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Circumcision

Circumcision significantly reduces the rate of HIV acquisition in men with HIV-positive female partners and may offer a slight protective benefit for gay men having insertive-only anal sex. Recent research indicates it may give female partners some protection as well.

The foreskin of the penis is rich in particular cells (called Langerhans cells) that are a target for HIV.

Following sexual activity the foreskin may trap sexual secretions around the head of the penis, which provides a greater opportunity for infection to occur.

Removing the foreskin thus reduces the likelihood of HIV infection.

Consistent condom use with HIV-positive partners and partners of unknown status, rather than circumcision, is advocated as public health strategy in Australia.

The research

Between 2005 and 2007 randomised clinical trials in three African countries found that adult circumcision reduced HIV infection from female sexual partners by 50-70%.

Follow up on the trials in 2011 found that circumcision continued to offer men a high degree of protection against HIV infection after nearly 5 years.

Since then, further research has confirmed earlier results and investigated issues such as sexual satisfaction after circumcision, circumcision of HIV-positive men, the impact on men's use of other protection strategies, the benefits for female partners, and the relevance of circumcision for gay men in developed countries.

The Clearinghouse on Male Circumcision for HIV Prevention provides information and reports on circumcision research and program implementation.
 

Benefits for female partners

Circumcision has been found to reduce the rate of sexually transmissible infections such as human papilloma virus, herpes, and syphilis among the female partners of circumcised men.

In 2014 a South African study provided the first convincing evidence that circumcision also gives women some degree of protection (15%) against HIV.

Circumcision and gay men

A 2008 meta-analysis of 17 studies found that circumcision only provided very small, and not statistically significant, benefits for gay men.

According to research presented at the IAS Conference in Vienna in 2010, among gay men in San Francisco who predominantly engage in insertive anal intercourse (and report any recent unprotected sex) only 0.7% were willing to get circumcised if proven safe and efficacious.

Researchers concluded that if such a strategy were implemented among gay men in San Francisco, it would have only a limited impact on HIV incidence in the gay male population.

View conference abstract

 


This page was published on 12 January, 2011

This page was reviewed on 24 March 2015