Male Circumcision Cuts Risk of HIV, Herpes, and HPV Transmission

By Eliza Strickland | March 26, 2009 10:36 am

circumcisionResearchers now have solid evidence that male circumcision protects against three viral sexually transmitted diseases (STDs), and say their findings should encourage parents around the world to circumcise their infant boys. A large study in Uganda involving 5,534 men found that those who underwent circumcision as adults were 25 percent less likely to become infected with herpes and more than 30 percent less likely to catch human papillomavirus (HPV) than their uncircumcised peers…. Previous research has shown that circumcision reduces a man’s risk of acquiring HIV by as much as 60 percent [Scientific American].

Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, says that the area beneath the foreskin of an uncircumcised male provides the “perfect breeding ground for viruses and bacteria.” It can tear and develop sores easily, and if it becomes inflamed, he said, “it gives you much more fertile ground for HIV to be transmitted” [Scientific American], as well as the herpes and HPV viruses. However, the study did not show protection against syphilis, a bacterial STD.

The results of the study, published in The New England Journal of Medicine, should not be misinterpreted to mean that circumcision alone can prevent STD infections, researchers say. “It must be emphasized that protection was only partial, and it is critical to promote the practice of safe sex,” they wrote [AP]. But any measure of protection is worth pursuing, researchers say. And preventing men from catching (and spreading) the HPV virus has a correlated effect of protecting women, as HPV can cause cervical cancer.

Despite the medical evidence, male circumcision engenders strong feelings based on culture, religion, family custom and personal choice. Less than one-third of adult men worldwide are circumcised, according to estimates from the Joint United Nations Programme on HIV/AIDS. And while circumcision programs are catching on in many parts of Africa, … establishing the surgery as a public health measure faces obstacles elsewhere. “There’s no doubt India is not going to jump on the bandwagon,” [study coauthor Thomas] Quinn says. “Muslims are circumcised, Hindus are not” [Science News].

Related Content:
DISCOVER: Male Circumcision: A New Defense Against HIV
DISCOVER: Finally! A Nearly Foolproof Circumcision

Image: iStockphoto

CATEGORIZED UNDER: Health & Medicine
  • SeanDudeMan

    Wow, finally some evidence.

  • Oliver Nelson

    There is some fierce opposition to circumcision out there. It will be interesting to see how some anti-circ groups respond to the new study. Not saying they are wrong, but I’m looking forward to the response. By the way, check out this great debate about circumcision on Opposing Views:

    http://www.opposingviews.com/questions/should-boys-be-circumcised

  • Jeremy

    “perfect breeding ground for viruses and bacteria.” It can tear and develop sores easily, and if it becomes inflamed, he said, “it gives you much more fertile ground for HIV to be transmitted”

    Anyone practicing simple basic hygiene won’t get to the point of skin tearing, and sores developing, and inflammation.

    I’m uncircumcised and I’ve never had any injury down there, much less swelling, inflammation, or sores. Yes, it may take some extra care to maintain personal hygiene, but it’s not rocket science.

    It just seems that this finding is based upon the premise that a man is injured or otherwise not taking care of himself prior to having sex and thus transmitting viral infections.

  • linda massie

    Why should any parent circumcise a child without its consent to prevent a sexually transmitted disease? paticularly when there are a variety of complications and the child will be sexually densentized for life. the circumcision of children regardless of gender is child abuse those advocating these practices come from circumcisied cultures and do not realise the sexual benefits of a foreskin.

  • eric

    yeah Linda,, (sarcasm to follow) there’s a real problem with men being unable to reach orgasm , seems to me most women complain about their men being “premature” in that department perhaps being circumcised might help some men better lovers… I’m glad i don’t have a smegma collector and 3 of my friends who had to get circumcised in their later years due to medical complications all wish it was done when they were babies too.

