Male circumcision 'could prevent millions of AIDS deaths'

[James123]

A large trial in South Africa, published last year, suggested that being circumcised reduced the chance of men becoming infected with HIV infection by about 60%......

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http://healthnews.thegoodfriday.co.uk/hiv_news.htm

[DingoBoi]

from a one-time encounter, an hiv negative man has pretty much a low risk of being infected with hiv from an unprotected encounter.   

For a circumsized man, that risk is slightly reduced.

I want to make clear that circumcision is NOT a ticket to prevention.

HIV doesn't discriminate, but it is true that in an encounter with somebody who happens to be hiv positive, one's chances of obtaining this are disminished if you are circumcized.

Personanally, I don't know yet how i feel about that.

to me, it seems to ring to the 'take PEP before sex so you don't get hiv".

Might it help?  Maybe.  Is it sure.  Hell no.

I hate the lack of safe sex information that is not included with these type of articles.

[gerry]

There's another thread with some pretty good discussions about this topic:

http://forums.poz.com/index.php?topic=1775.0

[Poz Brit]

Here in the UK the majority are intact and have not been mutilated, and from what I have read, HIV/AIDS is not, more prevalent here.

Also over here ,it is also illegal to dock dog’s tails, as it is deemed to be cruel, so is it alright to mutilate and cut off the foreskin of an infant boy for religious reasons or what ever?  Surly all that is attached has evolved for a purpose?

John(UK)

[alisenjafi]

Hey I am circumsied and I got the bug , I also posted a thread on this  here called" Is This  Bad Science"
http://forums.poz.com/index.php?topic=1775.0
So who can I sue! From my understanding there is some sort of law, stating that people with a condition can petition the powers that be on promoting untruths to their condition.
Could is a mighty word , I could have been a millionaire,
My questions are:
                              Since the virus can not be passed through skin how is circumsizion stopping the virus?
                               By getting circumsized , what other preventive measures if any are being taken? Such as getting counseling on safe sex, the importance of using a condom, abstinance?

Please read the other thread to see how I and many of your fellow posters feel on this subject.
Cheers
Johnny

[Cliff]

To be fair, I think when they say circumcision would reduce HIV transmission, I believe they are only speaking of vaginal transmissions from female to male.  I don't think they have reviewed whether circumcision would benefit male to male transmissions, (and it certainly would not be a benefit for a receptor, anal sex, who just so happens to be circumcised).

[jkinatl2]

<< Since the virus can not be passed through skin how is circumsizion stopping the virus?>>

because the area underneath the foreskin is not keratinized skin. It is a permeable mucousal membrane, which keratinizes after circumsizion. The mucousal membrance contains rather high concentrations of Langhoreans Cells, a type of dendritic cell specifically targeted by HIV.

<< By getting circumsized , what other preventive measures if any are being taken? Such as getting counseling on safe sex, the importance of using a condom, abstinance?>>

This is the issue I would have with circumsizion as an HIV preventative. It presupposes that a condom will not be used for intercourse (as foreskin or the lack thereof becomes irrelevant when wrapped in latex). It is a surgical response to an issue which demands a societal one.

Would widespread curcimsizion reduce HIV infections in Africa and developing nations? Maybe. Probably. However, the quality of medical care in hospitals in these areas is in and of itself a risk for HIV and other infections. Moreover, it is decidedly more expensive - not to mention of questionable long-term benefit - when compared to simply implementing condom distribution and accurate safer sex education for males and females.

As long as the USA ties it's HIV funding to abstinence-only caveats, it is useless to prevent the spread of the pandemic.

[Eldon]

Johnny and Dingo is correct. Circumcision reduces the rick BUT it does not PREVENT it. In these articles they need to focus on the counseling and the prevention aspect of someone's being.

Use protection each time you have sex, should be in the headline news.

[edfu]

Although the studies have  been looking only at vaginal transmission from female to male, I do not see why the biology behind them would not be equally applicable to anal transmission from male to insertive male.  One also must not forget that if the studies are accurate, it means there would be a smaller number of  insertive HIV+'s transmitting HIV to other sexual partners, whether female or male. 

The biology here needs to be stated clearly. The foreskin, which if unfolded would measure 20 to 30 square inches (that's 400-600 inches), contains a large number of Langerhans cells,a form of dentritic cell, as Jonathan has already pointed out.  These cells are concentrated on the inner foreskin layer, which lies directly against the head of the penis.  Langerhans cells are biological magnets for HIV, so the inner foreskin layer can absorb HIV up to nine times more efficiently than a woman's cervix. 

Usually, Langerhans cells play a protective role.  They ingest pathogens and ferry them down lymph channels along the penis to the lymph glands in the groin, to be killed by white cells.  A Langerhans cell will swallow HIV as readily as any other bacterium or virus, but unlike other pathogens, HIV will reproduce thousands of copies of itself inside the belly of the Langerhans cell for the duration of its trip through the lymph system (about five days). 

After reaching the lymph nodes in the groin the Langerhans cell explodes--literally--spewing tens of thousands of copies of HIV, and it then rapidly infects other immune cells before slipping into the bloodstream.  And if that's not enough, the intact foreskin is also susceptible to small tears and abrasions during sex that can provide even more opportunities for HIV to enter the body. 

That said, it is entirely true that the only thing that FULLY protects men, cut or uncut, from HIV is a condom.  HIV can (and does) enter the body through a circumcised penis via small abrasions, preexisting STD's such as herpes, and/or the urethra. 

For these reasons, I personally believe that uncircumcised men face a higher risk of acquiring and passing along HIV.