A QUANTUM OF SCIENCE
Are HIV rates in the
(Interestingly, CD4-rich Langerhans cells are found in human foreskin and vaginal tissues, but not in oral or rectal tissues. This suggests that HIV infections use a different biochemical route when introduced into the body through those tissues.)
The idea of reducing the risk of contracting HIV through circumcision is far from new. In 1987 a letter was published in the New England Journal of Medicine suggesting exactly that, and studies done in the last fifteen years bear out that theory. While the methods used and areas studied (largely in Africa) varied, the conclusions were so striking that in at least one case a circumcision/HIV infection study was halted years early so the findings could be considered for public policy discussions. Depending on the area studied and the risk factors of those involved in the study, HIV infection rates were found to be as much as 50% lower among circumcised African men than their intact counterparts. Various attempts have been made to expand the conclusions of individual studies through meta-analysis papers and their conclusions found an even greater protective effect of circumcision when those studied were from high-risk populations.
So why not support a policy of encouraging circumcision in the
First, the benefits of circumcision are greatly enhanced among high-risk populations. This means that for the average American man (whose risk is far, far lower than the average African man) the benefits are considerably lessened. This could well have something to do with the fact that an estimated 79% of American men are already circumcised – though as rates of circumcision have fallen to around 65% in the most recent surveys, that number is now trending downward. Secondly, use of barrier protection is far more prevalent in
The need for additional research is clear. Until scientists can repeat the highly successful African studies in
For more information:
CDC mulls routine circumcision of infants to reduce spread of HIV (NY Daily News)
Circumcision and heterosexual transmission of HIV infection to men. (Fink, 1987)
Comparative investigation of Langerhans' cells and potential receptors for HIV in oral, genitourinary and rectal epithelia. (Hussain, 1995)
Male circumcision and risk of HIV infection in sub-Saharan
Male circumcision for HIV prevention in young men in
© AQOS / P. Smalley (2009)