Circumcision in Baby Boys Prevent Heterosexual HIV Transmission

Male circumcision is one of the most powerful interventions that is currently available in the fight against HIV, according to an article published in the Medical Journal of Australia.

Dr Alex Wodak, Director of Alcohol and Drug Service at St Vincent’s Hospital, Professor David Cooper, Director of the National Centre in HIV Epidemiology and Clinical Research, and Professor Brian Morris, Professor of Molecular Medical Sciences at the University of Sydney discuss introducing circumcision as a long-term strategy to reduce heterosexual HIV transmission.

Circumcision
The prepuce or the foreskin, which covers the tip of the penis, is removed during a circumcision. The procedure does not exceed ten minutes and is done under the effect of a local anesthetic.

Dr Wodak said that Australia should change policy so that infant male circumcision rates are boosted in the face of rising heterosexual transmissions of HIV.

“A wealth of research has shown that the foreskin is the entry point that allows HIV to infect men during intercourse with an infected female partner,” Dr Wodak said.

“Soon after the HIV pandemic was first recognised, much lower HIV prevalence was found in areas of sub-Saharan Africa, where more than 80 per cent of males had been circumcised than in areas where the circumcision rate was less than 20 per cent.

Circumcision - Phimosis
Simple steps depicting surgical removal of foreskin.

“Circumcision of males is now referred to by many as ‘surgical vaccine’ against a wide variety of infections and adverse medical conditions over the lifetime.

“The public health benefits include protection not just from sexually transmitted HIV, but also from some common sexually transmitted infections and other conditions.

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“The prospect of the availability of a vaccine over the next 20 years is unlikely. Thus, circumcision now to prevent heterosexual HIV transmission in 2030 makes sense.

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“It should be viewed as part of a safer sex package. Condom use remains essential, with promotion of condom use plus circumcision of males being analogous to seatbelts plus airbags for reducing the road toll.

“Twenty-nine years after the existence of this epidemic was first announced, it is clear that a new chapter has opened with the recognition that male circumcision substantially reduces female-to-male HIV transmission.

“Australia would be wise to take advantage of this knowledge,” Dr Wodak said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source-MJA