Why Circumcision Lowers Risk of HIV

Promising trials hinted that circumcision could lower rates of HIV infection, but until now, researchers didn’t fully understand why

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Promising trials hinted that circumcision could lower rates of HIV infection, but until now, researchers didn’t fully understand why.

Now, in a study published in the journal mBio, scientists say that changes in the population of bacteria living on and around the penis may be partly responsible.

Relying on the latest technology that make sequencing the genes of organisms faster and more accessible, Lance Price of the Translational Genomics Research institute (TGen) and his colleagues conducted a detailed genetic analysis of the microbial inhabitants of the penis among a group of Ugandan men who provided samples before circumcision and again a year later.

(MORE:  If Circumcision Rates Keep Falling, Health Costs and Infections Will Spike)

While the men showed similar communities of microbes before the operation, 12 months later, the circumcised men harbored dramatically fewer bacteria that survive in low oxygen conditions. They also had 81% less bacteria overall compared to the uncircumcised men, and that could have a dramatic effect on the men’s ability to fight off infections like HIV, says Price. Previous studies showed that circumcised men lowered their risk of transmitting HIV by as much as 50%, making the operation an important tool in preventing infection with the virus. Why? A high burden of bacteria could disrupt the ability of specialized immune cells known as Langerhans cells to activate immune defenses. Normally, Langerhans are responsible for grabbing invading microbes like bacteria or viruses and presenting them to immune cells for training, to prime the body to recognize and react against the pathogens. But when the bacterial load increases, as it does in the uncircumcised penile environment, inflammatory reactions increase and these cells actually start to infect healthy cells with the offending microbe rather than merely present them.

(MORE: Can New Circumcision Devices Help Fight AIDS in Africa?)

That may be why uncircumcised men are more likely to transmit HIV than men without the foreskin, says Price, since the Langerhans cells could be feeding HIV directly to healthy cells. His group is also investigating how changes in the levels of cytokines, which are the signaling molecules that immune cells use to communicate with each other, might be influenced by bacterial populations.

“There is a real revolution going on in our understanding of the microbiome,” says Price, who is also professor of occupational and environmental health at George Washington University. “The microbiome is almost like another organ system, and we are just scratching the surface of understanding the interplay between the microbiome and the immune system.”

Previous work suggested that changes in the bacterial populations in the gut, for example, could affect obesity, and other studies found potential connections between microbial communities and the risk for cancer, asthma and other chronic conditions.

MORE: Study Identifies Four New Genetic Markers For Severe Childhood Obesity

156 comments
LadyShadetree
LadyShadetree

There are many reasons for the high rates of heterosexually-transmitted HIV in Africa, of which circumcision is just one.  Genital ulcer diseases like herpes and chancroid are another.  Mass urbanization that happened during colonialism is yet another.  Unsterile injections also played a role in the colonial days when vaccine needles and hypodermic syringes were reused hundreds of times.  And let's not forget the dangerous practice of eating bushmeat, which is also responsible for the rise of Ebola. 

If you have an axe to grind about circumcision, grind it elsewhere.  This is not the first or only study to show the benefits of circumcision.  As stated in the article, people should take a multi-faceted approach to HIV prevention.  Nobody said circumcision was a substitute for condom use or other safe sex methods.   

MichaelHarrington2
MichaelHarrington2

Unfortunately, uncircumcised guys have to deal with a constant bacteria build-up inside of their foreskin.  If not controlled, this bacteria can cause an unpleasant odor, an infection, or worse.  Its pretty simple though fellas....keep things clean down there and you shouldn't have a problem.  Make sure you retract your foreskin and wash with soap and water every day.  I would add a penis health creme that contains Vitamin A to your daily routine as well.  This creme will assist you in the fight against foreskin bacteria. Easy to use and totally effective.  Hope this helps and good luck. 

BiancaGastelum
BiancaGastelum

Themeatal opening on penis is just as mucosal as foreskin!! Circumcision is NOT a vaccine against aids!!!

