Male Circumcision And HIV-Risk Reduction

Are you “cut” or “uncut?” Based on some research, it might have an impact on your risk for HIV and other sexually transmitted infections. The results are mixed, but the bottom line is that it continues to be important to use condoms and to get tested regularly for sexually transmitted infections.

HIV-Risk Reduction in Circumcised Males

The Centers for Disease Control released findings from a series of studies early in 2008. In the summary, they state “Male circumcision has been associated with a lower risk for HIV infection in international observational studies and in three randomized controlled clinical trials.” However, they note that this is the case for male-to-female transmission of HIV, and less so for female-to-male transmission; thus, these studies did not focus on HIV-transmission in sex between men nor between women. However, a more recent study has not found any effect of circumcision on HIV-transmission to men’s female partners for men who were already HIV-positive (i.e., infected with the HIV virus).

Who Does This Apply To?

Not only are the findings about the role of circumcision in reducing the spread of HIV and AIDS mixed, they do not apply to everyone. First, these studies have to do with the circumcision of males, whether that reduces HIV transmission for them and their female partners. So, we know little about what strategies women could take to protect themselves from contracting HIV and other sexually transmitted infections. Further, it is quite clear that these findings pertain to the transmission of diseases through heterosexual sex; that is, these findings do not apply to sex among lesbian, gay, and bisexual people. In fact, it was announced that whatever effect circumcision has for preventing HIV transmission among heterosexual couples does not pertain to gay male couples. Finally, these studies have been conducted on men in Uganda and other African countries. We know much less about whether circumcision has any beneficial effects in the United States.

The Bottom Line

With such a high degree of inconsistency in these studies, it is not necessarily safe to rely solely on circumcision as the main approach to reduce the spread of HIV, AIDS, and other sexually transmitted infections. Though it may turn out that circumcision does, in fact, reduce the spread of disease, and is not simply “associated with” the reduction of disease spread, I would strongly emphasize the necessity of using condoms, including female condoms. To date, no other strategy is as effective in preventing the spread of disease during sex. Also, it is necessary to get tested regularly for sexually transmitted infections and to know the sexual health status of your sexual partners.