04 November 2008

Circumcision not yet stopping HIV

Circumcised men in South Africa are currently as likely to be HIV-positive as uncircumcised, according to a study.

Circumcised men in South Africa are currently as likely to be HIV-positive as uncircumcised, according to a study in the latest edition of the SA Medical Journal.

Its publication comes amid growing calls for governments to promote voluntary circumcision as a tool in the fight against the disease. The study was conducted by staffers from the Medical Research Council and the Human Sciences Research Council.

They said the removal of the foreskin reduced the probability of HIV infection. However just over 40% of the men in their sample of 3 025 got circumcised only after their first sexual activity. Of those circumcised after their 17th birthday, two thirds were sexually active before circumcision.

"HIV prevalence was equal among circumcised and uncircumcised men (11.1% vs. 11%)," the researchers said. When they looked only at the sexually active men in the sample, circumcision still showed no protective effect.

"The first key finding from this study was that male circumcision does not appear to be protective against HIV infection among men in South Africa, irrespective of whether they are sexually active or not," the researchers said.

Circumcision not a 'magic bullet'
There was a clear need for more research on the feasibility of a policy of mass circumcision in communities where traditional circumcision "may be done too late to offer the maximum protection, and the long-term protection of circumcision may be eroded by risky sexual behaviour".

One of the researchers, MRC statistician Catherine Connolly, told Sapa that though circumcision itself reduced the chances of HIV infection, it was "not a magic bullet".

"If you have multiple concurrent partners, eventually you'll probably sero-convert," she said. Any mass circumcision programme would have to be one aspect of a multi-dimensional programme that also looked at aspects such as attitude and behaviour.

Circumcision is practised as a traditional coming-of-age ritual by a number of ethic groups in South Africa, including the Venda and Xhosa. Some of South Africa's leading experts on HIV earlier this year called in a medical journal for urgent action to make circumcision part of the arsenal against the disease. – (Sapa, November 2008)

Read more:
Circumcision only stops some STIs
Circumcise against HIV: study


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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