  • Roger

    Interestingly, when you look at the raw data table in the study, there are some issues. While in Table 1, the rates of condom use were similar between the control group and intervention group (demonstrating good randomization), Table 2 of the study demonstrates that condom use was significantly greater in the intervention group (i.e. circumcision group) compared with the control group at 6 months(p<0.001). Without a plausible causal link between circumcision and increased condom use, the issue calls into question, for me, the validity of the results. The authors do state in their methods that "performed an adjustment for baseline characteristics using a Cox proportional-hazards model for the time to detection of HSV-2…" That is, they adjusted for baseline characteristics but not changes in sexual practices (e.g. condom use) in their primary analysis. They did do so in their secondary analysis, which is not presented in the results section of their article, or the online supplement. Interestingly, the Intervention group had lower rates of condom use at baseline, compared with the Control group. It is not clear how adjusting for that may have affected their conclusions. I would like to hear what the authors have to say about those adjustments, and would like to know what they think about the higher condom use at 6 months in men who were circumcised.

  • Chris TMC

    One factor that could affect the validity of the results goes right back to social causes. What type of people in the area prefer to have sex with cut or uncut men? Is there a socio-economic correlation? Is there an educational factor involved? Sorry but I really find it hard to believe that such striking differences exist separate and distinct from all other factors.

  • Mark Lyndon

    1) I’m tired of circumcised men trying to justify cutting parts off other people’s bodies. Babies aren’t going to be getting any STI’s before they’re old enough to decide for themselves whether or not they want part of their genitals cutting off. It’s their body; it should be their decision.

    2) These latest studies are from Africa. A 29 year study of males in New Zealand showed a slightly *higher* rate of STI’s among circumcised men:
    http://www.jpeds.com/article/S0022-3476(07)00707-X/abstract

    3) If we found out that cutting off part of a girl’s genitals reduced her risk of contracting an STI, would that make it acceptable?
    This study shows exactly that: http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138

  • http://discovermagazine.com John Cassady

    All other arguments aside I have to say that to call it child abuse is ridiculous. On top of that what do you mean regardless of gender, I am unaware of female circumcision. I do agree that if a man is uncircumcised that he should be able to take care of himself well enough to avoid infection and sores but some people are lazy and or stupid so I say it’s better safe than sorry.

  • eric

    Unfortunatly as a parent and once a child i can attest to the fact that children are having sex far before they believe that anything bad can actually happen to them… its the “won’t happen to me” scenario, sometimes parents have to make these decisions FOR or kids health. Baby girl got her ears pierced and i don’t think thats abuse.. male circumcision is NOT hte same as FEMALE don’t even try to say it’s the same, thats rediculous! i certainly would sugest lopping of the head of penises as a preventative measure..

  • eric

    OOPS WOULDN”T SUGGEST LOPPING OOOOOPS

  • Brian

    Honestly, I don’t care if circumcision helps prevent disease or not it’s beside the point. The point is that circumcision on a baby is mutilating the body of someone who has no say in the matter. When they grow up, it’s their choice. it’s like what Mark Lyndon said, if there was a study that showed cutting up the female genitals would prevent disease, would people be rushing to do that? There are a lot of nerve endings in the foreskin, sexual pleasure is reduced. But again that is beside the point. It is involuntary body mutilation. It is as simple as that. People should be able to make their own choice on the matter, not have it forced upon them as a baby.

  • Scientist

    Apart from other serious technical flaws in the study as wisely addressed by Roger, I would really like to discuss the moral and ethical implications of this study and the recommendations offered by the authors. Seriously, how can anyone be so lazy to maintain basic personal hygiene. There is sufficient evidence that education and socio-cultural values has a big role to play in prevention of STDs, much more than circumcision. Why was this study conducted in Uganda, which has an average life expectancy of a male of 44 years? Repeat this similar study in a developed nation and you would be hard-pressed to find any statistical significance at all, even without maintenance of personal hygiene.

    The authors of this study propose that a surgical technique like circumcision that lowers the rate of passing STDs in our society should be seriously considered as an option by insurance carriers. Using a similar argument, then why not just start chopping of other parts of the bodies who endanger our society in many more ways. Why not recommend that we start chopping the arms of those who buy illegal weapons to use at our schools, churches and neighborhoods. Behead those morons who lie to establish baseless decisions and wage wars that take lives of innocent civilians. Some other proponents will argue that “Oh my! How can I have my little boy look different from other boys in the high school locker room.” Unbelievable!

