Circumcision Doesn't Lessen HIV Transmission
THURSDAY July 16, 2009 -- Circumcision doesn't reduce transmission of HIV from infected men to women, says a study that included 922 HIV-infected men in Uganda.
The men, who were uncircumcised before the start of the study, were randomly selected to undergo immediate circumcision or circumcision after two years. The study also included HIV-uninfected female partners of the men. The women were checked for HIV infection at six, 12 and 24 months.
The study was stopped early due to "futility." The final analysis of 92 couples in the intervention group and 67 couples in the control group showed that 18 percent of women in the intervention group became infected with HIV, compared with 12 percent of those in the control group. Cumulative probability of HIV infection at 24 months was 22 percent among women in the intervention group and 13 percent among those in the control group.
While these results weren't statistically significant, they were sufficient to stop the study, said Dr. Maria J. Wawer of Johns Hopkins Bloomberg School of Public Health in Baltimore and colleagues.
"Circumcision of HIV-infected men did not reduce HIV transmission to female partners over 24 months; longer-term effects could not be assessed. Condom use after male circumcision is essential for HIV prevention," they concluded.
The findings appear in the July 18 issue of The Lancet.
The study results shouldn't deter programs working to increase circumcision services for men at risk for HIV, wrote Dr. Jared M. Baeten of the University of Washington in Seattle and colleagues in an accompanying commentary.
Involving women in decision-making about circumcision provides an opportunity to educate men and women about the risks and benefits of circumcision and to target risk-reduction counseling efforts to serodiscordant couples, where one partner is HIV-positive and the other HIV-negative, they noted.
The U.S. Centers for Disease Control and Prevention has more about HIV transmission.
Posted: July 2009