Circumcision In The Global Control Of AIDS

Main Category: HIV / AIDS
Also Included In: Urology / Nephrology;  Sexual Health / STDs;  Preventive Medicine
Article Date: 19 Sep 2008 - 3:00 PDT

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BERLIN, GERMANY (UroToday.com) - Dr. Hossein Sadeghi-Nejad presented data supporting the beneficial effect of circumcision in protecting against the transmission of the HIV virus. It is estimated that 30 - 34% of adult men worldwide are circumcised. It is thought that because the inner surface of the foreskin is keratinized and moist, it is more susceptible to the HIV virus. Dr Sadghi-Nejad presented data from 3 studies which demonstrated the protective effect of circumcision. He also indicated studies demonstrate that resumption of sexual activity soon after circumcision increased the risk of HIV transmission presumable as a result of non-epithelialized surfaces (Wawer, et al.; 15th Conference on Retroviruses and Opportunistic Infections; Boston, MA Feb 2008).

In spite of this data, the frequency of circumcision in the United States has been decreasing. If circumcision can reduce HIV transmission why wouldn't it be routinely performed? Some reasons are the economic cost, cultural barriers and potential risks and complications. There is also a concept of Risk Compensation. Some studies have demonstrated that there is increased risky behavior in individuals who believe that they have been protected by circumcision.

Dr. Sadeghi-Nejad concluded that "on the basis of the three randomized controlled trials reviewed, the WHO and UNAIDS Consultation in March 2007 recommended circumcision be recognized as an effective preventative method for men who have sex with women (MSW) and that it be offered in addition to (not as a substitute for) other prevention strategies."

Presented by Hossein Sadeghi-Nejad, MD, at the Annual Meeting of the American Urological Association - New York Section - September 6 - 13, 2008 - Berlin, Germany

Reported by UroToday.com Contributing Editor Harris M. Nagler, MD

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