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

130 comments
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.

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

RodaBlize1
RodaBlize1

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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.

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. 



anonnymousa
anonnymousa

greater is in Dr Osemen than in those that condemn Dr Osemen and doubt his powers, i tested HIV POSITIVE when i contacted him for help, but after taking his herbal medicine for two weeks behold all my pains were gone now i am now HIV NEGATIVE. doubt him not so that you will he cure from the deadly disease.contact him for HIV cure on his email address: healinghomeofallsickness@outlook.com he that help me shall also help you. please sir keep your good work cause there are a lot of people out there that will need your help.once more i say a very BIG THANKS to you for curing me.BENARD

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.

HayleyDawnKolarik
HayleyDawnKolarik

Infant Circumcision- why you think it's done: 

1. God wants it done. FALSE. "God made you perfect and in his image." God wouldn't give it to us if he didn't want us to have it. Disfiguring the body is prohibited in many religions including Judaism, Islam, and Christianity. 

2. Foreskin serves no purpose. FALSE. Millions of years of evolution have given foreskin to every man and most mammals. Evolution doesn't make mistakes like that.

3. Babies don't feel pain. ARE YOU RETARDED? Babies feel pain more intensely than adults. 

4. Babies won't remember. YES AND NO. 'Repressed memory' is a more appropriate description: and some do remember. 

5. Circumcision reduces risk of std's. FALSE It INCREASES the risk. Foreskin is a mucus membrane. Mucus TRAPS pathogens - it HELPS prevent disease. 

6. For hygiene. MAKES NO SENSE. How lazy can you possibly be? Taking care of a bloody wound in a diaper is easier? What else shall we amputate to stay clean - perhaps the labia? 

7. A deluge of other equally random and ridiculous excuses. -Circumcision has probably had more claims of benefit than any other medical procedure in history: that alone should tell you something. 

Infant Circumcision - Why it's actually done: 

1. Infants cannot defend themselves. - How many sane men would submit to cutting off healthy bits of themselves (some of the most sensitive bits no less..) for no benefit and without painkillers? 

2. The circumcision room is one of the most profitable areas in a ho$pital. 

3. Shame / Guilt / Maintaining an image / Stockholm syndrome. - It is easier to maintain a lie, than to admit having done harm to your child (or one of your parents having done harm to you).

NancyWyatt
NancyWyatt

So tell me this... IF circumcision does reduce STD's & more specifically HIV, then why does the United States have the highest rates of HIV in the entire industrial world and ALSO  has the highest rates of Routine Infant Circumcision of all industrial nations as well?    Empirical data belies these studies.  Not to mention what you're not reporting.. in 10 out of the 18 Countries where these "studies" were performed their HIV are rising.  Finally.. since when are BABIES having sex?  Routine mastectomy would dramatically lower breast cancer rates yet there have been no "studies" on it nor is anyone reporting on it.  Why is that?


aliberaldoseofskepticism
aliberaldoseofskepticism

I'm pretty sure there are only three studies suggesting circumcision lowers the risk of HIV infection, one from Kenya, one from South Africa, and one from Uganda. The link in those studies isn't statistically significant. (None has an odds ratio less than 0.33 or greater than 3.0. The study with the best results, the one from South Africa, has an odds ratio of 0.4.)

The biggest issue is that circumcised men might decide they don't need no stinkin' condoms. It's even being marketed as a "natural condom". (Be very wary of anyone who says "natural".) Condoms, unlike circumcision, have an odds ratio of 0.02, which is well above the aforementioned threshold, which is statistically significant.

alejoperez
alejoperez

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

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.

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.


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.


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

@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!

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.

cameradulce
cameradulce

@HayleyDawnKolarik   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!

konyerer80
konyerer80

@HayleyDawnKolarik   I beg to differ with you. Circumcision is something good. I come from a tribe in Africa wherein infants are circumcised. It is a cultural practice that has and continues to serve the community. Men from my community are great and take good care of their women. 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.     

NaomiSmith
NaomiSmith

@HayleyDawnKolarik  "1. God wants it done. FALSE. "God made you perfect and in his image." God wouldn't give it to us if he didn't want us to have it. Disfiguring the body is prohibited in many religions including Judaism, Islam, and Christianity."

From someone who obviously has no clue about Judaism. God made us in his image, and then made a sacred covenant with Abraham to circumcise themselves and their sons.

There is no possible way that I could ever get you to understand this, so I won't waste anyone's time any further.

FStevief
FStevief

@HayleyDawnKolarikFor hygiene. MAKES NO SENSE. How lazy can you possibly be?


You obviously haven't had much experience with uncircumcised men. They are very lazy and they always smell regardless of whether they say they are clean. They after all are use to the smell, the rest of us are not. And if the penny hasn't dropped yet I am circumcised and also gay, so I think I know what I am talking about...lol


thn1010
thn1010

@HayleyDawnKolarik  

Sorry, but in modern times repeating a falsehood over  & over won't make it the truth. It might have worked in the early 20th century, but not anymore. You basically just took all those topics and answered them the opposite of what research says. 

John57
John57

@NancyWyatt  

Oh man, once it's said on the Internet it becomes the "truth" no matter how many times it gets shown to be wrong:

HIV in the US is spread mainly through IV drug use and being anal receptive.  Circumcision obviously

won't help either of these groups of people.