    The authors urge the American Academy of Pediatrics to take a positive stance on the circumcision. Foreskin is something boys are born with and it is there for a reason. I understand if there is a medical reason for removal of the foreskin. Other than that doctors should have no influence on whether to remove it or not on the basis of some what, in my humble opinion, is very weak data.

  • Ladymongoose

    Both my sons are uncirc’d. I and my husband felt there were no compelling reasons for getting this done. If my sons wish to be ‘snipped’ when they are of age to consent to both the surgery and sexual activity, we will happily pay for their surgery. I’m not anti-circ in any way. I just saw no logical reason for removing a natural part of my newborn baby boy.

  • chris

    @ scientist
    “how can anyone be so lazy to maintain basic personal hygiene”

    What world do you live in? I can only guess this is an intentional logical fallacy.

    I would expect the growth of that skin to be a vestigal appendage in the modern world, but that does not dictate it’s removal.

  • Jack

    I think the story here is that some US medical professionals are so obsessed with trying to find a purpose for circumcision that they are fudging data and overestimating insignificant facts. This particular study was partially funded by our tax dollars and by Bill and Malinda Gates. Odd that this 20 -30 % change of risk, where cut men used condoms more and cut men certainly did not have sex some of the time is considered at all. In another Gates funded study HIV positive men and their wives showed CIRCUMCISED men were passing HIV to women at a higher rate. But that study was a dead end so they don’t talk about it. The end of course is to promote circumcision. In particular it is to widen the base in the USA. The US, due to the internet was slowly realizing that not only does circ not make you healthy, it can cause all sorts of problems. People also realized (and in the pre-internet days natural men did not talk about it) that circ removes about 20,000 fine touch nerve endings and the most sensitive part of the male genitals. It is like losing your lips or your fingertips. You may ask why do these people push this barbaric ritual as a health practice?
    If you had advocated something, and done something to thousands and it was revealed as bad, it is a natural reaction to defend it. This also applies to men that have been cut. NO man wants to hear that there member somehow has a problem. This also applies to mothers that had their son cut. There is this huge body of resistance to natural in the US. People must recognize the obsession of the medical people. None of this data, if it was not cooked up (and it is at least indefinite as condoms, behavior, sex – they did not know everything) is worth ripping and chopping off a baby boys most sensitive part in a developed country that has good water.
    Someone said this obsession and this push for mutilation is hate or anti male sexuality, I think it based on embarrassment and an obsession with trying to find a reason to do this amputation. Let us Americans at least ask the American Academy of Pediatrics Task Force on Neonatal [male] Circumcision when they review the policy on circ to have at least one natural male doctor (Someone that knows first hand the joy of these body parts that are amputated) included in the review as well as at least some consideration for the function and make up (thousands of fine touch nerve endings) of these parts. That would be the minimum.
    The real story is the obsession (as a UK med said on this story) of American circumcisers trying to keep the practice going in the USA. You see they have skin in this and they want the practice to continue, as otherwise they would be shown to be heinous genital mutilators.

  • Jack

    Eric,

    As men age, it is known that there’s a real problem with men being unable to reach orgasm. The problem is less if you have a member that was not shortened and did not lose its most sensitive part with about 20,000 never endings.

    A real study in Korea found that circumcised men have premature ejacultion problems. the cause was the circ scar sending wrong signals to the brain. First too soon as a youth and then not at all as an adult. This does not happen to everyone, but it happens to circumcised men at a much m,uch higher
    Smegma is made by all humans and is protective. As you age the protection (smegma) goes away. IN the US people shower and that removes it. People that don’t have a foreskin still get it. BTW, how do you know what you are taling about ERIC?

    There is almost no reason for men to get circumcised in their later years. In natural Finland this happens much less than 1%. Don’t give us that friends talk, it is either bad medical advice or cultural peer pressure.

