Does Male Circumcision Shield Women From HIV?

A new study presented at the Ninth International AIDS Society Conference on HIV Science in Paris this week suggested that voluntary medical male circumcision programs (particularly in African nations) are proving to be a surprising shield against HIV. 

Dr. Carols Toledo and fellow colleagues from the CDC reportedly saw an “extremely high prevalence of HIV and sexually transmitted infections in KwaZulu Natal” in relation to uncircumcised men, reports AIDS Map. This research supports a 2009 study suggesting male circumcision provides long-term indirect protection to women from HIV. Other studies show circumcision may help reduce the likelihood of transmitting HPV, syphilis, genital ulcers, BV, and herpes. 

The study Toledo mentioned involved 3,540 male participants. 51 percent of those circumcised were between ages 15 and 19; 45 percent were between 20 and 24; and 28 percent were between 25 and 29; and 20 percent were over 35. Of all 3,540 men, only 10 percent had a traditional circumcision — rather than a medical one. 

The study also researched 4,766 women between 15 and 49 who gave information about their last sexual partner. They were then tested for STIs and asked about symptoms and diagnoses. Of these women, 35 percent had partners who were circumcised, while 65 percent had partners who were uncircumcised. The women with circumcised partners had lower rates of HIV transmission (42 percent) than those with partners who were uncircumcised (54 percent). 

While Toledo said during his presentation these findings support the idea that male circumcision gives some community-level protection against HIV, AIDS Map reports, he also said there may have been few limitations in data. For example, “some women might have said their partner was circumcised when in fact he had had a ‘traditional’ circumcision that did not involve the complete removal of the foreskin.” 

But before you think everyone’s hating on uncircumcised men, let’s be fair. 

Psychology Today reports that during the height of the AIDS crisis, nearly 85 percent of adult men were circumcised — and HIV still spread rapidly. The studies involving African nations praising circumcision as an HIV prevention measure have many flaws, the publication points out, including that they were stopped before results came in.

Still, that didn’t stop nearly 40,000 Kenyans to voluntarily get circumcised in 2010. 

Another study published in The Journal of the American Medical Association showed that gay guys who were circumcised were 14 percent less likely to be HIV-positive than those who weren’t. 

Figures from the National Center for Health Statistics at the CDC show that rates of circumcision in America dropped ten percent in the last thirty years. In comparison to the nearly 70% of males in the world who are uncircumcised, the United States is one of the leading countries in the world who choose to circumcise their male babies.

There's also no way of knowing the true complication rate of circumcision. The AAP in their full  report states this twice. In no uncertain terms: "the incidence of complications from neonatal circumcision is unknown." That's because there is no protocol or policy anywhere that states doctors (or residents in training) need to report any complications, plus the infants don't have the wherewithal to report problems, and the parents don't have the knowledge to know what is a problem, and in an extremely litigious society like the U.S. it would take an extremely honest circumciser to expose himself to risk for performing an unnecessary surgery and causing damage that wouldn't be discovered for almost 20 years anyways. In short, there is no data collection on circumcision so we don't know. 

This HIV Therapy journal article summarizes all the fundamental methodological flaws in the African studies. That is to say, until there is medical parity, we can't trust these studies.