Sunday, March 28, 2004

BBC - Aids risk 'cut by circumcision'

The evidence for this has been accumulating for quite some time now, and I'd say that the precautionary principle requires that it be taken on board in attempting to restrict the spread of HIV. A little prevention now is worth any amount of free anti-retrovirals down the line.

Men who have been circumcised may be six times less likely to contract the HIV virus than uncircumcised men, research carried out in India suggests.

The study in the Lancet journal says that the thin foreskin tissue could be highly prone to HIV infection.
The latest study, which backs up earlier research in Africa, was carried out among 2,000-plus men in India.
Researchers say circumcision only reduces the risk of HIV infection - other sexual diseases are not affected.
A number of studies have shown that circumcision appears to lower the chances of contracting HIV.

Different susceptibility

When Aids first began to emerge in Africa, researchers found that it was more prevalent in the east and south of the continent than in the west.
Differences in sexual behaviour were widely thought to be reason for this.
But some scientists argued that as circumcision was more common in west Africa, it could be reducing the risk of HIV infection, as the foreskin could be more susceptible to the virus than other parts of penis.
This latest research, looking at more than 2,000 men in India, suggests exactly that.

The actual Lancet article can be found here. Following is a summary of the paper's findings:

Circumcised men have a lower risk of HIV-1 infection than uncircumcised men. Laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. However, some data suggest that circumcision could simply be a marker for low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0·15; 95% CI 0·04-0·62; p=0·0089); however, we noted no protective effect against herpes simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1.

Perhaps this piece of news will bring an end to anti-circumcision crusades of the sort perpetuated in the past* by Andrew Sullivan. So what if circumcision leads to some hypothetical loss of sensitivity? There's more to life than sheer physical pleasure, particularly when the pleasure at issue is one that can't be missed, never having been experienced. In any case, circumcised men still seem to find enough pleasure in the sexual act to seek out copulative possibilities, so Sullivan and other opponents of male circumcision are making a big deal out of very little, while the consequences in increased mortality of paying heed to them are likely to be steep indeed. I suspect it's meagre consolation to a South African dying of AIDS in his mid-30s that at least he got to enjoy superior orgasms before prematurely shuffling off his mortal coil.

*Google fails to turn up a link to the original comment on Sullivan's website, indicating that he's since had the good sense to remove that particular post from the face of the earth; what's problematic is that none of the dummies who quoted Sullivan on the subject bothered to actually use a permalink to record where exactly he said it, while Sullivan himself doesn't seem to bother with a link to archives of his older posts on his website.