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Male circumcision curbs HIV spread only after wounds heal

  •   Wed, Apr 29 2015 05:07:20 PM

New York, April 29 (IANS): While circumcision reduces the risk of human immunodeficiency virus (HIV) transmission by infected men, there is actually a possible increased risk of infecting female sexual partners while the circumcision wounds heal, warns a new study.

The World Health Organisation (WHO) recommends male circumcision (the surgical removal of foreskin from the penis) which reduces HIV acquisition by 50-60 percent.

"There is a window of a few weeks after circumcision when the risk that an HIV-infected man could transmit the virus to a female partner actually increases," said the study's first author Aaron Tobian, associate professor of pathology at the Johns Hopkins University School of Medicine.

"During that time, more HIV-infected men are shedding the virus, and on average they are shedding greater amounts of it, than before circumcision," he noted.

However, scientists report that a new study of HIV-infected men in Uganda has identified a temporary, but potentially troublesome unintended consequence of the procedure: a possible increased risk of infecting female sexual partners while the circumcision wounds heal.

The study examined 223 HIV-positive Ugandan men who were medically circumcised.

Circumcision reduced the number of HIV-positive men who were shedding the virus more than five-fold over the long term, but it had the opposite effect in the weeks right after the surgery.

Case by case, the likelihood of HIV transmission from a newly-circumcised man to his female partner is less than one-tenth of one percent, the researchers estimated.

But with the WHO seeking to circumcise nearly 29 million men, the study projects that this small increase could add up to 17,000 new infections among female partners of newly circumcised HIV-infected men.

"Although we're counselling men not to have sexual intercourse while their wounds are healing, we know that they are," Tobian said.

The solution, he says, may lie in another one of the study's findings. "If the men are on anti-retroviral drugs, this reduces the risk of their shedding the virus by about 90 percent," he pointed out.

The study was published in the journal PLOS Medicine.

 
  

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  • Ronald Goldman, Ph.D., USA

    Thu, Apr 30 2015

    Many professionals have criticized the studies claiming that circumcision reduces HIV transmission. The investigators did not seek to determine the source of the HIV infections during their studies. They assumed all infections were heterosexually transmitted.

    Many HIV infections in Africa are transmitted by contaminated injections and surgical procedures. The absolute rate of HIV transmission reduction is only 1.3%, not the claimed 60%. Even if the claim were true, based on the studies, about 60 men had to be circumcised to prevent one HIV infection.

    Authorities that cite the studies have other agendas including political and financial. Research shows that circumcision causes physical, sexual, and psychological harm, reducing the sexual pleasure of both partners. This harm is ignored by circumcision advocates. Other methods to prevent HIV transmission (e.g., condoms and sterilizing medical instruments) are much more effective, much cheaper, and much less invasive. Even HIV/circumcision studies advise using condoms. With condoms circumcision adds no benefit to HIV prevention.

    Circumcision will not be voluntary when it is forced on children.

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