    For babies the trauma is worse. There is a ripping of attached membrane from glans and then a cutting. Also an adult can avoid skin bridges, curved penis, and hair pulled up on the peins. His body his choice.

  • salman

    Exercised sex once time with a man and after one year later died of hiv – 3 time imake labrtury testI did not find anything, please help am 45 years old
    wdalfndy@yahoo.com

  • salman

    ineed some boady to help my,
    befor 3 years ago ihave sexual with man ( aim the one how use him as wife) only one time – after one year that man died by (hiv) aids so irun around to the librtury for test 3 time every 2 month ? that men after one and half year,
    so afrer that ifeel nothing and become more fat in this time my wight incruse 2 kg more thn befor ,
    my qutation , after how long the hiv discover after sexual
    wdalfndy@yahoo.com

  • Esi

    People shouldn’t compare male circumcison to female circumcison. They are totally different. And to say that male circumcision is abuse is absured. Male circumcision not only reduces the risk of HIV, Herpes, and HPV, but also reduces the risk of penile cancer, paraphimosis, balanitis, and phimosis. It also improves genital health and sexual activity. You guys act like scientists are dong something wrong just becuase they’re recommending circumcision. They’re just trying to find ways to avert the transmissions of STDs and to cut down on HIV cases and deaths. I mean it’s your choice whether or not you want to circumcise or circumcise your boys. But if it was up to me I would most definitely choose to circumcise my son.

  • http://www.nocirc.org linda massie

    BBS in Northern Ireland confirms male circumcision is child abuse without consent of child.

  • Obviously Missing Point

    And the one thing I find missing in all the debate above with people on both sides trying to prove or disprove this article:

    religious belief

    That’s right, nobody even came out with this above. I am by no means a religious expert, but if I’m not mistaken, when it comes to the christian belief in god and the bible, the BIBLE says that God requires it. I’m not sure about other cultures and religion, but am fairly sure that american religious belief includes male circumcision from biblical texts and church teachings.

    Just thought I’d add and point this missing fact out in the topics above. It’s another reason why some may be potentially pushing the ideal of male circumcisions at birth, as it mirrors biblical text and teaching concerning males and what is “right”.

    I support neither side of this, before anyone decides to post inflammatory remarks here to my words. Just tossing another possibility into the pot concerning why or how this study may or may not have come about.

  • Peter Keay

    “Obviously Missing Point”: do your research. The New Testament says that circumcision is NOT for Christian Gentiles. As for the Jews, research (the 1906 Jewish Encyclopedia and the Oxford Dictionary of Jewish Religion) and you’ll find that modern “circumcision” is an extreme version of what was, back then, a mild procedure. See also Dr. Peron’s article “Circumcision: Then and Now” in the magazine “Many Blessings.”

    There have been many good advances in HIV prevention. But I was surprised to see that, based on a few African studies which have internal flaws and are countered by some other studies suggesting the opposite, the US government may, very prematurely, promote circumcision of newborns.

    Sure, the procedure may be offered to adults. But how could anyone ever ethically justify remove a healthy, functioning structure from an infant? Assuming that he will engage in unsafe sex later, and wishing to *possibly* provide a *partial* reduction of risk of a disease, a disease preventable by other means, years and years down the road?

    The HIV/AIDS fight has many promising battles ahead, but implementing permanent mutilation of the bodies of infants is not a victory.

  • Isabel

    Aren’t we exaggerating in this country a bit when we define all circumcision as mutilation? And, pardon me, but aren’t you a bit smug, “Peter Keay”? You seem intelligent, but enraptured by your own intelligence.

    Obviously, there is some kind of belief system on both sides that don’t seem to be able to balance the pros and cons in a truly objective fashion. Moreover, I have been watching some of the circles of grown men that are enraptured with this subject and it makes me a little suspect of motive. Perhaps we need true causes for our grown (armchair) warriors to fight.

  • Concerned.

