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Reduced Risk of HIV Among Circumcised Men in India Related to Biology, Not Behavior, Study Says

March 26, 2004

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

Men in India who are circumcised are less likely to be HIV-positive than men who are not circumcised because of biological, not behavioral differences, according to a study published in the March 27 issue of the Lancet, Reuters reports (Reuters, 3/25). Some researchers have suggested that circumcised men are less likely to be HIV-positive because they engage in fewer risk behaviors because of their religious beliefs or other cultural factors. Other researchers have suggested that circumcised men have a reduced risk of other sexually transmitted diseases associated with genital ulceration or mucosal inflammation, which can increase the risk of HIV infection, according to the study (Bollinger et al., Lancet, 3/27). Robert Bollinger and colleagues from the Johns Hopkins University Medical School and the National AIDS Research Institute in Pune, India, examined 2,298 HIV-negative men who attended a STD clinic in India. The researchers assessed most of the men a total of four times for about a year and found that uncircumcised men were more than six times as likely to acquire HIV than circumcised men. However, the researchers did not find a similar protective effect against other STDs, including herpes simplex 2, syphilis or gonorrhea (Lancet release, 3/26). Circumcision only had a protective effect against HIV (Lichtarowicz, BBC News, 3/26). "These epidemiological data lend support to the hypothesis that male circumcision protects against HIV-1 infection primarily due to removal of the foreskin, which contains a high density of HIV-1-specific cellular targets, including CD4+ T-lymphocytes and Langerhans cells," the researchers said (Lancet, 3/27).

Recommendations
The study recommends that clinical trials be conducted where culturally appropriate to determine the safety and effectiveness of male circumcision as a means of reducing the spread of HIV. In addition, the study calls for additional research into methods of blocking the entry of HIV into cells contained in the foreskin (Reuters, 3/25). Three trials examining these issues currently are being conducted in Africa, Toronto's Globe and Mail reports. Researchers hope to verify that circumcision is a "true preventative agent" and that as a surgery it does not have high complication rates. They also hope to determine whether men change their sexual behavior after surgery, including whether there is an increase in risk-related behaviors (Strauss, Globe and Mail, 3/26).

Back to other news for March 26, 2004


Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!



  
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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.
 
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