Male circumcision shown to help prevent HIV transmission

By Dr. Ananya Mandal, MDSep 19 2010

According to a new study published in the Medical Journal of Australia, male circumcision can be seen as a “surgical vaccine” in the fight against heterosexual HIV transmission. The study based on spread of the virus in Africa showed that there was a reduced rate of transmission in regions where male circumcision was the norm.

According to co-author St Vincent's Hospital Alcohol and Drug Service director Alex Wodak this practice could be introduced as a long-term strategy in reducing heterosexual HIV transmission. He explained, “A wealth of research has shown that the foreskin is the entry point that allows HIV to infect men during intercourse with an infected female partner…Soon after the HIV pandemic was first recognized, much lower HIV prevalence was found in areas of sub-Saharan Africa, where more than 80 per cent of males had been circumcised than in areas where the circumcision rate was less than 20 per cent…Circumcision of males is now being referred to by many as 'surgical vaccine' against a wide variety of infections and adverse medical conditions over a lifetime.”

Speaking on Australia Dr. Wodak said that in the 50’s and 60’s more than 80 per cent of infant males were circumcised and recent Medicare statistics revealed circumcision among Australian boys had increased from 13 per cent in 1998 to 19 per cent in 2009. He said, “If Australia returned to the patterns we had in the 1950s and 1960s, I think that would be beneficial.”

Studies have failed to show similar benefits of male circumcision when it comes to sex between men. According to the World Health Organization there is “compelling evidence that male circumcision reduced the risk of heterosexually acquired HIV infection in men by approximately 60 per cent.”

Dr. Wodak went on to say that this simple surgical procedure also protects from some common sexually transmitted infections and other conditions such as urinary tract infections. He added, “The prospect of the availability of a (HIV) vaccine over the next 20 years is unlikely… Condom use remains essential, with promotion of condom use plus circumcision of males being analogous to seatbelts plus airbags for reducing the road toll.”

However Australian National University department of pediatrics and child health associate Professor Graham Reynolds feels this surgery is not imperative for prevention of infections. He said, “In order to prevent one infection, you circumcise unnecessarily a huge number of children who will never get a urinary infection, who will never get HIV, who will never get any other infection…if we paid proper attention to cleanliness in non-circumcised boys, we would get no problems.”