Circumcision Impacts HIV Transmission

Main Category: Sexual Health / STDs
Also Included In: HIV / AIDS;  Women's Health / Gynecology
Article Date: 05 Oct 2007 - 2:00 PDT

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Three recent clinical trials in sub-Saharan Africa compared the rates of HIV transmission from HIV positive women to circumcised and uncircumcised men through heterosexual activity. These clinical trials provide strong evidence that circumcision reduces by 50-60 percent the risk of virus transmission. The article appears in The Journal of Sexual Medicine.

"Weighed against the severity of HIV infection, the risk-benefit ratio of circumcision appears to be clearly in favor of adopting the procedure on a widespread basis in heavily affected areas," observed Yoram Vardi and Hossein Sadeghi-Nejad, authors of the study, entitled, "Male Circumcision and HIV Infection."

"Nonetheless, important medical and ethical issues remain, not the least among them is whether or not circumcision will be culturally accepted in different societies," note the authors. Circumcision status and practices are typically determined by culture, ethnicity and religion. Whether circumcision can be mandated as a universal preventive measure for all, even for those who are in strictly monogamous relationships and practice safe sex, remains to be seen.

Because there are inadequate data to conclusively assess the exact prevalence of complications of male circumcision in the region, it is not yet clear that the sub-Saharan studies can be applied to other parts of the world. However, at least one study of adverse events surrounding circumcision in Anglophone Africa reported that complications from circumcision were of only minor clinical significance.

"It is of utmost importance to point out that circumcision should not be offered as the only or best method for reducing the risk of HIV transmission," notes Ira Sharlip, President of the International Society for Sexual Medicine (ISSM) and Associate Editor The Journal of Sexual Medicine. "Safe sexual practices, condom usage and public education about HIV disease are equally, if not more important, in all regions of the world."

Irwin Goldstein, Editor-in-Chief of The Journal of Sexual Medicine, observed, "The JSM is proud to provide further research data in this poorly discussed area of sexual medicine. The 'take-home' message is that circumcision is a powerful means of reducing the transmission of the HIV virus in some parts of Africa, and may be a useful method of risk reduction for populations of men in other geographical areas of the world."

Dr. Ira Sharlip is Clinical Professor of Urology at the University of California, San Francisco; and President of the International Society for Sexual Medicine.

Dr. Yoram Vardi is Professor of Urology at the Technion Faculty of Medicine; and head of the Neuro-Urology Unit at the Rambam Health Care Campus, Haifa, Israel.

Dr. Hossein Sadeghi-Nejad is Associate Professor of Surgery in Urology at the University of Medicine and Dentistry of New Jersey, New Jersey Medical School; and the Director of the Center for Male Reproductive Medicine at Hackensack University Medical Center in Hackensack, New Jersey.

Dr. Irwin Goldstein is Director, Sexual Medicine at Alvarado Hospital; Director, San Diego Sexual Medicine, San Diego, California; and Clinical Professor of Surgery, University of California, San Diego.

The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male and female sexual function and dysfunction. As the official journal of the International Society for Sexual Medicine and the International Society for the Study of Women's Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from basic science and clinical research. For more information please visit http://www.blackwell-synergy.com/loi/jsm.

The International Society for Sexual Medicine (ISSM) was founded in 1982 for the purpose of promoting, throughout the international scientific community, research and knowledge in sexual medicine, considered as the subspeciality area of medicine that embraces the study, diagnosis and treatment of the sexual health concerns of men and women. The society has over 3000 members worldwide, with five regional societies that are affiliated with ISSM: the Africa Gulf Society for Sexual Medicine, Asia Pacific Society for Sexual Medicine, European Society for Sexual Medicine, Latin American Society for Sexual Medicine, and Sexual Medicine Society of North America. For more information please visit http://www.issm.info.

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