There is very good evidence that, circumcision protects men from becoming infected with HIV.

In Todays Medicin edition 27/13 writes editor Nicolai Döllner in the head that “WHO has jumped on the frivolous claims that circumcision reduces HIV risk by 60 percent.”

One of the most cited studies and the first that showed a correlation between the amount of virus in the blood and the risk of transmission of HIV, was published in The New England Journal of Medicine in 2000. The study also showed that none of the men who were circumcised, were infected with HIV (1). There were subsequently carried out three major randomized clinical trials, respectively Orange Farm, South Africa (2), Kisumu, Kenya (3) and Rakai, Uganda (4), where there included, respectively, 3,274, 2,784, and 4.996 younger men not circumcised. These studies showed that circumcision reduced the men’s risk of becoming infected with HIV by 51-60 per cent. A recent meta-analysis of these and other studies showed that circumcision gave an overall reduction in the risk of becoming infected with HIV at 58 per cent. (5). There is made a five-year follow-up study in Rakai, Uganda, which has proved long-lasting protection against HIV infection at 73 per cent. by circumcision (6). There is very good evidence that circumcision protects men from being infected with HIV.
I
t should though be emphasized that circumcision does not reduce transmission from HIV-positive men to women.

Unfortunately, there is no effective vaccine against HIV, but if there was a vaccine that gave 60 per cent. protection, there were probably many who wanted to be vaccinated.

Notice that If you would like to contribute to creating the highest quality in health care, one should stick to facts and not spread frivolous claims, and it is here that it goes wrong with the studies, read more below and in our other articles regarding this subject.

Answer to the news:

Although it may be to much to use the term ‘frivolous allegations’, it is nevertheless debated how valid the African studies are.

First, the members of the study is all African volunteer, thus not representative.

Secondly, there are – as known – no studies outside Africa, showing something similar. On the contrary, the prevalence of HIV in the United States are three times higher than in Western Europe, despite the fact that American men are known to be more circumcised (70-80%) than their European (10%) counterpart.

And thirdly, and this is the worst part, a 60 per cent lower risk, if it were the case, no protection is better or proper protection compared to the condom use. And since the circumcised men – because of the reduced sexual sensitivity after being circumcised – is far less likely to use condoms, circumcision campaigns in Africa, is possibly setting Africa up for a massive HIV disaster. So far new figures from Kenya suggest that HIV prevalence continues to grow.

Finally, you can add that a study from 2012 from Puerto Rico, which is performed without the interference of the researchers who did the studies in Africa show that there is no protective effect of circumcision against HIV.

Nicolai Döllner

By Carsten Schade Larsen MD, associate professor, Department of Infectious Diseases Q, Aarhus University Hospital, Skejby, Denmark.

 

Quinn TC, Wawer M, Sewankambo N et al: Viral load and heterosexual transmission of human immunodeficiency virus type 1. The New England Journal of Medicine 2000; 342: 921-929.
Auvert B, Taljaard, Lagarde E, Sobngwi-Tambekou J, Sitta R and Puren A. Randomized, Controlled Intervention Trial of Male Circumsion for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLoS Medicine 2005; 2: e298.
Bailey RC, Moses S, Parker CB et al: Male circumsion for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial. Lancet 2007; 369: 643-656.
Gray RH, Kigozi G, Serwadda D et al: Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized trial. Lancet 2007; 369; 657-366.
Weiss HA, Halperin D, Bailey RC, Hayes RJ, Schmid G and Hankins CA: Male circumsion for HIV prevention: from evidence to action? AIDS 2008; 22: 567-574.
Gray R, Kigozi G, Kong X et al: The effectiveness of paint circumsion for HIV prevention and effects on risk behaviors in a post-trial follow-up study. AIDS 2012; 26: 609-615.