healing (OUCHAMAGOUCHA!). The conclusions that can be drawn from this study include:

1. HIV-positive men who are circumcised and who resume sex before the wound is completely healed appear to be more likely to transmit HIV to their female partners than uncircumcised HIV-positive men.

2. HIV-positive men took longer to heal after circumcision compared to their HIV-negative counterparts, but the procedure is safe for both HIVers and HIV-negative men.

3. Circumcision reduced rates of genital ulcer disease among both HIV-positive men and HIV-negative men, when compared to their uncircumcised counterparts. Reduced ulceration was also seen in female partners of circumcised men.

It's important to note this is data from a single incomplete study. Consequently, these data cannot be used as the basis for generalized conclusions.

Dr. Bob



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