Studies in developing countries suggest that men who have been circumcised are at lower
risk of HIV infection than men who have not. However, data from United States couples
suggest no correlation between male circumcision and risk of infection.
For example, a study conducted in Kigali, Rwanda, of 837 married men who volunteered
for HIV testing showed that uncircumcised men had a statistically significantly higher
prevalence of HIV infection than circumcised men. This was despite the fact that they had
a relatively low-risk profile; that is, they reported fewer lifetime sexual partners and
prostitute contacts than circumcised men, were more likely to live in rural areas with
lower HIV prevalence rates, and were less likely to report a history of sexually
transmitted disease.1
In the United States, on the other hand, data from the 1992 National Health and Social
Life Survey, a nationally representative sample of 1,511 men and 1,921 women between the
ages of 18 and 59, showed that there was no evidence of a prophylactic role for
circumcision in regard to sexually transmitted diseases (STDs). In fact, circumcised men
were slightly more likely to have had both a bacterial and a viral STD in their lifetime.2
Likewise, it has been observed that circumcision of men had no significant effect on
the incidence of common STDs (genital herpes, genital warts and non-gonococcal urethritis)
in Australia.3 However, men with HIV infection were excluded
from the 300-subject analysis and the study findings may not extend to other settings
where hygiene is poorer.
Male circumcision involves a simple procedure to remove the foreskin covering the glans
of the penis. This differs from female circumcision, an operation that removes part of the
female genitals, often resulting in permanent health damage. This procedure is also called
female genital mutilation or FGM. Damage that may occur includes urinary and menstrual
problems, psychological trauma, painful intercourse, obstructed labor and infertility due
to infection.
-- Kim Best
References
- Seed J, Allen S, Mertens T, et al. Male circumcision,
sexually transmitted disease, and risk of HIV. J Acquir Immune Defic Syndr Hum
Retrovirol 1995;8(1):83-90.
- Laumann EO, Masi CM, Zuckerman EW. Circumcision in the
United States. Prevalence, prophylactic effects, and sexual practice. JAMA
1997;277(13):1052-57.
- Donovan B, Bassett I, Bodsworth NJ. Male circumcision
and common sexually transmissible diseases in a developed nation setting. Genitourin
Med 1994;70(5):317-20.
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