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May 12, 1997

Is there a direct link between non-circumcision and HIV infection? What I mean is I have heard that a person who is not circumcized is more likely to get infected. Why is that? I had protected vaginal intercourse with a prostitute and after hearing this, I'm worried. Can you give me any information on this issue?

Response from Mr. Sowadsky

Hi. Thank you for your question.

There have indeed been studies showing that uncircumcised men were at greater risk of acquiring HIV, as compared to circumsized men. This is most likely due to two reasons.

The first is an increased chance of genital ulcer disease (like chancroid and syphilis) in uncircumcised men. These men may not be aware that they have an open lesion (due to these diseases), if the foreskin covers the lesion. Such an occurance is especially likely with syphilis, since a syphilis lesion (called a chancre) is painless, and may therefore not be noticed. When a person has an open lesion (like those due to chancroid, syphilis, herpes etc.), it's much easier for HIV to enter the bloodstream, and therefore cause infection.

The second possibility is that if an uncircumcised man does not practice good genital hygiene, he is more likely to develop genital infections, which could then lead to a breakdown in the integrity of the skin. When the integrity of the skin is broken down, this too, can allow HIV to enter the bloodstream easier.

Overall, if an uncircumcised man practices good genital hygiene, he is at no greater risk of infection that a circumcised man. But if an uncircumcised man does not practice good genital hygiene, he may be at greater risk of infection than a circumcised man, due to the increased chances of other genital infections.

If a man has protected sex (uses a condom), whether he is circumcised or not, his risks are low, as long as he uses the condom correctly, and it does not break, leak, or fall off.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

Studies re: HIV transmission in Gay men
Risk from Saliva Exposed to Mucous Membranes

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