Study: Adult Circumcision Minimally Effective at Controlling U.S. HIV Transmission

Circumcision would not significantly reduce the spread of HIV in the United States, a new study suggests.

The study, carried out in San Francisco, indicated that circumcision as a tactic for reducing HIV transmission would only be minimally effective, reported an article posted at Scientific Computing.

Although studies in Africa have indicated that circumcision might help reduce the spread of HIV in straight men by removing foreskin cells that are vulnerable to the virus, the new study--which focuses on gay American men--does not arrive at the same conclusion, in part because circumcision is already so prevalent in the U.S. Moreover, only a very small minority of men surveyed for the study said that they would undergo circumcision even if it were proven to reduce their risk of contracting HIV.

"Our study indicates that any potential benefit may likely be too small to justify implementing circumcision programs as an intervention for HIV prevention," said Chongyi Wei, a post-doc with University of Pittsburgh Graduate School of Public Health, which carried out the study, and an author of the paper on the results, which was presented at this week's International AIDS Conference in Vienna.

Previous studies have also indicated that gay men do not benefit from circumcision the way heterosexuals seem to when it comes to HIV transmission. One study by the U.S. Centers of Disease Control and Prevention showed that circumcision seemed to make no difference in HIV transmission rates when it came to anal sex, an AP story from Aug. 26, 2009 reported.

That article also noted that circumcision is more than a medical procedure, freighted with religious, political, and social significance. It is part of some religious traditions, but also excoriated by some political groups. One anti-circumcision group, Intact America, views the procedure as a violation: "It's removing healthy, functioning, sexual and protective tissue from a person who cannot consent. You're mutilating a child," Intact America's executive director, Georgeanne Chapin, told the AP.

Last year, the CDC floated the controversial idea of recommending circumcision as a standard part of neonatal care as part of an effort to combat HIV in the United States. The proposal anticipated that the next generation will include more uncircumcised males than the current generation. Moreover, more Hispanics and African Americans are choosing not to have their make babies circumcised; studies indicate that those populations are harder hit by HIV and AIDS than are Caucasians. Worldwide, only about 30% of all men are circumcised.

Although circumcision is commonplace in some parts of Africa, it is often not conducted until adulthood. A June 30 AP article reported that the traditional circumcision rite, which is not typically performed by physicians or carried out in a sterile environment, can result in potentially fatal infections.

Elsewhere in Africa, circumcision is not so commonplace, partly because there are too few qualified medical professionals to carry out the procedure. However, a new medical device, called a ShangRing, simplifies the procedure and reduces discomfort and pain to a minimum, the AP reported last Feb. 16. Use of the ShangRing reportedly involves a much lower incidence of infection or other complications.