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A Sydney epidemiologist has reacted forcefully to a study showing that male circumcision may play a part in preventing HIV infection.

Andrew Grulich, senior lecturer in epidemiology at the National Centre in HIV Epidemiology and Clinical Research [

NCHECR], told Sydney Star Observer, “We need to be careful not to change our educational message.”

The Melbourne study, published recently in the British Medical Journal, appears to show that circumcision provides “significant protection” against HIV infection by removing receptor cells from the inner surface of the foreskin. The Melbourne research team found the most telling evidence from a study of Ugandan heterosexual couples, where each woman was HIV-positive and her male
partner was not. Over a 30-month period, 40 of 137 uncircumcised men became infected compared with no new infections among 50 circumcised men.

However, while welcoming the study’s findings which could lead to the development of creams to block the uptake of HIV, Grulich said, “You can’t extrapolate from that, and from the African data, and say that circumcision is an effective way of preventing HIV infection.”

He said little research had been undertaken on the role of circumcision and protection against HIV in developed countries.

“Even in Africa, the protective effect of circumcision is nowhere near as effective as wearing a condom. Using a condom every time will protect you against HIV infection, whereas the protection of circumcision is uncertain at best.”

Grulich said that a joint research project between NCHECR and the National Centre in HIV Social Research would provide much-needed data on the role of circumcision and HIV protection among gay men. The research, as yet unpublished, included a question relating to circumcision in interviews with newly-infected gay men between 1993 and 1999.

“There’s no difference between the two groups [circumcised and uncircumcised] which strongly suggests circumcision doesn’t protect against HIV infection in gay men.”

See also:

Circumcision and HIV infection: Review of the literature and meta-analysis

Published in 1999 in the International Journal of STDs and AIDS, this review of the combined raw data finds that a man with a circumcised penis is at greater risk of acquiring and transmitting HIV than a man with a non-circumcised penis.