"Breakthrough" Finding That Circumcision Might Reduce Risk of HIV Should Be Confirmed, Pursued, Opinion Piece Says

The recent finding that male circumcision might reduce the risk of men contracting HIV through sexual intercourse with women by up to 70% "is the most important breakthrough in HIV prevention since the efficacy of the male condom was unequivocally demonstrated in laboratory and human studies," Thomas Coates, a professor of medicine at the University of California-Los Angeles, writes in an opinion piece in South Africa's Star (Coates, Star, 10/30). French and South African researchers conducted a randomized, controlled clinical trial that enrolled 3,274 HIV-negative, uncircumcised men ages 18 to 24 living in South Africa. Half of the men were randomly assigned to be circumcised, and the other half served as a control group, remaining uncircumcised. The researchers continually tested the men for HIV infection over 21 months, recording 20 HIV infections among the circumcised men and 49 infections among the uncircumcised men. The study was published in the November issue of PLoS Medicine (Kaiser Daily HIV/AIDS Report, 10/26). Male circumcision has advantages over condoms, which many men do not like to use and which can be expensive and inaccessible when they are needed, Coates writes, adding that, unlike condoms, circumcision is a "one-time irreversible event." However, the procedure "cannot be done by just anyone" and requires the patient to refrain from sexual activity until the wound has healed, he says. Two other ongoing studies to determine the effects of circumcision on the risk of HIV infection "need to be examined to ensure their findings are replicating, and not contradicting," the South African trial, according to Coates. If the findings "hold up," studies need to be launched immediately to determine how best to implement large-scale male circumcision "without negative effects," Coates says (Star, 10/30).

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