Male circumcision to prevent HIV infection

Male circumcision is the surgical removal of the foreskin of the penis.

There is now compelling evidence that male circumcision reduces the risk of acquiring HIV infection in men through heterosexual sex by approximately 60%. In other words, male circumcision reduces the risk of HIV transmission through sexual contact between a man and a woman.

In 2011, the World Health Organization (WHO) and the United Nations on HIV/AIDS (UNAIDS) stated that male circumcision is an effective procedure for preventing HIV infection if performed by a surgeon in a safe environment, as circumcision reduces the risk of HIV infection and other sexually transmitted infections (STIs) from an infected partner.

Experimental evidence supports the theory that Langerhans cells (part of the human immune system) in the foreskin may be a source of entry for the human immunodeficiency virus. Circumcision of the foreskin removes the main entry point for the HIV virus.

There are also several biological explanations for why removing the foreskin may reduce the risk of contracting HIV:

  • the foreskin is vulnerable to microcracks or inflammation that appear during sex, and can facilitate the penetration of HIV infection through the skin into the body;
  • the inner part of the foreskin has a high concentration of immune cells that are vulnerable to HIV infection;
  • HIV can survive much longer if it gets under the foreskin;
  • Removing the foreskin reduces the chance of contracting STIs that cause sores or inflammation (such as herpes or syphilis) that facilitate the transmission of HIV.

An HIV-negative man with a circumcised penis also has a reduced risk of infection from anal sex. One study found a 20% risk reduction for HIV-negative gay, bisexual and other men who engage in anal sex.

However, it is worth saying that penile circumcision in HIV-positive men does not reduce the risk of transmitting the virus to other sexual partners.

Thus, male circumcision provides only partial protection from HIV infection and other STIs and should be only one element of comprehensive HIV prevention, which includes:

Read about other ways to prevent HIV infection in our article: “Basics and recommendations for HIV prevention.”

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