With so much talk about circumcision, is there any value in it for someone who is already HIV+?
- kadelLv 71 decade agoFavorite Answer
You're less likely to pass it on to someone else
Circumcision Halves H.I.V. Risk, U.S. Agency Finds
By DONALD G. McNEIL Jr. New York Times
Published: December 14, 2006
Circumcision appears to reduce a man’s risk of contracting AIDS from heterosexual sex by half, United States government health officials said yesterday, and the directors of the two largest funds for fighting the disease said they would consider paying for circumcisions in high-risk countries.
Q&A About the NIAID-Sponsored Adult Male Circumcision Trials in Kenya and Uganda (National Institute of Allergy and Infectious Diseases)
The announcement was made by officials of the National Institutes of Health as they halted two clinical trials, in Kenya and Uganda, on the ground that not offering circumcision to all the men taking part would be unethical. The success of the trials confirmed a study done last year in South Africa.
AIDS experts immediately hailed the finding. “This is very exciting news,” said Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development, who has argued that circumcision slows the spread of AIDS in the parts of Africa where it is common.
In an interview from Zimbabwe, he added, “I have no doubt that as word of this gets around, millions of African men will want to get circumcised, and that will save many lives.”
Uncircumcised men are thought to be more susceptible because the underside of the foreskin is rich in Langerhans cells, sentinel cells of the immune system, which attach easily to the human immunodeficiency virus, which causes AIDS. The foreskin also often suffers small tears during intercourse.
But experts also cautioned that circumcision is no cure-all. It only lessens the chances that a man will catch the virus; it is expensive compared to condoms, abstinence or other methods; and the surgery has serious risks if performed by folk healers using dirty blades, as often happens in rural Africa.
Circumcision is “not a magic bullet, but a potentially important intervention,” said Dr. Kevin M. De Cock, director of H.I.V./AIDS for the World Health Organization.
Sex education messages for young men need to make it clear that “this does not mean that you have an absolute protection,” said Dr. Anthony S. Fauci, an AIDS researcher and director of the National Institute of Allergy and Infectious Diseases.
Circumcision should be used with other prevention methods, he said, and it does nothing to prevent spread by anal sex or drug injection, ways in which the virus commonly spreads in the United States.
The two trials, conducted by researchers from universities in Illinois, Maryland, Canada, Uganda and Kenya, involved nearly 3,000 heterosexual men in Kisumu, Kenya, and nearly 5,000 in Rakai, Uganda. None were infected with H.I.V. They were divided into circumcised and uncircumcised groups, given safe sex advice (although many presumably did not take it), and retested regularly.
The trials were stopped this week by the N.I.H. Data Safety and Monitoring Board after data showed that the Kenyan men had a 53 percent reduction in new H.I.V. infection. Twenty-two of the 1,393 circumcised men in that study caught the disease, compared with 47 of the 1,391 uncircumcised men.
In Uganda, the reduction was 48 percent.
Those results echo the finding of a trial completed last year in Orange Farm, a township in South Africa, financed by the French government, which demonstrated a reduction of 60 percent among circumcised men.
The two largest agencies dedicated to fighting AIDS said they would now be willing to pay for circumcisions, which they have not before because there was too little evidence that it worked.
Dr. Richard G. A. Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has almost $5 billion in pledges, said in a television interview that if a country submitted plans to conduct sterile circumcisions, “I think it’s very likely that our technical panel would approve it.”
Dr. Mark Dybul, executive director of President Bush’s $15 billion Emergency Plan for AIDS Relief, said in a statement that his agency “will support implementation of safe medical male circumcision for H.I.V./AIDS prevention” if world health agencies recommend it.
He also warned that it was only one new weapon in the fight, adding, “Prevention efforts must reinforce the A.B.C. approach — abstain, be faithful, and correct and consistent use of condoms.”
Researchers have long noted that parts of Africa where circumcision is common — particularly the Muslim countries of West Africa — have much lower AIDS rates, while those in southern Africa, where circumcision is rare, have the highest.
But drawing conclusions was always confounded by other regional factors, like strict Shariah law in some Muslim areas, rape and genocide in East Africa, polygamy, rites that require widows to have sex with a relative, patronage of prostitutes by miners, and men’s insistence on dangerous “dry sex” — with the woman’s vaginal walls robbed of secretions with desiccating herbs.
Outside Muslim regions, circumcision is spotty. In South Africa, for example, the Xhosa people circumcise teenage boys, while Zulus do not. AIDS is common in both tribes.
Nelson Mandela’s autobiography, “Long Walk to Freedom,” contains an unnerving but hilarious account of his own Xhosa circumcision, by spear blade, as a teenager. Although he was supposed to shout, “I am a man!” he grimaced in pain, he wrote.
But not all initiation ceremonies are laughing matters. Every year, some South African teenagers die from infections, and the use of one blade on many young men may help spread AIDS.
In recent years, as word has spread that circumcision might be protective, many southern African men have sought it out. A Zambian hospital offered $3 circumcisions last year, and Swaziland trained 60 doctors to do them for $40 after waiting lists at its national hospital grew.