BiancaGastelum
BiancaGastelum

The meatal opening is just as mucosal as the foreskin... Circumcision is Not a vaccine against aids!!!

adael.birth.doula
adael.birth.doula

The microbiome is surely interesting, but its alarming that the people were promoting the circumcision campaign before they had evidence as to the reason it could work. I am tired of African men being offered as the world's biggest experiment on prophylactic foreskin removal and an excuse to continue to hurt infant males in the US; for it offers no protection against HIV to our men as compared to uncircumcized men in the developed, Western world. Plus, these men in Africa are voluntary subjects of the campaign. Infant boys are circumcised for the preference of their parents, which is no reason to remove healthy tissue. At least as it pertains to infants in the West, circumcision is medical ritual, not medical treatment. It is an aberration that anyone other than a urologist may do this surgery on anybody other than a male experiencing a chronic problem with his penis. We are right to cringe when we hear about female circumcision, how it can even be done by non-medical professionals with no training in gynecology in certain parts of the world, and how women with missing parts of their external genitalia experience less sensation and pleasure during their sexually active lifetime. We need to apply the same gut-chuck reflect against doing this to infant boys before they are able to cope with the sacrifice of their own anatomy. The men in Africa, convinced that they are doing the right thing for their health, have the benefit of self-determination and the self-esteem boost that making your own choices provides. Infant boys do not feel that way; it hurts them, and they cry, and they have to heal from it without knowing the reason for the hurt.  

PhoenixOFentse
PhoenixOFentse

The men in Africa , The men in Africa , The men in Africa. Have u been here? People in Africa don't circumcise for HIV - it's been a cultural practice before the colonail power and oppression. On the AIDS thing I cannot comment as I'm not qualified enough

marylanser
marylanser

This is ridiculous! What do men in Uganda have to do with the rest of the developed world? Nothing. The only protection proven worldwide to be effective in preventing transmission of HIV is use of condoms. Who are they trying to kid?

BradGrant1
BradGrant1

Circumcision doesn't prevent HIV.

MorrisNancy
MorrisNancy




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JohanManyakol
JohanManyakol

I love all the "most probably, could be, should be, may be, probable connections", etc in this so called research. There is not one fact. Go read a bit about this 60% reduction in HIV infection. The way it was done was done to suit the required outcome. No research facility of importance will link their name to these figures.This "circumcision to help fight HIV" is going to get the entire Africa HIV positive. Remember most people on my continent do not have a high level of education, things that make medically sense to an average High School student is a foreign concept to the vast majority of Africans. It took decades to convince them to wear condoms, now this nonsense with circumcision is convincing these people that they do not require condoms any more. This will, in the long run, cause HIV to be spread even wider and it will lead to an increase in births, putting yet more strain on health resources. A simple campaign, as was tried in one of the countries with massive success, of teaching people and re-affirming moral values is cheaper and more effective, but no American company is making money out of this, so it will not be done. Infant circumcision is, in my opinion, medical malpractice if it is done for "preventative" reasons.    1 in 77 neonatal male deaths in the USA is because of circumcision related reasons. This figure is well hidden, since usually parents are blamed for not taking proper care of the penis after circumcision or some or other aspect like bleeding of the penis, complications during surgery (trying to fix a botched circumcision)etc. This is similar to that school of thought in South Africa where a doctor may not say a person had died of HIV/AIDS. He has to say they died from some or other decease like TB. Thus no one in South Africa has ever died of AIDS. If you cannot convince the government of the most advanced country in Africa that AIDS kills, how are you going to convince a rural African, after having a circumcision to help prevent HIV, to wear a condom? i live with these people and they think this is a license to really step things up because they are now immune. Well once again someone in the USA is getting rich of Africa's back.


RichardGindes
RichardGindes

@JohanManyakol This is not the only study showing the health implications of circumcision and this is not a medical journal, try reading one...

vikingrxcom
vikingrxcom

saying that a circumcised penis vs non and saying that bacteria levels are the reason they can fight aids is not scientific. You need better facts to support this post Vigrx.

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jacnorectangle
jacnorectangle

circumcision in africa is not a good idea because many hospitals don't have access to sterile equipment. that is probably the main cause of HIV in africa. it's a racist myth that african HIV is fuelled by promiscuity. consider the difference between the U.S. and africa. why would straight people over here be free of HIV but not over there? what are we doing differently? it's because our hospitals are very careful about sterilizing tools. this study shows that boys are getting HIV from the circumcision procedure itself: http://www.webmedcentral.com/article_view/2206. and now many africans think that cut men are immune to HIV and don't need to wear condoms. having unprotected sex with a freshly wounded penis that was cut by an unsterilized knife is a recipe for disaster. 

