About AIDS

The idea that foreskins might play a role in HIV infection has been kicking around for almost 20 years: As the penetrator, it was said, cut men are less likely to contract HIV. However, there was only anecdotal evidence, but no data. Why would circumcision matter?

Then in the late Nineties, clinical research showed that some foreskin cells, typically covered except during erection, are like Langerhans cells in a woman's vaginal lining; they "pick up" viruses and transport them through the tissue – or skin. Perhaps no cuts or sores on the penis were necessary for HIV to get inside. Meanwhile, new epidemiological data in Uganda also supported the HIV-prevention value of circumcision.

In July, dramatic information was released from a huge French and South African study: Circumcision may reduce the risk of men contracting HIV through vaginal sex by a staggering 70%, compared to noncircumcised men.

Of 3,000 men in this trial, half got clipped and half didn't; then they went about their usual behaviors. At the 12-month point, it was too clear: for every 10 uncut men who became infected, only three cut guys did. The study was stopped nine months early, and the uncircumcised men were given the chance to get docked.

Although these epi studies focus on vaginal intercourse, similar effects probably are true for anal sex. Rectal tissues produce secretions like vaginal fluids, possibly containing HIV, with which the top-man will connect, and some blood may be present, too.

We don't expect "intact" "About AIDS" readers to rush out looking for a surgeon! However, this shows the need for uncut guys to pay special attention to reducing their risk. Roll on that rubber, no matter which hole you're plugging. If you don't, at least wash thoroughly with the foreskin pulled back, immediately after sex; at least that could reduce your exposure time.