0

Adult Male Circumcision Can Reduce Hiv Transmission

photo

Dr Gregory Pinto

By DR GREGGORY PINTO

Next to abstinence, safe monogamous sex with condom use every single time is the best method to reduce the chance of HIV transmission.

John Hopkins University Researcher Dr Aaron Tobian and colleagues showed that male circumcision reduces HIV infection, genital herpes and HPV rates for men and women.

Three randomised studies in countries with high HIV rates - South Africa, Tanzania and Uganda - have confirmed that male adult medical circumcisions can reduce HIV transmission from women to men by as much as 60 per cent, and from men to women by about 15 per cent. This significant reduction in HIV transmission also correlates with the reduction in transmission of other sexually transmitted diseases such as syphilis, herpes, hepatitis and HPV (Human Papilloma Virus).

HPV is associated with a higher incidence of cervical cancer for women, and male circumcision can lead to a large reduction in cervical cancer risk in women.

Although it is true the women with circumcised partners are not as likely to develop cervical cancer, they are however not completely without risk.

The International Agency for Research on Cancer (IARC ) conducted a scientific multi-centre case control study on cervical cancer and male circumcision in Spain, Brazil, Columbia, the Philippines, Thailand that showed convincingly that male circumcision as associated with a reduced risk of cervical HPV and cervical cancer in the man's female sexual partners.

How does circumcision offer a reduced risk of HIV transmission?

Most of the penile skin consists of keratinised epithelium that has an outer layer, the stratum corneum, which is a layer of dead cells that is protective against viruses in that it is less likely to tear and it provides a protective barrier against viruses including HIV.

The foreskin of uncircumcised penises has a mucosal layer that is not keratinised and it has a much higher risk of minor tearing and allowing the transmission of viruses including HIV.

Bahamian men, for the love of your female partners and yourself, consider painless circumcision that has little to no recovery time and can prevent possible HIV transmission and cervical cancer.

Circumcision can be done as a quick painless outpatient procedure whereby the male is either put to sleep under general anaesthesia or placed under conscious sedation with regional anaesthesia. Men require minimal or no recovery period.

It is a painless minimally invasive procedure that can be life saving for both men and their female partners.

• Dr Greggory Pinto is a Bahamian urologist who has trained in South Africa, Germany and France. He is a member of the European Association of Urologists. Dr Pinto can be reached at Urology Care Bahamas at the Surgical Suite, Centreville Medical Centre, Collins Avenue and Sixth Terrace. Call 326-1929, e-mail welcome@urologycarebahamas.com, or visit urologycarebahamas.com.

Comments

ml66uk 1 year, 3 months ago

Male circumcision is a dangerous distraction in the fight against AIDS.

From a USAID report: "There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher." http://www.measuredhs.com/pubs/pdf/CR...">http://www.measuredhs.com/pubs/pdf/CR... (this will include men who were circumcised tribally rather than medically, but they and their partners may also believe themselves to be protected, and the whole rationale for the RCTs into female-to-male transmission was a purported correlation between high rates of male circumcision and low rates of HIV)

It seems highly unrealistic to expect that there will be no risk compensation. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms". This figure seems to have been unchanged in 2012. http://www.info.gov.za/issues/hiv/sur...">http://www.info.gov.za/issues/hiv/sur... http://www.hst.org.za/sites/default/f...">http://www.hst.org.za/sites/default/f... http://jhhesa.org/sites/default/files...">http://jhhesa.org/sites/default/files...

A study in Zambia found that "30% of women at R1, and significantly more (41%) at R2, incorrectly believed MC is fully protective for men against HIV." http://journals.plos.org/plosone/arti...">http://journals.plos.org/plosone/arti...

It is unclear if circumcised men are more likely to infect women. The only ever randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised: http://www.thelancet.com/journals/lan...">http://www.thelancet.com/journals/lan...

ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them.

0

ml66uk 1 year, 3 months ago

Around two thirds of the world's men (including 88% of the world's non-Muslim men) never get circumcised.

Drops in male circumcision since 1950: USA: from 90% to around 60% Canada: from 48% to 32% UK: from 35% to about 5% (about 1-2% among non-Muslims) Australia: 85% to 11% ("routine" circumcision is now banned in public hospitals in all states except one) New Zealand: 95% to below 3% (mostly Samoans and Tongans) South America and Europe: never above 5%

0

Biochem242 9 months ago

Genital mutilation needs to be banned in the Bahamas. Bahamas needs to follow Iceland and other countries who are banning this barbaric practice. How many botched circumcisions have been reported already, among the infant deaths why don't you speak about that instead of trying to get clients. The prepuce is the most sensitive part of the penis, I hate when people like you disregard it as just a useless piece of skin, it performs many functions one being to keep the glans from drying up or becomming keratinized making it dry and less sensitive.

https://metro.co.uk/2017/08/02/why-am...">https://metro.co.uk/2017/08/02/why-am...

https://www.thesun.co.uk/news/7338166...">https://www.thesun.co.uk/news/7338166...

0

Sign in to comment