Major Study Finds HIV Infection Higher in Uncircumcised Men



Dr. Debrework Zewdie, Director of the Global HIV/AIDS Program for the World Bank



Major Study Finds HIV Infection Higher in Uncircumcised Men
Blade April 2006, pp. 96

By Dan Tyler

During a seminar addressing AIDS in Africa at UCLA on February 22nd, 2006 Dr. Debrework Zewdie, Director of the Global HIV/AIDS Program for the World Bank, commented on the findings of a continent-wide study, correlating the higher rates of HIV infection within uncircumcised men as compared to men who were circumcised in comparable population groups.
Dr. Zewdie, who holds a Ph.D. in Immunology from the University of London and managed the AIDS Campaign Team for Africa (ACT Africa) as well as a number of research, management, and teaching positions in 16 African nations before assuming her current role with the World Bank, explained upon further questioning, that since an uncircumcised penis has additional foreskin, apparently it could create a pocket that seems to be able to retain (and later transmit) the HIV virus. She admits, that this finding conflicts with the conventional wisdom that being uncircumcised provides no significant risks to men’s health.
However, she maintains that the evidence collected is undeniable.
Having drawn upon two decades of extensive studies of HIV-positive men in every African nation, from South Africa to Senegal; Lesotho to Uganda; and every country in between, the evidence is especially compelling since it was gathered and analyzed by World Bank scientists who were directed by the economists with whom they collaborate because in terms of dollars and cents, ultimately they are interested in the cheapest and most efficient ways to combat AIDS and the transmission of HIV. Toward that goal, they were simply looking for the most common denominator, and much to the surprise of everyone, it appears that circumcision plays a much more significant role than anyone ever expected.
In a February 2006 report titled, “Who Gets AIDS and How” scientist Damien de Walque, of the Development Research Group for The World Bank cites:
“...recent evidence from a randomized control trial (demonstrates) that male circumcision has a protective effect.”

This has strong implications for the gay community worldwide, especially for gay men who cruise online for sex where being “uncut” is often promoted as a selling point, so to speak, with a large number of admirers and devotees.
As a range of studies conducted by AIDS Project, Los Angeles; the United States Centers for Disease Control, in Atlanta; and Gay Men’s Health Crisis, in New York have concluded that a direct correlation exists between the purveyors of online sex and a high incidence of unprotected sex, often catalyzed and exacerbated by the use of crystal methamphetamine and/or other party-and-play (PnP) drugs, subsequently, there appears to be strong evidence to suggest that the guy “with something extra” may in fact, have a statistically higher chance of having more to offer than anyone imagined.
Especially chilling, is the additional implication that the virus potentially stored and/or transmitted within the foreskin has found a medium which again supercedes convention apart from blood or semen as the traditionally known routes of transmission, and suggests that unprotected oral sex with these men may be significantly more risky than had been acknowledged by the majority of health care practitioners.
Although there have as of yet been no formal recommendations by the World Bank’s HIV/AIDS Program for parents to circumcise their male infants (or for men to seek out circumcision later in life) Dr. Zwedie stated that it would be a very easy and cost-efficient way to greatly lessen the rate of infection.
Only one comparable study has been run in the United States among gay, HIV-positive men conducted by a university in Colorado. The results of the study were considered too controversial to publish.
If a man, circumcised or not, has concerns about his HIV status and safer sexual practices, he should refrain from sex until after consulting his physician. At the very least, careful washing of his or his partner’s uncircumcised penis with hot, soapy water, before and after sex is consistent with standard hygienic practice and should be continued.
Talking about sexual health with your partner before sex and using condoms, of course, remains the best practical approach at maintaining a healthy individual as well as a healthy community by virtually eliminating the chance of transmission; although, in light of these new findings, many who have not done so already, might want to consider incorporating the use of condoms or dental dams while engaging in oral sex.

Dan Tyler is an ethnographic researcher and essayist at the University of California, Los Angeles. He can be reached at danieltyler@mac.com