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The first study, by
researchers in Australia, shows that the
inner foreskin has the largest
concentration of Langerhans' cells,
which are the initial cellular targets
in the sexual transmission of HIV. After
analyzing biopsy samples from 10
uncircumcised and 10 circumcised men,
researchers found that the inner
foreskin has a significantly higher
density of Langerhans' cells than other
areas of the foreskin. By removing the
inner foreskin, circumcision removes the
skin surface which is most susceptible
to HIV infection, reducing not
eliminating the risk of contracting HIV.
No differences were found in epithelial
or keratin thickness between the remnant
foreskin, inner foreskin or shaft skin.
The second study, by
researchers in Seattle, WA; Chicago, IL;
Winnepeg, Canada; Research Triangle, NC;
and Kisumu, Kenya, shows that
circumcised men had a significantly
lower risk for coital injuries
(bleeding, scratches, cuts, abrasions or
"getting sore") compared to
uncircumcised men and that there was no
difference in sexual function between
circumcised and uncircumcised men.
Researchers divided 2,784 patients from
Kisumu, Kenya into two groups: a control
group and a group to be circumcised
within 30 days of randomization.
Detailed evaluations were done at one,
three, six, 12, 18 and 24 months after
circumcision. Results show that there
was no difference in sexual function
between the two groups and that the
circumcised group reported fewer coital
injuries.
"These are important
reports which support the concepts that
circumcision does not interfere with
sexual function and that circumcision is
an important element of HIV prevention
in sub-Saharan Africa," said Ira D.
Sharlip, MD, an AUA spokesman. "At the
same time, it should be emphasized that
circumcision must be combined with other
techniques of HIV prevention, such as
safe sex and voluntary testing. It is
not sufficient to rely on circumcision
alone to prevent HIV transmission." |
