Is circumcision is a preventive measure against HIV/AIDS?

Answer 1

No, circumcision is NOT a preventative measure against HIV.

Condoms are preventative measures against HIV while HIV medications are a preventative measure against AIDS.

Circumcision is a personal, aesthetic, or religious choice ONLY.

Now circumcision can help with personal hygiene but any man with foreskin can take an extra minute to be thorough in the bathroom and be just as clean as a man without.

There IS recent research that suggests that foreskin can facilitate the transfer of HIV into an uninfected man's body so therefore increase your risk of contracting the virus... but again, circumcision is NOT preventative, it only slightly reduces your risk.

Only refraining from sex, engaging in non-fluid transfer sexual activities (mutual masturbation, using sterilized toys, etc), or condoms prevent HIV.

Answer 2

Rationally thinking, circumcision alone can not be a preventive measure against AIDS, there should be willingness and will power on the part the both male and female population to abstain from having sex with multiple partners.

Answer 3

NO. Circumcision is the cutting of the foreskin around the penis. The only preventative measure for HIV/AIDS is NO sex.

Answer 4

no, its not a preventive measure against HIV/AIDS...it just prevents the accumulation of "smegma" in the glans penis which may cause infection if not cleaned always...its more like a hygienic practice, even traditional for some cultures....but never to prevent HIV/AIDS...

Answer 5

I heardat the AIDS conference that being circumcised is better at preventing it

Answer 6

Absolutley NOT!!! It is just to remove the flap of skin that covers the head of the penis. It is only for basic hygiene, even though many doctors would say it is not necessary.

Answer 7

no, it's to prevent poor hygiene...men can't do anything themselves.

Answer 8

NO THE SURGERY IS NOW CONSIDERED COSMETIC

Answer 9

There was some study that came out that concludes this.

Don't forget that there is a saying, there are lies, damn lies, and statistics.

There is another one - A lie will be halfway around the world before the truth has got its pants on.

I don't know the purpose of this study, but

Impact of male circumcision on the female-to-male transmission of HIV Auvert B.1, Puren A.2, Taljaard D.3, Lagarde E.4, Sitta R.4, Tambekou J.4
1 UVSQ - INSERM U687 - APHP, ST Maurice CEDEX, France, 2 NICD, Johannesburg, South Africa, 3 Progressus CC, Johannesburg, South Africa, 4 INSERM U687, St Maurice, France

Introduction: Observational studies suggest that male circumcision could protect against HIV-1 acquisition. A randomized control intervention trial to test this hypothesis was performed in sub-Saharan Africa with a high prevalence of HIV and where the mode of transmission is through sexual contact.

Methods: 3273 uncircumcised men, aged 18-24 and wishing to be circumcised, were randomized in a control and intervention group. Men were followed for 21 months with an inclusion visit and follow-up visits at month 3, 12 and 21. Male circumcision was offered to the intervention group just after randomization and to the control group at the end of 21 month follow-up visit. Male circumcisions were performed by medical doctors. At each visit, sexual behavior was assessed by a questionnaire and a blood sample was taken for HIV serology. These grouped censored data were analyzed in an “intention to prevent” univariate and multivariate analysis using the piecewise survival model, and relative risk (RR) of HIV infection with 95% confidence interval (95% CI) was determined.

Results: Loss to follow-up was <11%; <1% of the intervention group were not circumcised and < 2% of the control group were circumcised during the follow-up. We observed 45 HIV infections in the control group and 15 in the intervention group, RR=2.77 (95% CI: 1.56 – 4.91; p=0.0005). When controlling for sexual behavior, including condom use and health seeking behavior, the RR was unchanged: RR=2.93 (p=0.0003).

Conclusions: Male circumcision provides a high degree of protection against HIV infection acquisition. Male circumcision is equivalent to a vaccine with a 63% efficacy. The promotion of male circumcision in uncircumcised males will reduce HIV incidence among men and indirectly will protect females and children from HIV infection. Male circumcision must be recognized as an important means to fight the spread of HIV infection and the international community must mobilize to promote it.

Some factors casting doubt on the findings:

1. A summary of the study includes this:

Inclusion criteria:
...
Consenting to avoid sexual contact (except with condom protection) during the 6 weeks following the medicalized circumcision
The men were told:

When you are circumcised you will be asked to have no sexual contact in the 6 weeks after surgery. To have sexual contact before your skin of your penis is completely healed, could lead to infection if your partner is infected with a sexually transmitted disease. It could also be painful and lead to bleeding. If you desire to have sexual contact in the 6 weeks after surgery, despite our recommendation, it is absolutely essential that your (sic) use a condom.
So:
1. The circumcised experimental group, but not the intact control group, got into the HABIT of using condoms
2. They learnt HOW to use condoms
3. They had to make sure they HAD condoms (which are in scandalously short supply in South Africa), and
4. last but not least, they were PROTECTED by condoms.

