[afro-nets] HIV and circumcision

[Claudio Schuftan <claudio@hcmc.netnam.vn>]

Circumcision Seen as Method to Block HIV Infection
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Reuters (03.26.04)

A recent study shows that circumcised men are less likely to
contract HIV for biological, not behavioral, reasons. Previous
studies have shown that men whose foreskin was removed are six
to eight times less likely to become HIV-positive, but scien-
tists debated about the reason.

Researchers at Johns Hopkins University Medical School-Baltimore
found circumcision has a protective effect against HIV, but not
against other STDs such as syphilis and gonorrhea. "The speci-
ficity of this relation suggests a biological rather than behav-
ioral explanation for the protective effect of male circumcision
against HIV," Dr. Robert Bollinger wrote in the Lancet. Bollin-
ger and co-authors studied men in India, where circumcision is
not common, between 1993-2000. All of the 2,298 study partici-
pants were attending one of three STD clinics and were HIV-
negative at the study's start. Researchers assessed the men's
HIV status and risk behavior regularly. Because circumcision did
not prevent the men from contracting other STDs, Bollinger be-
lieves the study supports the hypothesis that HIV protection de-
rives from the removal of the foreskin, which contains cells
with HIV receptors that scientists suspect are the primary entry
point for HIV into the penis. "Our results suggest that the
foreskin has an important role in the biology of sexual trans-
mission of HIV," Bollinger said.

Bollinger and his team have called for clinical trials, where
circumcision is culturally acceptable, to assess the safety and
effectiveness of the practice as a tool against HIV/AIDS. They
also stressed the need for new compounds to block the virus's
entry into the cell. The study, "Male Circumcision and Risk of
HIV-1 and Other Sexually Transmitted Infections in India," ap-
peared in The Lancet. 2004 Mar 27;363(9414):1039-40.