The preliminary results from two major trials in Kenya and Uganda of around 8,000 men show that medical circumcision of men reduces their risk of acquiring HIV during heterosexual intercourse by 53 percent. It supports a previous South African study, which showed a 60 per cent reduction in HIV infection among circumcised men.

The US National Institutes of Health announced its decision to end the study early in light of the striking findings.

Kwango Agot of the University of Nairobi, Kenya, a senior programme officer at the study centre, explained that uncircumcised men are at higher risk of contracting HIV because the foreskin is rich in sentinel cells of the immune system and attach easily to HIV. "The foreskin sometimes ruptures during intercourse."

In response to the media reports, The New Zealand AIDS Foundation (NZAF) was quick to point out that the results does not mean that circumcised gay and bisexual men are only half as likely to get infected with HIV.

Five top United Nations agencies - the World Health Organization, UN Population Fund, Joint UN Programme on HIV/AIDS (UNAIDS), UN Children's Fund and the World Bank - have also cautioned that despite the findings, urging people to continue using condoms during sexual intercourse.

"Circumcised men can still become infected with the virus and, if HIV-positive, can infect their sexual partners," said a joint statement.

It added that circumcision should never replace other known, effective preventive methods and should be considered as part of a comprehensive prevention package.

Eamonn Smythe, NZAF Acting Executive Director, was quoted in GayNZ.com as saying, "There is no evidence to suggest that circumcision prevents the spread of HIV through unprotected anal sex, which is the most common method of transmission between men in New Zealand."

"The anus lining has a dense collection of cells that act as receptors for HIV, which are spread across a much greater surface area than the foreskin," Smythe said. "The great majority of gay and bisexual men with HIV in New Zealand are likely to have become infected through the lining of the anus."

Smythe also discourages gay men who are considering circumcision as a substitute for using condoms as little research has been done about the correlation between circumcision and HIV infection via anal sex, stressing that the best prevention against HIV for gay and bisexual men are still condoms.

Next page, what is circumcision?

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What is circumcision?
Source: Gayhealth.com

Circumcision is a surgical procedure that removes your foreskin (the folds of skin around the head of your penis, or glans). Newborns, children, adolescents and adults alike get circumcised, for several reasons: religious, aesthetic, because foreskin is uncomfortably tight and difficult to retract (phimosis) and for cleanliness - some people think a circumcised penis is easier to keep clean and free from infections including sexually transmitted diseases (STDs) and balanitis. Others, however, are opposed to the procedure, arguing that circumcision is medically unnecessary and, in the case of newborns, a cruel application of pain. Indeed, the issue of circumcision is a contentious one.

Around sixty percent of American men are circumcised, whereas most men from Latin America, Asia and Europe are not. Circumcision of males is a religious requirement of the Jewish and Muslim and faiths and as a result is practised extensively throughout the Middle East, North Africa, Malaysia and Indonesia.

How is it done?
For adult males, the operation typically takes about 30 to 45 minutes and is performed under local anaesthesia. No hospitalisation is required. Most men recover in three weeks. Minor complications such as swelling, bleeding, pain and infection may occur after the operation.

Important considerations
Once you get circumcised, you can kiss that foreskin goodbye - there's no good way to undo the procedure! Some men advocate non-surgical foreskin restoration, in which the remaining skin on shaft of the penis is, over time, stretched over the head of the penis to create a hood of skin that resembles foreskin. Remember, this is not the same as having original foreskin, and you should not undergo this restoration without consulting your doctor first. Other surgical procedures try to create a flap of skin to cover your glans. They often result in a loss of sensation and scarring.

Some men who've been circumcised as adults report that the glans (the head of the penis) becomes less sensitive after surgery.

Keep in mind, there are varying degrees of circumcision: some men who've been circumcised still have a fair amount of foreskin. Their penises may even look intact!

Researchers from Australia reported on June 9, 2000 that circumcision may provide protection against HIV and STDs. The inner surface of the foreskin contains HIV receptors, which are susceptible to the virus and other infections, the researchers say. By removing the foreskin, many of these receptors are removed, which may help protect you. Even so, all men should always use condoms to help ensure their safety from disease.
One last thing: don't get pressured into getting circumcised. It's your body and your choice. If your boyfriend pushes you to have the procedure, maybe he's the one who should speak to a doctor!

Possible side effects
While you heal, the area around the incision may be swollen and painful; your doctor may recommend ice-packs to bring down the swelling and prescribe medication to control the pain.

Dangerous complications
Circumcision, no matter at what age, is considered a safe and routine procedure. All surgeries, however, carry risks for bleeding and infection, and an adverse reaction to anesthesia. As always, choose an experienced physician to perform the procedure. If done incorrectly, your penis can be injured if too much skin is removed. In rare instances, a separation of the incision can also occur.
Newborns who are circumcised may hemorrhage from the procedure, but this is "rare," says Harry Fisch, M.D., Director of the Center for Reproductive Health at Columbia Presbyterian Medical Center.

How long is the healing process?
Healing time for newborns takes about one week. Some swelling and formation of yellow crust around the incision area is normal. If you are circumcised after infancy, healing can take up to three weeks. During this time vigorous exercise and sex should be avoided. Be sure to follow your surgeon's instructions on proper care of the wound, and contact him or her immediately if your entire penis looks swollen and red, if fresh bleeding occurs after surgery, or if pus drains from the incision.

How do you reverse it?
Once your foreskin is removed, there is no good way to restore it. Some fans of foreskin advocate non-surgical foreskin restoration, in which the remaining skin on the shaft of the penis is stretched, over time, to create a retractable hood of skin that resembles foreskin. This is not a replacement for original foreskin, and you should consult your doctor before trying this procedure.

Other surgical procedures try to create a flap of skin, resembling original foreskin, to cover your glans. Beware! They often result in loss of sensation and scarring.

How much does it cost?
As a guide, The Family Planning Association of Hong Kong performs the procedure at its Wanchai Clinic. Circumcision operation for males aged 18 years or above is performed under local anesthesia in our operating theatre in Wanchai and the operation fee is HK$3,000. Wanchai Clinic at 27119656 or Ma Tau Chung Clinic at 21920202

In Singapore, the Singapore General Hospital (Urology Centre or Department of General Surgery) charges about S$570 or S$220 through a Polyclinic referral. Central Appointments: 6321 4377

Readers elsewhere should check with their GP or local hospital.