Lifestyle
Circumcision can't protect MSM from HIV infection
By Ben Wasserman
Oct 8, 2008 - 1:19:23 PM

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Wednesday October 8, 2008 (foodconsumer.org) –Circumcision does not seem to reduce risk of HIV infection in men who have sex with men (MSM), according to a new study published in the Oct. 7 issue of JAMA.

Studies of people in sub-Saharan Africa have already showed that men who had sex with women can reduce their risk of getting HIV from their female sexual partners by 40 to 60 percent.

The review is based on 15 studies conducted in seven countries involving 53,000 men who mostly were Caucasian and about half were circumcised.

Being circumcised was found to reduce the risk of getting HIV by 14 percent in MSM compared to those who were uncircumcised.   But Gregorio A. Millett and colleagues, authors of the review at Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, said the reduction was not statistically non-significant.

However, the authors said higher quality studies did show an positive association between circumcision and reduced odds of HIGH infection in the MSM.

Among the MSM who primarily practiced insertive anal sex, their risk of getting HIV seemed to be lowered by 29 percent, but again the authors said that was not statistically significant.

Studies conducted before the introduction of highly active antiretroviral therapy showed circumcision reduced MSM's risk of getting HIV infection by 53 percent.

The authors said "Pooled analyses of available observational studies of MSM revealed insufficient evidence that male circumcision protects against HIV infection or other STIs."

"However, the comparable protective effect of male circumcision in MSM studies conducted before the era of highly active antiretroviral therapy, as in the recent male circumcision trials of heterosexual African men, supports further investigation of male circumcision for HIV prevention among MSM."

It should be understandable that circumcision reduces risk of HIV transmission.   The inner surface of the foreskin is made of cells that are more vulnerable to HIV invasion than cells on other parts of the penis. Removal of those sensitive cells should reduce the risk.

Studies did not tell the difference between the risk of HIV infection for men who practice insertive sex and the risk for men who practice receptive sex.   The authors said more research is needed to examine the possible difference.

Experts said men should not count on circumcision to reduce their risk of getting HIV infection.  Practicing safe sex is more important.