    Circumcision does not impede sexual pleasure. Period. To suggest otherwise is pretty stupid.
    And to compare male circumcision to female circumcision is ridiculous. IF there comes a time when numerous studies find that cutting the clitoral hood off female infants reduces their risk of contracting and spreading STI’s (assuming lack of a clitoral hood doesn’t affect sexual pleasure.. which is debateable), I see no reason why people would not do it.

    Male circumcision isn’t simply about protecting the guy from STI’s, it’s to protect his partners as well. How many sexually active teenagers do you know who would be responsible enough to choose circumcision before having sex? The reason it’s done to them as babies is so that it’s less traumatising, since they’re not fully aware of what is happening, and less painful.

    People pierce their children’s ears when they’re babies.. do you see anyone trotting around proclaiming that it’s child abuse? No. And why not? Because the effects are not harmful. Same deal. End of.

  • the far

    concerned and other american cirumfetishes here. if circ prevent’s HIV explain why circumcising U.S.A has the highest rate of STDs in the developed world? both male and female circumcision are done for he exact same reasons it is hypocritical to condemn the mutilation of one gender and support mutilating another. condoms help prevent STDs where them. and whyany teenagers slice thier organs when condoms are widely available and are free at sexual health clinics?

    Would any female undergo circumcision of any type if it could be demonstrated that it would prevent penile or prostate cancer in males? If such reasons would be unacceptable to females, then why should similar arguments be made to justify male circumcision?

  • http://www.qldcircumcision.com.au Circumcision Sunshine Coast

    I believe that circumcision is a family choice and those that chose circumcision should be respected just as those who chose not to circumcise. I am very supportive of new findings that say circumcision helps stop the spread of disease. I have chosen to circumcise both of my sons and do not regret my decision even for a moment.

  • John

    It is highly uninformed to state circumcision does not impede sexual pleasure the removal of the nerve endings in the foreskin and subsequent thickening reduces sexual pleasure and satisfaction through thickening of the glans. The scientific evidence to support circumcision (SPREAD OF DISEASE) is very thin.

  • Former Marine

    After I recieved a Circumcision in the Service, I was more sensitive then ever before. I was more tender then before. I wish my mother had the doctor do it when I was a baby. She told me that My older brother had screamed and she was afraid for me.

    Yes I was glad that I had it done. The Whole Platoon did it too. However the Corpsman said you would save $50.00 If you waited to do it after you got out that’s what it would cost you. There were about six of us. The guy who got circumcised told us his girl friend really liked it better like that . That’s really the reason we had it done.

    Same thing was for my tonsils, he screamed and my mother was afraid of hurting me. I wished that I had that done too.

  • John Flushing

    The foreskin is a normal body part. It is really no different from the clitoral hood of a woman, or even the big toenail of a man. We do not make little kids have their big toenails cut off to prevent ingrown toenail, nor do we make little kids have their tonsils out to prevent tonsillitis.

    The parents have no right to amputate a normal, healthy body part. This is ultimately a civil rights issue, plain and simple. As men, we do not demand any special rights or privileges. We merely demand the SAME rights and privileges afforded to women.

    The hygiene issue is something that I find to be both disgusting and offensive. We teach our little girls how to clean their private parts. If a little girl can be trusted to clean her private parts, then I’m sure that a little boy can be trusted to clean his. As a male, I find it to be VERY insulting to my intelligence (and also very degrading) to think that I somehow can’t be trusted to keep my private parts clean, even though a little girl can clean her private parts without any trouble.

    Furthermore, the fact that women have a foreskin also goes to prove how inconsistent and hypocritical people really are with regard to this. So many of these people claim that a parent has every right to cut off a boy’s foreskin. Yet I can guarantee that these are the same people who would scream bloody murder if a doctor were to do so much as make a pinprick in a little girl’s foreskin.

    That was a part of MY penis that they removed without MY consent (how would a woman feel if they cut off her clitoral hood)? I have to be reminded of this every time I go to the bathroom. If that alone is not a good enough reason to criminalize the practice then I do not know WHAT IS.

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