Human Immunodeficiency Virus
There is strong evidence that circumcision reduces the risk of HIV infection in heterosexual men in high-risk populations. Evidence among heterosexual men in sub-Saharan Africa shows a decreased risk of between 38 percent and 66 percent over two years, and in this population studies rate it cost effective. Whether it is of benefit in developed countries is undetermined.
There are plausible explanations based on human biology for how circumcision can decrease the likelihood of female-to-male HIV transmission. The superficial skin layers of the penis contain Langerhans cells, which are targeted by HIV; removing the foreskin reduces the number of these cells. When an uncircumcised penis is erect during intercourse, any small tears on the inner surface of the foreskin come into direct contact with the vaginal walls, providing a pathway for transmission. When an uncircumcised penis is flaccid, the pocket between the inside of the foreskin and the head of the penis provides an environment conducive to pathogen survival; circumcision eliminates this pocket. Some experimental evidence has been provided to support these theories.
The WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) state that male circumcision is an efficacious intervention for HIV prevention, but should be carried out by well trained medical professionals and under conditions of informed consent. The WHO has judged circumcision to be a cost-effective public health intervention against the spread of HIV in Africa, although not necessarily more cost-effective than condoms. The Centers for Disease Control and Prevention (CDC) has calculated that newborn circumcision is cost-effective against HIV in the US. The joint WHO/UNAIDS recommendation also notes that circumcision only provides partial protection from HIV and should not replace known methods of HIV prevention.
The available evidence does not indicate that circumcision provides HIV protection for heterosexual women. Data are lacking regarding the effect circumcision may have on the transmission rate of men who engage in anal sex with a female partner. It is undetermined whether circumcision benefits men who have sex with men.
Read more about this topic: Sexual Effects Of Circumcision, Effects, Sexually Transmitted Diseases
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