ShpongleEyez
ShpongleEyez

Let's focus on the real victims here. The voiceless, defenseless, innocent children who are mutilated every day all round the world.

I don't understand how someone can think cutting a piece of your body, or your child's body and not just any part of the body, but the most sensitive, nerve riddled, intimate, private part of the body is not bodily harm.

IF IT WASN'T BODILY HARM, YOU WOULDN'T BLEED !

Blood means harm. Blood always means harm, how can people be this stupid...well it's not really a question of how it's more a question of how come in this day and age, there are people that still do this to children that aren't even old enough to speak for themselves yet.

Insanity. Pure insanity.

chrisdack1981
chrisdack1981

@ShpongleEyez  So menstrual cycle is " bodily harm "  ? They are not talking about female gentile circumcision . I'm guessing your either left wing nut or religious crazy

14.23.b.i.g
14.23.b.i.g

@chrisdack1981

That is a straw man if I ever saw one. Oversimplifying Eyez's argument and creating an easy to counter response as "menstrual cycle is bodily harm". Yes, menstruation is bodily harm. It is the sloughing off of the inner walls of the uterus. Implying that something that does not seriously harm someone is not bodily harm is wrong. And to imply that circumcision is not an unnecessary procedure is pure ludicrous. Also, love the ad hominims. 


Circumcision removes the main erogenous zone of the penis, the frenulum. 

Circumcision removes the protecting layer of the glans, hardening it and removing sensitivity.

Circumsision removes 20,000 nerve endings from the penis. Twenty thousand.




Agendum
Agendum

You still have to wear a condom silly people. Circumcision does not make you immune to HIV nor does it prevent wet dreams or spinal paralysis. The HIV claim is just another desperate attempt to justify an outdated ritualistic tribal practice as these excuses have been following another for the last two centuries.

Too bad no one sees that this is just an attempt to grab children's' valuable tissues for other biotech reasons, so called medical "wa$te."

wjohnatty
wjohnatty

Western Medicine is not science in the same way that particle physics, bio chemistry or astronomy is a science. Today medicine cannot tell us whether eggs, bacon and steak is causing us to become ill. And it appears that everything that we were told about heart disease and diabetes over the past several decades is going to be put in trash. Then there's psychiatry that has its host of issues most of which is that its basically unscientific from its diagnosis, its etiology to its treatment (most psychiatric drugs use the placebo effect).


I dont buy what the AAP is saying about circumcision and its benefits the same way i would reject the idea that if you sew up a girl's vagina it will certainly reduce the risk of cancers and HIV. Circumcision is morally wrong and to say it isn't is corruption of the highest order that the US and the UN is participating in the 21st century. We know why US authorities has to support circumcision, and hence why the UN is pushing it. Just dont call it science.

abqdan
abqdan

So we'll circumcise babies because when they become adults, they might have unprotected sex with another adult who whas HIV? That's ludicrous. The only protection against HIV infection is consistent use of condoms when having sex with multiple partners. The WHO failed to sell the idea of condoms in Africa, so now they are trying to sell the kits required for infant circumcision. 


When the penis is cared for properly, there is no increased risk. Take a look at the HIV rates in the US and other western countries where circumcision is uncommon. There is actually a HIGHER transmission rate in the US, despite the high circumcision rate.

cameradulce
cameradulce

The answer is simple people, but the problem "why" you don't understand is your ignorance. (Sorry for that)

You may ask WTF?

Islam says: A BOY MUST BE CIRCUMCISED. (A word from QURAN is only for the good favor for us).
You can see that circumcion prevents hiv, and too many STD's.

Everything is in that book has a reason WHY. But science is confirming the question "WHY?".

I'm a muslim (proud to be) and thanks to this fact, I am circumcised male. 


People, every development that was done is a confirmation from the QURAN (google some proofs: ex. how the baby is created from semen,,the sea's watter never mix, circumcion and hiv, and too too many other facts)

People start reading the QURAN with your heart and you'll understand the truth. Make it to save your self not mine.


