Circumcision can help protect gay men from contracting HIV
depending on their sex habits, landmark Australian research has
found.
But the controversial findings have sparked alarm among HIV
educators concerned that homosexual men will throw out their
condoms if they've had the snip, wrongly believing they are
naturally protected.
"We have shown for the first time that men who predominantly take
on the insertive role in sex are less likely to contract HIV if
they've been circumcised," said Dr David Templeton, from the
National Centre in HIV Epidemiology and Clinical Research in
Sydney.
"That's very interesting, but most HIV infections are contracted in
the receptive role, so what we're talking about is a risk reduction
for a small group of men who didn't have a huge risk in the first
place."
University of NSW researchers recruited 1,400 HIV-negative men,
two-thirds of whom were circumcised, and tracked them over four
years to analyse patterns in HIV infection. Over that time, 53
developed HIV.
Results presented at an HIV conference in Perth showed no evidence
that circumcision reduced HIV risk among gay men in general.
However, men who predominantly opted for the insertive role had an
85% reduced risk of getting HIV if they were circumcised.
Circumcision is believed to be protective because the operation
removes part of the foreskin that is more prone to lesions,
allowing the virus to enter the body thorough the penis.
Dr Templeton said while the statistic looked impressive, it was
relatively difficult to catch HIV through this kind of sexual
activity anyway.
The receptive role was the most common means of infection.
Just seven of the 53 cases were among insertive partners, with
study modelling showing five could have been avoided had the man
been circumcised.
"That's only nine percent of all HIV infections overall that can be
attributed to being uncircumcised, not enough to advocate throwing
out condoms or advocating widespread circumcision," he said.
Stevie Clayton, chief executive of the AIDS Council of NSW said it
was very important gay men did not see circumcision as a magic
bullet.
"And in a public health sense, a mass circumcision program is very
unlikely to be an effective or cost-effective way to go," Clayton
said.
Mathematical modelling presented to the conference suggested she
was correct.
Circumcision of all gay Australian men would cost $196 million in
the first two years and would prevent 37 infections a year in the
next decade and 57 per year by 2030, according to the
projection.
