Caution on HIV circumcision

Australian AIDS groups have urged caution over calls for a review of Australian circumcision policy, saying there is no evidence the procedure would benefit gay men.

David Cooper, director of the National Centre in HIV Epidemiology and Clinical Research, told the XVI International AIDS Conference in Toronto last week Australia should consider more infant circumcision.

He made the recommendation because trials among heterosexual communities in Africa have shown circumcision could lower HIV transmission risk, The Sydney Morning Herald reported.

Cooper said circumcision could provide protection from HIV infection because it took away the sensitive lining of the foreskin.

Despite the promising African research, there is no evidence increasing infant circumcision in Australia would reduce the risk of HIV infection among gay men, according to local AIDS organisations.

John Kaldor, the National Centre in HIV Epidemiology and Clinical Research’s deputy director, said circumcision had little relevance to gay infection rates because many gay men practised both insertive and receptive anal sex.

Men who contracted HIV from anal sex usually did so when they were the receptive partner.

It’s quite clear that most of the transmission that occurs among gay men is the receptive partner [being infected], Kaldor told Sydney Star Observer.

Whether a receptive partner was circumcised or not would have no bearing on his risk of being infected.

And Kaldor said it was speculation to say gay men practising insertive anal sex had less risk of contracting HIV if they were circumcised.

Australian Federation of AIDS Organisations executive director Don Baxter told the Star the African research might be worth thinking about in relation to some Australian populations, such as Aborigines.

But circumcision was not relevant to gay men’s HIV infection risk.

We don’t have any evidence that circumcision would be valuable or of benefit to reduce the risk for gay men, Baxter said.

And certainly gay men who think that having circumcision will be a significant reduction of risk, if they have unprotected anal sex, is actually a nonsense, I think.