Gay men considering adult circumcision to reduce the risk of HIV infection could end up being bottoms, suffer sexual dysfunction, and gain no benefit at all, new Australian research suggests.

Dr Limin Mao from UNSW’s National Centre for HIV Social Research has examined the Health in Men survey of around 1000 gay men in their mid-30s and 40s, two-thirds of whom were circumcised, for whether circumcision had an impact on sexual performance or condom usage during anal sex.

Circumcision has been proven in reducing the risk of heterosexual men becoming infected from an HIV-positive woman from vaginal sex. But our main finding is that, circumcised or not, gay men are just as likely to use condoms, Mao said.

There is no current evidence as to whether circumcision can protect homosexual men, either as a top or a bottom, but there has been significant interest in whether the procedure could play a role in curbing the HIV epidemic in western countries’ gay communities. In Australia the number of boys being circumcised is now around 10 percent.

Gay men are concerned about sexual dysfunction, premature ejaculation, as well as old arguments that circumcision reduced masturbation or sexual desire, Mao said.

In our study we found gay men who were circumcised at infancy didn’t report having some kind of negative or positive impact on sexual dysfunction.

However, nearly all men who were circumcised after infancy reported some sexual dysfunction, erectile problems or premature ejaculation, and one in five reported some complication as a result of the circumcision. Particularly they were twice as likely to be bottoms.

Rather than reducing the risk, these men were far more likely to become infected if condoms were not used with a HIV-positive male partner, she said.

If male circumcision does take place, our study confirms that infant circumcision is much safer, she said, but added that more research was needed into the younger generation of uncircumcised gay men.

They’re coming from a generation where circumcision is really down, but also given the interesting findings from Africa, we need to know whether they are thinking about circumcision and whether they want to forgo condom use.

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