Even if it decreases it in men

Mar 8, 2007 14:32 GMT  ·  By

The recent finding that circumcision decreases HIV infection in men by up to 60% is overshadowed now by the recent discovery that the procedure could increase women's risk of infection.

The new research found that if HIV-positive men do not abstain from sexual contact till the circumcision is properly healed, then their partners are exposed to a much higher risk of receiving the virus from them.

Experts have already said that the results on circumcision impact were not conclusive and could have been biased by other factors, like condom use, thus this is not a reliable method of controlling HIV spread in sub-Saharan Africa, where over 60 % of the HIV victims are women.

The research discovered that the following surgery the men transmits more easily the virus to their female partners, as in fact it's about an open wound, exactly what the virus needs. "Women are already so vulnerable in this epidemic," said Jennifer Kates, an AIDS expert at the Kaiser Family Foundation. "We need to be particularly careful about anything that could put them at even greater risk."

The mixed Ugandan-American team investigated 997 Ugandan couples in which the males were found HIV-positive. 70 men with HIV passed through circumcision but in a month after the surgery in 11 cases, the female partner got the virus, while in the control group - formed by 54 uncircumcised men with HIV - only 4 women got infected with the virus, which is about half compared to the former situation.

But the researchers also warn about the low statistical power of the research, due to the small sample and both groups of men and women were given constant HIV prevention education and free condoms. "We need to err on the side of caution to protect women in any future male circumcision program," said Dr. Maria Wawer, the study's lead investigator, a researcher at Johns Hopkins Bloomberg School of Public Health.

Investigators believe the social and economic discrepancies between men and women could be behind the higher rate of infection amongst women, with many women bound to unfaithful men. "While male circumcision has extraordinary potential to prevent HIV infection, these new findings remind us that we must proceed with thought and care in developing strategies to expand male circumcision in Africa," said Dr. Kevin De Cock, director of WHO's AIDS department. "Circumcision is an additional prevention strategy rather than a replacement for anything else."