Circumcision May Not Cut Gay Male HIV Risk

U.S. researchers found there is little evidence to support the claim that circumcision protects men from getting the AIDS virus during sex with other men.

Researchers from the Centers for Disease Control and Prevention reviewed 15 studies involving 53,567 gay and bisexual men in the United States, Britain, Canada, Australia, India, Taiwan, Peru and the Netherlands and found no benefit for those who were circumcised.

Circumcised men were 14 percent less likely to be infected with the human immunodeficiency virus, or HIV, than those who were uncircumcised, but the finding was not statistically significant, the CDC researchers said.

“You can’t necessarily say with confidence that we’re seeing a true effect there,” said Gregorio Millett of the CDC, who led the study. “Overall, we’re not finding a protective effect associated with circumcision for gay and bisexual men.”

Previous studies in Africa showed that male circumcision cut the risk of female-to-male HIV infection by half.

Experts believe the reduced risk is due to the increased susceptibility of cells on the inside of the foreskin, the area of the penis that is removed during circumcision.  

It still remains unclear as to whether circumcision cuts the risk of spreading AIDS in sex between men.  Outside of Africa, the HIV epidemic’s center, homosexual and bisexual men player a much larger role is spreading AIDS.

Last week, the CDC reported that 48 percent of the 1.1 million Americans infected with HIV are homosexual or bisexual men, yet three-quarters of men in the U.S. are circumcised.

“We really cannot recommend overall male circumcision as a strategy for men who have sex with men in the United States,” Millett said.

Dr. Peter Kilmarx, of the CDC, said the group is preparing recommendations on circumcision in the U.S. that will be made public next year.

According to Millett, there are signs that circumcision could protect some men depending on their sexual practices.

Previous studies in Peru and Australia showed that men who participated in insertive anal sex, and were not penetrated by partners, saw significant protection from HIV due to being circumcised.

“Of course, if you’re being penetrated by a partner during sex, you being circumcised is not going to protect you from HIV infection,” Millett said.

According to Millett, two previous U.S. studies that occurred before the introduction of HAART, a drug treatment for HIV infections, showed that men who were circumcised were 53 percent less likely to be infected with the HIV virus.

Millett said that the success of HAART, which has turned HIV infection into a chronic disease, might have led some gay and bisexual men to engage in riskier sexual practices.