Allah bless you!  SALAM!

Queen
Queen

I just - as a woman - would like to agree with those who say that uncircumcised men smell no matter what. They do! I would never go back to an uncircumcised man again! I have tried a couple of both... Also, if you have ever lived in a warm area you know how boarding school boys have problems with their hygiene if they are not circumcised. Some even get maggots! Yes, maggots down there..... EW! Have heard enough personal experiences about that. It has been proven that it helps reduce the risk of HIV with up to 60% and other STDs as well. Worth considering, especially in certain countries. However, in Africa most are not circumcised as infants but as young teens. Many are rather proud of it! Some say the penis gland becomes less sensitive after circumcision - with the circumcised men I have been together with, I have the opposite impression for sure. Maybe because they were not circumcised as infants - I don't know.

Foreskin is not a mucus membrane - it's just skin! About the religious or cultural importance of this, I will not even begin to explain.

@HayleyDawnKolarik

FelixGarfield
FelixGarfield

@Queen  And I'm sure you always smell like a rose garden, Your Majesty. But since the penis is not a "gland" (do you mean "glans"?) and the inner lining of the foreskin does include a mucous (not "mucus") membrane, may I suggest you pick up an anatomy textbook before trying to "begin to explain" anything else to us.

14.23.b.i.g
14.23.b.i.g

@Queen The same thing in regards to maggots can happen to a vagina


https://www.youtube.com/watch?v=UVIL2VumGik


>reduces by 60%

You know what doesn't mutilate the penis and nets you a higher chance of not getting HIV? Using a condom and being monogomous


>the circumcised men I have been with opposite impression


Yeah, i'd like to talk to these guys. Cause all the ones i have talked to on restoringforeskin . o r g have said otherwise. 


>Just skin

You are straight up ignorant. Please educate yourself.


I would never advocate for the removal of breast tissue of every female despite there being an incidence rate of 231,840 for breast cancer. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics 

(wouldn't do cause you can catch breast cancer and treat only those that get it.)


While you advocate for the removal of tissue from males to reduce an incedence rate of 50,000 for HIV

http://www.cdc.gov/hiv/statistics/basics/ataglance.html

(wouldn't do circ cause you can just use a condom and be more choosy of your sexual partner)


alejoperez
alejoperez

@Queen  Hygiene is key, both in the male and female, a female organ "DOES SMELL IF LEFT UNWASHED"

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wjohnatty
wjohnatty

@RodaBlize1  Seriously??? YOu are a teacher in the United Kingdom? What do you teach - African colloquial English?

cameradulce
cameradulce

@RodaBlize1  I know, people like you are there only to steal money.

Nobody is going to trust you. But please kid don't make those things here.


killer.nate
killer.nate

Please consider my thoughts on this issue:  They forgot to mention that circumcision is extremely painful and that such an excruciating experience to a little baby will physiologically affect that person for the rest of their life.   Circumcision is a lose/lose for those it's forced upon.  Even if the person grows up and is completely okay with their circumcision, they will live in denial, and express their unknown frustrations in ways that we as a society don't even understand yet....   If they are not okay with their circumcision, well then they still have to live in frustration because they know something was taken from them that they will never fully gain back. Circumcision never wins,  if someone (an adult) wants to be circumcised then go right ahead and let them.  But babies never want to be circumcised, they never have and never will want to be circumcised.

konyerer80
konyerer80

@killer.nate  I beg to differ with you. Circumcision does win and it is something good. I come from a tribe in Africa wherein children are circumcised. No child has ever died of it and no one lives to be traumatized. Men from my community are among the best on the continent. They are innovative, creative, productive, and adventurous. I think, there is something great about circumcision and would encourage the practice especially on infants. Come to think of it, a circumcised penis looks good and much easier to handle than an uncircumcised one.      

cameradulce
cameradulce

@killer.nate  You are wrong mon ami. I am circumcised from my age 10. And I never had any problem. You feel better when circumcised, even more protected. Trust me. This is an obligation for Islamic religion and it should be for every religion.


