26 July 2010

HIV preventative effect too small to justify circumcision, claims new study

by Kate Melville

Previous research carried out in Africa indicated circumcision to be effective in limiting the spread of HIV, but a new analysis by University of Pittsburgh Graduate School of Public Health researchers suggests circumcision would have a very small effect on reducing HIV incidence in the United States. The new study was funded by the CDC and the findings were presented at the XVIII International AIDS Conference.

The logic behind circumcision's supposed preventative effect is that it removes the cells in the foreskin that are most susceptible to infection by HIV. Clinical trials conducted in Africa have found it reduces the risk of HIV in heterosexual men, yet the Pittsburgh researchers contend that there is little evidence that it can reduce transmission among American gay men.

The study was based on surveys of 521 gay and bisexual men in San Francisco. The findings indicated that 115 men (21 percent) were HIV-positive and 327 (63 percent) had been circumcised. Of the remaining 69 men (13 percent), only three (0.5 percent) said they would be willing to participate in a clinical trial of circumcision and HIV prevention, and only four (0.7 percent) were willing to get circumcised if it was proven safe and effective in preventing HIV. The researchers extrapolated these findings to the entire gay and bisexual male population of San Francisco and determined that only 500 men would potentially benefit from circumcision.

"Circumcision in the U.S. already is very common, making it applicable to a limited number of men as a potential HIV prevention strategy in adulthood," said study author Chongyi Wei. "Our study indicates that any potential benefit may likely be too small to justify implementing circumcision programs as an intervention for HIV prevention."

Compelling new evidence for benefits of circumcision
Mass Circumcision Project - Science a GoGo's Discussion Forums

Source: University of Pittsburgh Schools of the Health Sciences