“Private practitioners also do it,” Dr. Halperin said. “In some places, it’s $20; in others, much more. Lots of the wealthy elite have already done it. It prevents S.T.D.’s, it’s seen as cleaner, sex is better, women like it. I predict that a lot of men who can’t afford private clinics will start clamoring for it.” (S.T.D.’s are sexually transmitted diseases.)
Male circumcision also benefits women. For example, a study of the medical records of 300 Ugandan couples last year estimated that circumcised men infected with H.I.V. were about 30 percent less likely to transmit it to their female partners.
Earlier studies on Western men have shown that circumcision significantly reduces the rate at which men infect women with the virus that causes cervical cancer. A study published in 2002 in The New England Journal of Medicine found that uncircumcised men were about three times as likely as circumcised ones with a similar number of sexual partners to carry the human papillomavirus.
The suspected mechanism was the same — cells on the inside of the foreskin were also more susceptible to that virus, which is not closely related to H.I.V.
- MirzaLv 45 years ago
No, circumcision does not prevent HIV infections. The recent studies seem to suggest that it might decrease HIV infections, but doesn't prevent them entirely. The mechanism by which this works, no one knows; thus, it may just be a really lucky correlation rather than a cause/effect relation. People had two ideas how it might decrease the infections. One is that there are a type of cells that appeared to bind to HIV. People had thought that these cells draw the HIV into the body, but very recent research has found this to be untrue. It might actually help keep HIV at bay, to a degree, by degrading many HIV viruses before it can enter the body. In effect, circumcision would remove most/all of these helpful cells. See 1st link. The second theory is that some think that improper hygiene might contribute to an environment that allows HIV to survive long enough to get into the body via the mucus lining of the urethra and such. Clearly, good hygiene should eliminate this disparity. Surely enough, there's research that with proper hygiene, the infection rates between circumcised and uncircumcised men are insignificant. See 2nd link. The third thought is that the inner foreskin is very thin. Also the glans of the uncircumcised penis is very thin. During sex this might cause tiny abrasions and tears, especially if the guy's rough during sex. This isn't without it's own flaws. A circumcised penis is drier and may be prone to cracks in cold dry weather. Also, sex with a circumcised penis requires more lubrication as both partners dry out easier. When this happens, abrasion is just (if not more) likely. So while the uncircumcised penis "might" be more fragile, it retains the natural lubrication of the female partner better so it won't likely tear as often as it might otherwise. Lastly, it's fully possible that these studies were just lucky coincidences (though, with a larger sample size, this gets less and less likely). What's most important to point out is that the US has one of the highest HIV infection rates of the developed nations, and it also have one of the highest circumcision rates. Clearly, there is something far more important at play that circumcision status. These studies and this claim should be taken with a grain of salt, as safe sex will trump circumcision any day.
- 1 decade ago
Circumcision can save over two million in the next 15 years. This is very serious and should not be taken as a joke.
All these studies have been carried out by prestigious and respectable research institutions and universities, and are back in many cases by official organisations such as the US National Institutions of Health or the World Health Organisation.
Why uncircumcised men are more prone to STD’s?
Scientist have discovered that the skin covering the inner side of the foreskin is by its nature (has a very low amount of a protein called ‘keratin’ which stops viruses entering into the body, plus some other factors) acts as an ‘open door’ to STD’s. Circumcision, by removing the foreskin, ‘closes’ this ‘door’.
Circumcision rates are increasing nowadays, both in the United States and overseas. Many African and South American countries with little circumcision tradition are starting to promote the procedure to help to reduce the AIDS-HIV infection rates.
The sites below have very interesting information related to this topic. Please have a look.
- Anonymous1 decade ago
no.. see it supposedly helps stop the infection spreading..o.k. decreases the chances of it spreading, but it's "not foolproof"..it's not recommended..just because
you get circumcised, that doesn't mean you can't spread the virus otherwise we all would stop using condoms..
really you should ask doctors..ask people who have the disease and look out for the newest research by scientists
i think that it's mainly people coming from cultures where circumcision is common and use this info because it makes them feel better...o.k. not totally, studies have been undertaken but all I'm saying is don't trust it..and there is some value because they don't want it to be spread to other people but don't rely on circumcision (ABC)- 'Abstinence, Being faithful to your partner, Condoms'
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- Anonymous1 decade ago
There is no realtion between circumcision and HIV.
The circumcision is doen for many reason -
2. Medical problem
3. Own pleasure.
It is little painfull operation but takes very little time. Its easier to be done on kids compare to that in adults due to delayed curing time and working inconveniences. After operation one can not wear shorts or pant for 7 to 10 days and has to live in a robe only.
- 1 decade ago
Some HIV patients already have a very compromised immune system. I am not sure if a doctor will perform a surgery that is not necessarily needed.
- babyj248Lv 41 decade ago
I do not understand why you believe there is a link between HIV and circumcision... So no, no value at all.
- T.M.Y.Lv 41 decade ago
There is no value in it at any time, except in rare circumstances where the foreskin binds to the head of the penis.
- Anonymous1 decade ago
Well considering it's supposed to be cleaner I don't see why not.
- HenryLv 61 decade ago
No, not before or after.