The Kindest Cut?

Bolstered by a study showing circumcision can reduce a heterosexual man's chances of HIV infection by as much as 70%, many hard-hit developing nations have rolled out mass circumcision programs. But health experts have been unsure whether the procedure would be beneficial for straight men in Western nations. Until now. An analysis of patient records of more than 26,000 African-American men who sought HIV testing at two Baltimore clinics showed that circumcised men had a 51% lower HIV prevalence rate than their uncircumcised peers. The large-scale research supported the results of three smaller U.S. studies that also suggested circumcision is beneficial for Western men. Based on the data, some health experts are now calling for circumcision to be adopted as an HIV prevention strategy for some U.S. populations, particularly minority groups with high HIV prevalence rates. 'It is to be hoped that [the study], in conjunction with the weight of evidence from international studies, will persuade the American Academy of Pediatrics to recognize the public-health importance of this surgery,' writes Ronald H. Gray, a professor of epidemiology at Johns Hopkins University, in an editorial accompanying the study, both published in The Journal of Infectious Diseases. The benefits of circumcision are much lower for gay and bisexual men, however. A study reported in 2008 in the Journal of the American Medical Association showed circumcised gay men had only a 14% lower HIV incidence level. The lower protection is likely because many gay men practice both insertive and receptive anal sex, and circumcision protects only insertive partners.