On December 13, 2006, the U.S. National Institutes of Health (NIH) declared that male circumcision significantly reduces the risk of acquiring the HIV virus. Now, some physicians and news media outlets are promoting circumcision as a possible "vaccine" for AIDS. This question and answer page is an attempt to dispel the myths and assumptions surrounding these reports by presenting the facts.
How did male circumcision and AIDS first become linked?
The association between circumcision and AIDS began in 1986, when the late California urologist and circumcision promoter Aaron J. Fink proposed that the keratinization damage caused by male circumcision would prevent HIV infection. A number of studies on the subject have been conducted in Africa since that time.
Does male circumcision actually help prevent HIV/AIDS?
Studies linking male circumcision and AIDS are conflicting. Two studies completed in 2006 in Kenya and Uganda concluded that male circumcision had a 48% - 53% protective effect against HIV over a 14 month period, and an earlier published Auvert Study (criticized for having methodology flaws and overly optimistic conclusions) found that circumcision reduced HIV transmission in South African men by 63% over a period of 21 months. The multi-country Mishra study concluded that circumcision may actually increase transmission of the AIDS virus, however, which is what many earlier studies found. The Brewer Study, published in March 2007, also concluded that circumcision in Kenya, Lesotho, and Tanzania increases the transmission of AIDS, and the Connolly study published in November 2008 found that circumcised men in South Africa are just as likely to be HIV-positive as uncircumcised men.
What about female circumcision and AIDS?
The relationship between female circumcision and AIDS has also been studied, with similar conflicting results. The Stallings Study found that female circumcision reduces transmission of the AIDS virus, while other studies have shown that it increases transmission.
Has America's high rate of male circumcision helped prevent HIV/AIDS in the USA?
The United States has one of the highest rates of male circumcision and also one of the highest rates of HIV infection in the developed world, suggesting that circumcision is not helping. Conversely, Finland and Japan have some of the lowest rates of circumcision and also some of the lowest rates of HIV/AIDS. In Australia, the AFAO has now concluded that male circumcision has no role in the Australian HIV epidemic.
Should men be allowed to undergo circumcision?
If a fully informed consenting adult feels that circumcision is right for him, then that's a personal choice he should be allowed to make. In practice, though, most circumcisions are forced onto others against their will, and even voluntary adult circumcision is likely to do more harm than good.
What about children? Should doctors be allowed to circumcise infants and boys if future studies conclusively show that male circumcision helps prevent AIDS over the long term?
If doctors are granted permission to cut off part of a child's functional genital anatomy because it might help prevent a disease later in life, then there is no limit to the number of body parts that they can amputate. They could argue that child mastectomy would wipe out breast cancer, for example, and that partial castration would reduce the incidence of testicular cancer. Circumcision of infants and boys for any reason other than a clear, compelling, and immediate medical need is sexual assault.
Will doctors ever begin promoting female circumcision as a way to help prevent AIDS?
It's a very real possibility. If physicians are successful in convincing governments to allow boys and infants to be forcefully circumcised as part of the war on AIDS, it may only be a matter of time before other doctors use the Stallings Study to justify circumcising girls for the same reason.
Circumcision and AIDS
A Bill to End
Male Genital Mutilation
in the U.S.