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Circumcision reduces the risk of HIV infection in heterosexual US men
Date:12/17/2008

ngs were limited by small sample size or extremely low HIV prevalence and did not achieve statistical significance. Indeed, HIV prevalence in the United States is very low (about 0.4 percent), and the proportion of circumcised adult males is high (about 80 percent), which could make it hard for conventional observational studies (i.e., studies that are not clinical trials) to discern whether circumcision actually has a protective effect. By focusing on patients who had documented exposure to an HIV-infected female partner, the current study was able to reveal that there was indeed a protective effect. This approach, the investigators said, "represents a significant methodological advancement over most previous observational studies."

In a separate editorial on the topic, Ronald H. Gray, MBBS, MSc, of Johns Hopkins University, pointed out that circumcision may be especially important for minority U.S. populations, including Hispanic as well as African American mensubgroups most at risk for HIV infection. He also noted that the American Academy of Pediatrics has thus far not recommended routine neonatal circumcision, and that Medicaid does not cover the procedure. "It is to be hoped," he said, "that the paper by Warner et al., in conjunction with the weight of evidence from international studies, will persuade the Academy to recognize the public health importance of this surgery for prevention of HIV in minority U.S. populations."

Fast Facts:

  • Recently reported clinical trials in Africa have shown that interventional use of adult male circumcision reduced the risk of HIV infection in heterosexual men.
  • The current U.S. study was able to show that circumcision significantly protected heterosexual African American men. It did so by focusing on subjects who had documented exposure to an HIV-infected female partner.


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Contact: Steve Baragona
sbaragona@idsociety.org
703-299-0412
Infectious Diseases Society of America
Source:Eurekalert

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