Male circumcision may protect against HIV due to changes in bacteria.
Article Type: Brief article
Subject: HIV infection (Risk factors)
HIV infection (Prevention)
HIV infection (Demographic aspects)
Circumcision (Health aspects)
Pub Date: 05/01/2010
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2010 Source Volume: 18 Source Issue: 35
Geographic: Geographic Scope: Uganda Geographic Code: 6UGAN Uganda
Accession Number: 236247777
Full Text: Male circumcision is associated with significant reductions in HIV, herpes simplex virus and human papillomavirus among men and significant reductions in bacterial vaginosis among their female partners. This study analysed penile swabs taken from 12 participants randomly selected from the circumcised arm of the Rakai, Uganda, circumcision study, which enrolled 5,000 uncircumcised HIV-negative men and randomised half to be circumcised. Swabs were taken before circumcision and one year after, when all 12 participants were still HIV-negative. Samples contained more than 40 distinct bacterial families, including aerobic and anaerobic bacteria. Circumcision was associated with a significant change in the overall microbiota (p=0.007) and a significant decrease in anaerobic bacterial families (p=0.014). Two bacterial families were uniquely abundant before circumcision and within these families were a number of anaerobic types previously associated with bacterial vaginosis. Researchers propose that the uncircumcised penile environment may support anaerobes which activate Langerhans cells and help HIV infect the body. Thus, the reduction in anaerobic bacteria after circumcision provides protection from HIV and other sexually transmitted diseases. If this is true, and if the bacteria can be eliminated without foreskin removal, such a procedure could be an alternative to circumcision where it is culturally unacceptable or difficult to implement. There are other hypotheses for why circumcision reduces HIV transmission including that the inner foreskin thickens and provides a more effective barrier against HIV. The researchers plan to look for specific bacteria associated with HIV risk, and to explore how such bacteria might be eliminated. (1,2)

(1.) Price LB, Liu CM, Johnson KE, et al. The effects of circumcision on the penis microbiome. PLoS ONE 2010;5(1):e8422.

(2.) Safreed-Harmon K. Circumcision may protect against HIV due to changes in bacteria. AIDSmap News, 8 January 2010.
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