Paletero_
Paletero_

@konyerer80 @killer.nate 
Perhaps but it shouldnt apply to everyone, DDT is also used in African tribes as a last resort against malaria but I wouldn't use it here where luxury of less harmful pesticides can be used.
and the matter of uncut verses cut depends...some can have an ugly scar others not...for uncut some can have too tight a skin or too much or just right.


lawrencenewman110379
lawrencenewman110379

The only way circumcision reduced my chance of contracting HIV was by destroying my sexual sensitivity completely, so I ended up opting out of sex because I simply cannot derive any pleasure from it.   I have no idea why so many people want to defend this genital mutilation which is EXACTLY THE SAME AS FEMALE GENITAL MUTILATION.  


You'd have to be a moron to believe that circumcision reduces the risk of STDs.  The only reliable way to assess this would be to create a control experiment with two groups of people under observation who have sex with HIV-infected people at measured time intervals.  There are far too many confounding variables to draw any conclusions from these methodologically flawed studies.  It's simply another excuse that the pro-circ rapists and paedophiles are using to justify what is sexual assault. 


My parents and I were duped by the National Health Service in the UK when I was 14.  We were told I needed a circumcision due to a tight foreskin. I subsequently found out that circumcision is never necessary for a tight foreskin, and in fact there is not one justifiable reason for the practice. I, nor my parents, provided informed consent, as we were never told that it would destroy all my erogenous tissue, anaesthetise my penis and thus remove all sexual pleasure from me for life.   


I'm suicidal because of what they did to me.  IF you support circumcision, you are a rape advocate, plain and simple. 



cameradulce
cameradulce

@lawrencenewman110379   

The answer is simple, but the problem "why" you don't understand is your ignorance. (Sorry for that)

You may ask WTF?

Islam says: A BOY MUST BE CIRCUMCISED. (A word from QURAN is only for the good favor for us).
You can see that circumcion prevents hiv, and too many STD's.

Everything is in that book has a reason WHY. But science is confirming the question "WHY?".

I'm a muslim (proud to be) and thanks to this fact, I am circumcised male. 


People, every development that was done is a confirmation from the QURAN (google some proofs: ex. how the baby is created from semen,,the sea's watter never mix, circumcion and hiv, and too too many other facts)

People start reading the QURAN with your heart and you'll understand the truth. Make it to save your self not mine.


Allah bless you!  SALAM!

anonnymousa
anonnymousa

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BradGrant
BradGrant

Asia has low rates of circumcision and low rates of HIV. Explain? Do it now.

BradGrant
BradGrant

What did I just read? This isn't science.

NigelOswyn
NigelOswyn

What else can one expect from a "news" magazine owned by a people who use it as a means to validate the scars on their genitals?  If they suddenly realised their centuries old crime of male infant genital cutting, they would have to own up to the fact that they are nothing more than promoters of child abuse.  They have to find excuses to keep cutting in order to make cutting okay in their superstitious minds.

Eighty five percent of males internationally are intact and not queuing up to have their bits altered.  They are not complaining, and neither are their partners.  The time is long overdue for men to take back their bodies and end the cycle of abuse that male genital mutilation, euphemistically known as "circumcision," is.  Men have the right to grow up with intact genitals and decide how they want to prevent HIV, even if this pseudo science were true.  How many people conducting these so called "studies" have scars on their genitals?  Are they willing to offer themselves up for cutting if any of them are intact?  I doubt it.

thn1010
thn1010

@NigelOswyn 

 "Eighty five percent of males internationally are intact and not queuing up to have their bits altered."

- Misinformation as usual. The global circumcision rate is estimated to be as high as 37.4%, while WHO estimates 30%. Meaning every third male on this planet is circumcised. Your numbers are ridiculous even compared to anti-circumcision organizations, going through a few of them I found some claim of 20%  and that lacked any references.

cosmopolite
cosmopolite

@thn1010 @NigelOswyn : No one has ever asked a careful stratified large random sample of men from around the world to down trousers and have their penises gently tugged on to determine circ status. Circ is also not a binary, but a continuum. Some men were circumcised but have a lot of foreskin left. Some men never went under the knife, but have short foreskins that leave the glans mostly or entirely exposed when they are flaccid.

So we will never know how many men around the world are circumcised. It is true that intact men in intact cultures seldom ask for circumcision unless WHO and UNAIDS bang the drum claiming that circumcised men are less likely to catch AIDS.