Impact of circumcision on the risk of developing HIV/AIDS among Indian men.

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Impact of circumcision on the risk of developing HIV/AIDS among Indian men.

A prospective study (1993 to 2000) of 2,298 men presenting to sexually

transmitted disease (STD) clinics in India with non-HIV venereal diseases

evaluated the impact of circumcision on the risk of developing HIV/AIDS. All of

these men were tested for HIV/AIDS, as well as other non-HIV STDs, on a

quarterly basis, and all were free of HIV/AIDS infection when they entered the

study. The men in both groups were closely matched in terms of sexual behaviors

and related risk factors, irrespective of their circumcision or religious

history. Over the duration of the study, the 191 circumcised men were 85% less

likely to develop positive blood tests for HIV when compared to the 2,107

uncircumcised men. However, circumcision appeared to offer no protection against

syphilis, gonorrhea, or genital herpes.

Jewish World Review March 31, 2004 / 9 Nissan, 5764

http://jewishworldreview.com/0304/gezunt1.asp

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Lancet 2004; 363: 1039-40

Male circumcision and risk of HIV-1 and other sexually transmitted infections in

India

J Reynolds, E Shepherd, Arun R Risbud, Raman R Gangakhedkar,

S Brookmeyer, Anand D Divekar, Sanjay M Mehendale, C Bollinger

Circumcised men have a lower risk of HIV-1 infection than uncircumcised men.

Laboratory findings suggest that the foreskin is enriched with HIV-1 target

cells. However, some data suggest that circumcision could simply be a marker for

low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending

sexually transmitted infection clinics in India, we noted that circumcision was

strongly protective against HIV-1 infection (adjusted relative risk 0·15; 95% CI

0·04-0·62; p=0·0089); however, we noted no protective effect against herpes

simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation

suggests a biological rather than behavioural explanation for the protective

effect of male circumcision against HIV-1.

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