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.
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