The researchers could hardly say to the experimental group, "but after that you don't have to use condoms" could they?

Meanwhile the intact control group was not required to use condoms for the first six weeks of the study, just sent out to take their chances.

This throws the results into, er, a cocked hat.
2. The circumcised men would have had to take some time away from any sexual activity, reducing their exposure to HIV.

3. The circumcised men would inevitably get more exposure to safe-sex information during their time in medical hands, waiting for and recovering from, their operations.

4. Humans are not lab rats. They have sex in non-random ways. Many of the men in the study would put themselves at little or no risk of contracting HIV, a few at great risk, so the effective sample size is much smaller than it appears, making the margin of error much larger.

5. Because HIV-positive men were excluded from the study, there would have been a higher proportion of men with natural immunity in both groups than the general population, reducing the effective sample size still further.

6. Because all the subjects did not just agree to be circumcised but wished to be, they were not a representative sample of the general population.

7. 11-14 percent of the original participants (360 - 458 men) were lost to study or disqualified from continuing. Their HIV status and/or circumcision status might not be typical of the total, introducing sufficient bias to refute the claimed finding.

8. Michel Garenne of the Institut Pasteur in Paris points out that the claimed 63% efficacy is not comparable to that of a vaccine and would result in considerable infection over time.

9. Jennifer Vines, MD, of the Oregon Health & Science University in Portland, comments "...the authors did not control for other sources of HIV transimission such as blood transfusions or exposure through infected needles. ... Controlling for this route of infection could result in a smaller difference between HIV infection rates in the circumcised versus uncircumcised groups, indicating that circumcision may not be as effective at decreasing HIV transmission as the article suggests."

10. Columnist Stephen Strauss (below) points out that the study was cut short before even half as many men were infected as were infected before it began.

11. The Lancet (which earlier published a strident call for circumcision by Robert Bailey) refused to publish the study (apparently with ethical concerns about not telling men they had HIV). The study has been published by the Public Library of Science, an "open source" online medium.

12. The Abstract of the AIDS Conference in Rio reported 15 seroconversions from the circumcised group and 45 seroconversions in the uncircumcised group. (The New Scientist, 6 August, reported 15 seroconversions in the circumcised group but 51 in the uncircumcised group. On 29 July the Science and Development Network reported 18 seroconversions in the circumcised group and 51 in the uncircumcised group.) On 23 October, PLoS reported that there were 20 seroconversions in the circumcised group and 49 in the uncircumcised group. From the official figures: 15-45 at the AIDS Conference in Brazil and 20-49 in the PLoS Journal, between 1 August and 23 October there appear to have been 4 seroconversions among the uncircumcised and 5 seroconversions among the circumcised: in less than 3 months, a 3:1 difference has shrunk to 2.45:1 difference. (At this rate, there will be no difference by August 2006. )

13. We've seen it many times before. Circumcision is touted as the great panacea for this or that dreaded disease of the age - but as the studies are refined, the advantage withers away.

14. The rampant evangelism of the Conclusion suggests that the experimenters are not altogether detached.

Even if the findings are correct:

1. If they are acted on outside this controlled setting, men with a keratinised, reduced penis would be less likely to use condoms.

2. The biggest danger, still unmeasured, is that the mantra "Circumcision prevents AIDS" will become widespread, and circumcised men will take no other precautions, spreading more HIV than their circumcision prevents. Beliefs like "Sex with a virgin cures AIDS" are already widespread in Africa. Circumcision is a painful, memorable operation that makes a permanent, visible change to the penis: it would be a resolute man who didn't feel it had made him safer - and therefore act less safely.

3. There is some suggestion that circumcision increases male-to-female transmission. If so, promoting it could be disastrous.

4. As UNAIDS said in 2000, relying on circumcision to protect against AIDS if it offers only this level of protection is like playing Russian roulette (with one bullet in the chamber instead of three).
Relying on circumcision to halt the AIDS epidemic is like fighting a housefire with a soda-syphon.

5. While a vaccine can be improved, this quite limited preventive effect is as much as circumcision can ever possibly give.

6. Rather than "Circumcision prevents HIV transmission" it would put matters in a better perspective to say "Circumcision (on average) delays HIV transmission". If the findings of this study are correct, where an intact man can expect to be infected with HIV after a year, for a circumcised man it would take two years more.

7. So rather than say "therefore men should be circumcised (to make unprotected sex somewhat safer)", the message should be "intact men should be especially sure that the sex they have is protected."

8. In STATS, Rebecca Goldin points out that the low HIV/AIDS rate in the US means it would require 10,000 circumcisions to prevent 5.5 HIV infections, so the risks of circumcision are at least comparable.

9. This (perhaps) makes a case for voluntary adult circumcision. Babies still have a right not to be second-guessed about their sexual practice 16 or so years from now, availability of a vaccine then, or their wishes about what parts of their body they may keep.

Answer 10

no