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BOSTON (Reuters Health) - Circumcision appears to reduce the likelihood of men becoming infected with HIV, the virus that causes AIDS, and of passing it on to their female partners.
However, among men who are already infected with HIV, circumcision does not seem to protect their partners from becoming infected, according to findings reported here at the Conference of Retroviruses and Opportunistic Infections.
Circumcision protects men from acquiring genital herpes infections with HSV-2, and it also reduces the rates of genital and urinary disease (including bacterial vaginosis) in their female sex partners, Dr. Aaron Tobian of Johns Hopkins University in Baltimore reported Sunday.
Because genital ulcer disease, HSV-2 infections and bacterial vaginosis are all co-factors for HIV infection, the findings of this study indicate a protective effect of male circumcision against HIV acquisition in these women, Tobian explained.
Three previous African trials have shown that circumcision lowers the chances of a man becoming infected with HIV. "The effects of male circumcision on male and female sexually transmitted infections were much more equivocal," Tobian continued. To investigate, a two-part trial was undertaken.
Tobian's team initially screened 6400 uncircumcised men and identified 3500 who were free of HIV and HSV-2. These men were randomly assigned to be circumcised or to just be followed for 2 years.
"What we found was that there was a 25 percent reduction in HSV-2 acquisition - and those men were circumcised," Tobian reported.
The second part of the trial enrolled the wives of the men. After 12 months, "those women who were married to circumcised men had a decrease in symptomatic genital ulcers by 25 percent." Rates of bacterial vaginosis were also reduced, by 20 percent, he announced.
"This is, for us, one of the most heartening findings," Dr. Maria Wawer, also from Johns Hopkins, commented.
"From our observation data, we had also hoped that male circumcision of (HIV) positive men might reduce the transmission of HIV to their female partners," she continued in the presentation. But this was not the case, in a trial conducted in Uganda.
