Circumcised Men Have Lower Rate of HIV Infection Than Uncircumcised Men, Studies Say
November 16, 2004
Circumcised men have a significantly lower rate of HIV infection than uncircumcised men, according to recent studies conducted in Africa and India that have "given new impetus" to some HIV/AIDS experts who consider the procedure a possible prevention method, the Boston Globe reports (Donnelly, Boston Globe, 11/16). The association between circumcision and a decreased risk of contracting HIV previously has been suggested, as many scientists say that circumcision can provide protection from HIV for heterosexual men because the inner surface of the foreskin -- which is removed during circumcision -- has a large concentration of a type of white blood cell that HIV might use to enter the body (Kaiser Daily HIV/AIDS Report, 9/7). New data from USAID also suggests that the inner surface of the foreskin absorbs HIV nine times as effectively as cervical tissue.
Cultural, Religious Factors
Although researchers have "suspected" an association between circumcision and HIV prevention for about 15 years, many have not recommended the procedure because they believe that religious and cultural practices "might explain the link," according to the Globe. Most HIV/AIDS experts have attributed some countries' lower HIV prevalence rates to large Muslim populations, which normally practice "more conservative sexual behaviors" than Christian populations, the Globe reports. Even if circumcision is shown to decrease the risk of HIV infection, the "question is, what do you do with that information?" O'Reilly asked. "The preference for or against circumcision among different groups is a fairly strongly held conviction," he said, adding, "It has a lot to do with group identity. In tribal circumstances, it might be us versus them -- we circumcise and they don't." However, low HIV prevalence cannot be attributed to cultural and religious practices in all circumstances, according to the Globe. Almost 100% of boys in Madagascar are circumcised by puberty, and approximately 10% of the population is Muslim, 45% is Christian and 45% follow traditional beliefs. The country also has high rates of sexually transmitted diseases but relatively low HIV prevalence at 1.4%. "It's an intriguing question why HIV prevalence varies so dramatically across different parts of Africa as well as parts of Asia," Daniel Halperin, a USAID HIV prevention expert, said, adding, "The main, although not the only, factor explaining this appears to be male circumcision." Although USAID recently has begun funding a training session in Zambia for health care workers to perform voluntary circumcision, Halperin said that the agency will not recommend circumcision as a prevention method. '"It really needs to come from the Africans themselves," he said, adding, "They may be the ones to implement it on their own or ask for donor assistance. Maybe that's when things will change" (Boston Globe, 1/16).
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.