At the IAS conference plenary session, Dr Robert C Bailey presented data from three randomised controlled trials of male circumcision to prevent HIV infections. The three trials, based in Uganda, Kenya and South Africa, of which Dr Bailey was principal investigator, were stopped before completion as evidence that male circumcision was between 57 to 60% effective in preventing the female to male transmission of HIV was so strong. Bailey likened circumcision to a vaccine, telling delegates ‘one would be challenged to find any public health intervention with such a strong and consistent efficacy’.
While circumcision is likely to make substantial inroads into slowing the HIV/AIDS pandemic globally, it is not, however, recommended as an effective HIV prevention for men who have sex with men.
Dr David Templeton, from the National Centre in HIV Epidemiology and Clinical Research at the University of NSW, who was presenting an abstract on circumcision status and risk of HIV seroconversion in gay men in Sydney, told OUTinPerth that ‘The majority of HIV infections in gay men in Australia and most other developed countries occur after unprotected receptive anal sex. So therefore, a person’s own circumcision status would have no bearing on their risk of acquiring HIV’.
Data is not yet available as to whether there is a protective benefit in circumcision for MSM who only practise insertive sex. Dr Templeton pointed out that regardless, circumcision is still only up to 60% efficacious in heterosexual men studied, contrasting this with condom use which he said has ‘an efficacy rate of 90% plus when used correctly and consistently for sex.’
Dr Templeton added ‘It is the most important thing that the gay community does not start to think ‘I’m circumcised, therefore I can go out and have unprotected sex’, because they are running a very high risk of contracting HIV if they don’t use condoms consistently for both receptive and insertive anal sex.’
