Circumcising HIV-infected males may offer no protection against transmitting the virus to their HIV-negative female partners, according to a study presented Sunday at the 15th Conference on Retroviruses and Opportunistic Infections in Boston.
In recent years, three male circumcision studies in South Africa, Kenya, and Uganda showed the procedure reduced female-to-male HIV infection risk by 50-60 percent. And last year, the World Health Organization endorsed male circumcision among other HIV prevention strategies.
Some AIDS experts also believed circumcision of infected men could protect female partners. And if fewer circumcised men got infected, that could also benefit their sex partners, said a co-author of the new study, Dr. David Serwada of Makerere University in Kampala. The study was a collaborative effort by researchers from Johns Hopkins and Uganda.
The trial enrolled 1,015 HIV-infected men from an area with high HIV/AIDS incidence who agreed to be randomly assigned to undergo circumcision immediately or in two years. The presentation focused on 161 serodiscordant couples, among them 93 immediately circumcised men and 68 male controls. In both groups, the incidence of transmission was highest in the first six months of follow-up - 27.3 in the circumcised group and 17.8 in the control group. During the rest of the study, the incidence was 5.7 in the circumcised arm and 4.1 in the control group.
The study confirmed circumcised men had a lowered incidence of herpes and other genital ulcers. The higher HIV incidence occurred among couples who began having sex more than five days before a trained health expert certified the circumcision wound had fully healed. However, these numbers are so small that the findings are statistically insignificant, leaving the issue in need of further study, said study co-author Dr. Maria Wawer of Johns Hopkins.
02/04/08
UGANDA: Male Circumcision No Aid to Women in Study
Source: New York Times:: Lawrence K. Altman; Courtesy of the CDC National Center for HIV, STD, and TB Prevention