Male circumcision not immunity for HIV

By Dr Pius Musau

Male circumcision, the total or partial removal of the foreskin, has been practiced since time immemorial among many communities.  Today, statistics show that for every one circumcised male, five others are not. The percentages of the circumcised vary with regions due to cultural, religious and medical reasons for the circumcision.

But male circumcision has recently gained popularity after studies showed up to 60 per cent protection against heterosexual HIV transmission. There have been drives to increase the numbers of circumcised males in the society in the hope that the effects will be a collective reduction in the risk of contracting this incurable disease. But this is just part of the story.

Historical background

Out in the wild, the foreskin came in handy in the protection of the “small head” from pricks by thorns, grass and shrubs. In the race to propagate species, it also made copulation easier and faster before the female took off, a predator appeared or a stronger male happened on the scene. The foreskin was in essence the very survival of humankind and today, there is controversy as to its role in the quality of sex.

How does removal of the foreskin prevent HIV?

The foreskin has abundant supply of blood, a wide surface area endowed with receptors to which the virus can attach and is prone to injuries during intercourse. All these are factors that promote the likely spread of HIV and their removal reduces the risk of contracting the disease accordingly. But it is reduction of, not immunity against, the risk to contract HIV from a person of the opposite sex.

Why circumcision is not a magic bullet

•     HIV is not a disease exclusive to the uncircumcised. Those with risky behaviours like multiple sex partners, alcoholism and improper or inconsistent condom use stand the risk irrespective of their circumcision status.

•     It is a relative protection; circumcision does not give you immunity against the disease.

•     Those who get the wrong idea that circumcision will keep them from getting HIV heighten their risk by reckless behaviour and can easily contract the disease faster than the uncircumcised.

•     Circumcision causes a wound and if one gets intimate with a positive partner before complete healing; his risk rises above the standard one in the population.

•     Studies have not shown this protection in same sex encounters.