Circumcision reduces risk of HIV-1

Pune, Jan 7 (UNI) Circumcised men have a lower risk of HIV-1 infection than uncircumcised men, as per finding of observational studies at the National Aids Research Instititute (NARI) here and corroborated by clinical trials in some African countries.

''Researches observing circumcised men as against the uncircumcised were one of the many variables in the study of HIV-AIDS,'' NARI's Director Dr R S Paranjpe told UNI.

According to Deputy Director NARI Dr Sanjay Mahendale, circumcision is essentially a biological phenomena.

In his research paper on the study published in ''Lancet 2004'', he stated that laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. Some data also suggests that circumcision could simply be a marker for low-risk behaviour.

In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, ''it was noted that circumcision was strongly protective against HIV-1 infection. There was, however, no protective effect against herpes, simplex virus type 2, syphilis, or gonorrhoea. The specificity of the relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1'', Dr Mahendale said.

Some investigators have argued that circumcision is simply an epidemiological marker of reduced behaviours related to risk of HIV-1 infection, including religious and cultural factors. Others have suggested that circumcision reduces the risk of other sexually transmitted diseases associated with genital ulceration or mucosal inflammation, which secondarily reduces the risk of HIV-1, said he added.

Circumcision has also been postulated to reduce the risk of HIV-1 by removing a possible entry point of the virus-the thinly keratinised mucosa of the inner foreskin and its HIV-1 target cells.

It was aimed to investigate the association between circumcision and infection with HIV-1 and other sexually transmitted infections (STIs).

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