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Statement on Adult Male Circumcision and HIV Prevention
Recent media reports on adult male circumcision and HIV prevention have
centered on efforts to promote circumcision among men at high risk of AIDS
in New York City, including gay men and other men who have sex with men. These
efforts come on the heels of findings that adult male circumcision might significantly
lower — but not eliminate — a man's risk of acquiring HIV during vaginal sex.
In December 2006, the National Institutes of Health announced the findings
from three research studies demonstrating that adult male circumcision reduced
men's risk of acquiring HIV through vaginal intercourse. Gay Men's Health Crisis
recognizes the importance of these findings, which make adult male circumcision
the first biomedical HIV prevention tool since the female condom was introduced
13 years ago. However, GMHC would also like to highlight the gaps in knowledge
presented by these findings. We will be closely following further research to
determine what long-term impact these findings will have. In order to be effective,
any recommendations associated with these findings will need to balance scientific
research with cultural considerations.
The Trials:
The recent circumcision trials were conducted in countries in sub-Saharan
Africa with low rates of circumcision, very high HIV prevalence and significantly
higher rates of female-to-male HIV transmission rates than in the United States. In
the US, the highest rates of sexual transmission are in two categories: among men
who have sex with men, and among women infected by heterosexual contact with men. The
adult males participating in the trials were circumcised by trained professional health
care workers, and received extensive counseling and latex condoms. Previously, three
other clinical trials demonstrated similar findings.
What these findings mean:
The data shows that male circumcision may reduce the risk of adult males
to contract HIV through vaginal sex. Key areas not addressed by these findings:
- The effect of circumcision on HIV transmission for gay men and other men who have sex with men is unknown.
- The effect of circumcision for anal intercourse is unknown.
- It is unknown whether male circumcision in HIV-positive men protects their male or female sexual partners.
It is important to state categorically that circumcision does not
eliminate the risk of acquiring HIV. In order to be well protected against
acquiring and transmitting HIV and other sexually transmitted diseases all
sexually active men, whether or not they are circumcised, should engage in
practices that lessen risk, including using latex or polyurethane condoms
with water-based lubricants. Condoms continue to present the most effective,
inexpensive, non-invasive and readily available method for preventing HIV
transmission among sexually active individuals.
We are eager to work with public health officials at the federal Centers for Disease Control and Prevention and the NYC Department of Health & Mental Hygiene to determine how the findings of these and other scientific-based HIV prevention studies can be most useful to members of our communities.
Additional information about circumcision is available at:
http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm
http://www.aidsvaccineclearinghouse.org/MC/index.html
* * *
Gay Men's Health Crisis (GMHC) is a not-for-profit, volunteer-supported
and community-based organization committed to national leadership in the
fight against AIDS. Our mission is to reduce the spread of HIV disease,
help people with HIV maintain and improve their health and independence,
and keep the prevention, treatment and cure of HIV an urgent national and
local priority. In fulfilling this mission, we will remain true to our
heritage by fighting homophobia and affirming the individual dignity of
all gay men and lesbians. We provide services and programs to over
15,000 men, women and families that are living with or affected by
HIV/AIDS in New York City. For more information, please visit www.gmhc.org.
© 2007 Gay Men's Health Crisis
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