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Circumcision and Disease Prevention

Jan 28, 2013

Circumcision does not necessarily reduce the risk of transmitting sexually-transmitted infections (STIs), including HIV, the virus that causes AIDS, say researchers from Puerto Rico.

While past studies have shown that circumcision can effectively protect people from STIs, most of those studies were conducted in Africa. The Puerto Rican researchers wanted to know similar results would be found in the Caribbean.

What Is Circumcision?

Circumcision involves removing the foreskin from the tip of the penis. Many parents choose to have their baby boys circumcised for religious or cultural reasons. Others feel that circumcision has health benefits, such as reduced risk of infections, because the foreskin provides a pocket for bacteria and viruses to thrive.

To learn more about their own geographic area, the researchers randomly chose 660 participants from a pool of patients at an HIV/STI prevention and treatment center in San Juan. The men were between the ages of 16 and 83, but their average age was 37 years. Almost a third of the men were circumcised.

Reaserch Results: Circumcision and HIV

STI rates of circumcised men and uncircumcised men were compared. The researchers found that the circumcised men had higher rates of HIV and genital warts. They were also more likely to have had more than one STI in their lifetime.

“Results indicate that being [circumcised] increased (rather than decreased) the likelihood of having HIV infection,” the authors wrote.

“Contrary to most of the published research on the role of circumcision on HIV transmission, our data indicate that in and of itself, circumcision does not confer a significant protective benefit against STI/HIV infection,” they added.

The researchers acknowledged that their study participants were from one clinic that focuses on STIs and HIV. Their findings might not apply to larger areas, such as the entire island of Puerto Rico or the Caribbean region.

The researchers couldn’t explain why their results were so different from the results of the African studies. They didn’t think that biology played a role, but thought perhaps social and cultural differences did. In other words, perhaps the ways that different societies form relationships and engage in sexual activity affects these outcomes. Future research could examine this idea more closely.

Health care providers and policy makers should be careful before recommending circumcision as an HIV-prevention strategy, the authors suggested.

Resources

The Journal of Sexual Medicine

Rodriquez-Diaz, Carlos E., PhD, et al.

“More than Foreskin: Circumcision Status, History of HIV/STI, and Sexual Risk in a Clinic-Based Sample of Men in Puerto Rico”

(Full-text. First published online: August 15, 2012)

http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2012.02871.x/abstract