John57
John57

@aliberaldoseofskepticism  

The AAP included 231 studies which showed reduced rate of STI's in circumcised me.

The 3 studies in Africa were peer reviewed, subjected to stringent meta-analysis and are considered valid

beyond any reasonable doubt by the AAP, the CDC, UNAIDS, WHO and Cochrane.

But of course you know better.

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.


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.

aliberaldoseofskepticism
aliberaldoseofskepticism

And a good number of those males are in sub-Saharan Africa. So why do we think circumcision lowers risk of HIV again, when it's quite common in regions of the world where HIV is most prevalent? And those males are eschewing condoms because they've been told by the World Health Organization that they don't need condoms because they have a "natural condom". (Oh, "natural", the biggest woo word on the planet.) And the ads promoting circumcision talk of "conquering" (as a caption below a picture of four women). You're promoting condomless promiscuity. I...can't go along with that.

Also, do we have any actual proof of this latest claim? I mean, circumcision advocates have claimed alternately that the foreskin has more (the most common party line) or fewer (Weiss, 1993) Langerhans cells. Can't be both. They continued this canard after it was proven that HIV breaks down inside the Langerhans cell due to the action of langerin (de Witte, 2003).

bwanadik
bwanadik

@NaomiSmith @HayleyDawnKolarik 


Actually, your statement  "God made us in his image, and then made a sacred covenant with Abraham to circumcise themselves and their sons" is  true only in the sense that it was written in a book of fables.  Circumcision is irreversible, and much more likely would be  is exactly the thing a conquering people (Egyptians) might do to an enslaved people (Jewish) for control of the enslaved.  It is relatively easy to spot a recalcitrant slave  when all you have to say is "Drop Trou".  It is sad that folks of the Jewish persuasion adopted this practice and incorporated it into their beliefs. 


On a funny note (a sad, pathetic, funny note), both Jews and Moslems practice circumcision.  The irony here is that one religion that generally despises the other,  adopted the same genital mutilating practice as the other.


I do understand:  Some god told Jewish folks to mutilate their men to prove themselves worthy.  And some very disturbed individuals said "Okay, you betcha" and the practice of mutilating little boys began.  Very few within Judaism can contemplate the "why" of circumcision.  To do so would require the acceptance of 3,000 years of idiocy, which would then call into question just how vindictive and vengeful the "God of Abraham"  is/was, which would then call into question the complete insanity of "believing in gods" actually is.

AdVictoriam1
AdVictoriam1

@NaomiSmith@HayleyDawnKolarik It was required as a mark for national acceptance in the 12 tribes. However the circumcision of 2,000 years ago is not analogous to modern day stretching and cutting of the foreskin. There was no bell or removal of tissue from the glans, and whatever the situation or circumstances were in an ancient time, where survival as a group was the primary concern, the advent of Christ and the New Covenant negated the practice as obsolete ('circumcision of the heart' for the Gentiles). 


cosmopolite
cosmopolite

@FStevief @HayleyDawnKolarik It is trivial to spend 20 second washing the tip of the penis before entering the bedroom.

To say that intact men are too lazy to clean themselves and therefore should have their bodies surgically altered, patronises men in general and intact men in particular. Dirty smelly men should be rebuked. But their existence is not a reason to remove the foreskin. Some women leave something to be desired in the vulva hygiene department. The conclusion is not the surgical removal of the labia minora, but making the bidet universal.

Many gay men value the erogenous properties of the foreskin. A gay man has told me that over the course of his lifetime, he has been intimate with more than 1000 partners, and that he has never encountered a man who was disgusting under the foreskin. If the foreskin is retractable, a daily shower suffices.

aliberaldoseofskepticism
aliberaldoseofskepticism

That's interesting. I shower every morning, before any romantic entanglement, and at the gym both before and after a workout. If anything, people think I'm OCD. I'm also not circumcised.

cosmopolite
cosmopolite

@thn1010 @HayleyDawnKolarik Publishing in peer reviewed journal + author wears a white lab coat = Always true?

Sorry, but that simplistic equation does not always hold.

aliberaldoseofskepticism
aliberaldoseofskepticism

My irony meter just exploded. But you're right. The foreskin isn't a mucous membrane. It's just skin.

cosmopolite
cosmopolite

@John57 @NancyWyatt : You are bearing out Ms Wyatt's point: the reality of HIV on the ground in the USA, is such that routine circ is unlikely to reduce the transmission of HIV in that country.

cosmopolite
cosmopolite

@John57 @aliberaldoseofskepticism : A small group of of mostly American names dominates circ-HIV thinking at the CDC, UNAIDS and WHO. The AAP merely repeated the conclusions of those bodies. Nobody on the AAP's circumcision Task Force was an epidemiologist.

The African RCT's were not subject to stringent meta-analysis. Europe and Australasia do not agree that the RCTs tells us anything about whether boys and men in the First World should be circumcised.

To my knowledge, all studies claiming that circumcised men are are less likely to contract this or that STD use subjects from the Third World, or from the urban underclass in the First World. Such studies are not relevant to the vast majority of readers of this thread.