Circumcision and HIV
Three studies recently conducted on adult men in Africa indicate that there may be a connection between circumcision status and a lower female-to-male HIV transmission rate. Because of this, some are calling for mass circumcisions to be implemented in this AIDS-ravaged continent as a way of slowing the spread of HIV. However, there are problems with promoting circumcision as a means to combat HIV in Africa, and even more problems with concluding that infant males in America should be circumcised at birth to reduce their risk of contracting HIV.
The following articles are excellent resources:
Male circumcision is not the HIV 'vaccine' we have been waiting for!, published in the May 2008 edition of Future Medicine's Future HIV Therapy.
HIV and Circumcision: Facts to Consider - Circumcised Men Get HIV, by the International Coalition for Genital Integrity, Oct 2007.
Male Circumcision and HIV Blog
HIV Talking Points by Colorado NOCIRC, May, 2007
NOCIRC Pamphlet: Answers To Your Questions About Circumcision and HIV/AIDS, April, 2007
Doctors Opposing Circumcision: HIV Statement, March, 2007
HIV infection and circumcision: cutting through the hyperbole by Robert S Van Howe, MD, November 2005
Doctors and Children's Groups Say Male Circumcision Must be Voluntary, Consensual, by MGMBill.org, December 2006
Science Fact or Science Fiction: Could Circumcision Really Prevent AIDS?, by Norm Cohen, Director, NOCIRC of Michigan, January 2007
ABC, not circumcision, gives best defence against HIV
An article with an interesting perspective by David J. Llewellyn, Att, November 2007
A letter to the editor
Gillian Longley, a neonatal nurse in Boulder, sent a letter to the editor of the Denver Post in response to an article which highlighted the results of these studies as a reason why circumcision should be performed. The following is her original text. You can also view her letter as it appeared in the Denver Post on December 20th, 2006.
Circumcision and the prevention of AIDS
Re: "Circumcise adult men, HIV study advocates," Dec. 14 news story.
Circumcised men can and do become infected with HIV. In fact, the United States, which has probably the world's highest percentage of non-religiously circumcised men in the sexually active age range, also has the highest rate of HIV in the developed world.
Behavior, not anatomy, is the key factor in reducing the rate of acquisition of HIV. All men, circumcised or not, still must be taught and must practice safe-sex behaviors: abstinence, delaying onset of sexual of activity, reducing numbers of partners, use of condoms, testing, and monogamy. (This also goes for their partners.) An uncircumcised man who consistently uses condoms or practices monogamy in a tested relationship will be at infinitely less risk for acquiring HIV than a circumcised man having unprotected sex, especially with multiple partners. And he will still have all the benefits and sexual sensitivity of his normal, intact penis.
It is of significance that the African circumcision studies were conducted on consenting adults. Unfortunately, most of the circumcised males in the world did not consent to this alteration of their sexual organs, having had it forced upon them for cultural reasons when they were babies or children.
It is clear from an ethical point of view that any circumcision program should be strictly voluntary. When a male is old enough to weigh whether he considers circumcision as a preventive for HIV to be a rational or desirable choice, compared to his own estimation of the value of having an intact sex organ, he can make a fully informed decision for himself. Circumcision should only be done when absolutely medically necessary or when an adult gives fully informed consent.
Gillian Longley, RN, Boulder
