BASIC FACTS ABOUT MALE
CIRCUMCISION & HIV INFECTION

A campaign to encourage African men to get circumcised to prevent infection by HIV gained a powerful boost by three new studies unveiled at the world AIDS forum in Rome.

New cases of HIV among men fell by an astonishing 76% after a circumcision programme was launched in a South African township, researchers reported.

Had no circumcisions been carried out, the tally of new infections among the overall population, men and women combined, would have been 58% higher (Reports news24.com on 21 July 2011)

So what are the facts around circumcision...

Male circumcision is a surgical process which involves the removal of the foreskin on the tip of the penis. This leaves the normally covered tip of the penis exposed and with time it becomes hardened (Keratinized). The HI Virus now has more difficulty penetrating the skin.

The promotion of circumcision as a way of preventing HIV&AIDS has been on the increase of late. Several types of research have documented that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex.

• Research shows that the foreskin’s inner mucosal surface is more susceptible to HIV because it has more immune cells that are vulnerable to HIV infection. The presence of the foreskin acts as a physical barrier, trapping HIV next to the surface of the penis for longer periods. In this moist environment, the HI Virus can survive longer.
• The foreskin may also have greater susceptibility to tears during intercourse, providing a portal of entry for STIs and HIV.
• Finally, the higher rates of sexually transmitted genital ulcerative disease, such as syphilis, observed in uncircumcised men may also increase susceptibility to HIV.

Although circumcision is a means of preventing HIV transmission, it must be noted that it applies only to female-to-male transmission and is not 100% safe. It should therefore be treated as an additional preventative measure. Other known methods such as abstinence, limitation to one sexual partner and the use of condoms are still to be advocated.

However, if the procedure is not performed correctly, the following complications have been reported: Serious infection, severe loss of blood, mutilation, penile amputation, possible death in extreme cases.

Such risks are often due to poor training of the staff who performed the procedure, a lack of appropriate surgical equipment and a lack of patient follow-up.

Male circumcision should be considered part of a comprehensive HIV-prevention approach to include the following: The provision of HIV testing and counseling services, treatment for sexually transmitted diseases, the promotion of safer sex practices, and provision of male and female condoms including promotion of their correct and consistent use.

References:

1. Fauci A.S The AIDS epidemic. National English Journal of Medicine. 1999.UK
2. AFP. The Brunei Times. March 2007. Brunei.
3. Auvert B, Buve E, Lagarde E, Kahindo M et al (2001) Male circumcision and HIV infection in four cities in sub Saharan Africa. Aids 15 (supplement 4): S31-S40.
4. http://www.cdc.gov/hiv/resources/
   factsheets/circumcision.htm
5. The South African Medical Research Centre http://www.mrc.ac.za/public/facts19.htm