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Circumcision may protect against HIV
NEW YORK, Aug 13 (Reuters Health) -- Circumcision may protect men from sexually transmitted diseases including HIV -- the virus that causes AIDS, according to results of a new study of African truckers. In the study of 746 male trucking company employees from Kenya, men who were not circumcised had a four-fold increased risk of acquiring HIV infection and a 2.5-fold increased risk of developing sexually transmitted genital ulcers during the study period. The study authors point out that their findings back up previous studies that yielded similar results. The new report, however, adds "substantial weight to these findings," according to researchers from the University of Washington in Seattle and their colleagues from Africa and Canada. The findings are published in the August issue of the Journal of Infectious Disease. Exactly how the presence of foreskin or uncircumcised status may increase risk of HIV or genital ulcers is not fully understood, but the investigators speculate that perhaps viruses can survive longer and replicate in an uncircumcised environment. They note that poor hygiene may exacerbate this effect. In the study, researchers followed the men, all of whom were HIV-negative when the study began, for an average of 20 months. Of the original cohort, 13% of men were uncircumcised. During the study period, 43 men acquired HIV, translating into an annual incidence rate of 3.0%. The yearly incidence of genital ulcers was 4.2%, the study showed. Circumcision status had no bearing on risk for genital warts or urethritis (an inflammation of the urethra that can be caused by STDs including gonorrhea and chlamydia). Currently, the American Academy of Pediatrics states that while circumcision does have certain medical benefits which parents should consider, the scientific evidence is not strong enough to recommend it as a routine procedure. About 80% of American men are circumcised, but the procedure is performed less frequently in Canada and Europe. As a result of their findings, the investigators suggest that studies looking at whether attitudes toward circumcision can be changed should be conducted, especially in areas with a high incidence of HIV. Such studies will help determine if implementing circumcision as a means of reducing risk for HIV is, in fact, feasible.
The Journal of Infectious Disease 1999;180:330-336.
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