Circumcision as a Weapon Against HIV

Concern is growing among health care professionals over the increasing trend against male circumcision, a practice that they say could avert more than 20 percent of new HIV infections by 2020, saving an estimated US$16.6 billion in future medical costs.

On May 7, 2012, a regional court in the western city of Cologne in Germany found that the circumcision of under-age boys for religious reasons was an unlawful act that caused bodily harm. Although the decision has no binding force on other courts, the decision has sparked uncertainty not only among health professionals but in Jewish and Muslim communities because male circumcision is a widely accepted religious rite.

Although the World Health Organization has estimated that some 665 million males aged 15 and older are circumcised, 70 percent of them Muslim, the numbers have been declining in many first-world states including the United States, Canada, the United Kingdom, New Zealand and Australia, although voluntary medical circumcision has been rising in South Africa, the epicenter of the HIV problem.

The practice of circumcision is undeniably painful since it involves moving the flap on skin on the head of the penis, perhaps the most sensitive part of the mail body. Arguments against the practice have been growing since the 1970s because of a belief that it causes psychological trauma that could affect the child later in life, and that the flap of skin is an important conductor of pleasure for uncircumcised men.

The Bill and Melinda Gates Foundation is supporting the wider use of circumcision its propagation and the World Health Organization is being urged to do the same, with critics arguing that any such campaign carries with it the real danger that societies in Africa, where the AIDS prevention efforts are mostly focused, will result in the large scale circumcising of infants who have no choice in the matter.

It should be noted that female circumcision has nothing to do with health. It is nothing more than the practice of female genital mutilation and is a gross insult to womanhood. It stems from male fears of women’s sexuality and usually involves cutting out the clitoris, which is enormously painful though milder versions which only involve trimming the labia may have no more effect on ability to be aroused than the male counterpart.

More than 40 observational studies among heterosexual men, however, show that circumcised men have about a 60 percent reduced risk of HIV compared to uncircumcised men. Three randomized controlled trials were conducted in Sub-Saharan Africa that showed circumcised men were at 60 percent less risk of HIV than uncircumcised men.

Thus the health benefits appear undeniable. “All these three trials were stopped by independent Data Safety Monitoring Boards as the effect was so strong and it was thought unethical to not offer circumcision to men in the control arm," had said Dr Helen Weiss, Reader in Epidemiology and International Health, The London School of Hygiene and Tropical Medicine (LSHTM) in an exclusive interview to Citizen News Service (CNS) at AIDS Vaccine 2011. Read more.