Friday, October 2, 2009

SOUTH AFRICA: "Lower Risk of HIV Infection Among Circumcised MSM: Results from the Soweto Men's Study"

IAS Conf on HIV Path, Treatment & Prevention 2009 (07.20.09):: T. Lane; H.F. Raymond; S. Dladla; J. Rasenthe; H. Struthers; W. McFarland; J. McIntyre

Male circumcision has been found to reduce female-to-male HIV transmission through vaginal sex in randomized controlled trials. However, one recent meta-analysis of observational data found insufficient evidence of a protective effect with men who have sex with men (MSM), while noting the lack of data from high-prevalence settings. In the Soweto Men's Study, researchers examined the association between insertive anal intercourse and HIV infection among MSM in a peri-urban South African community.

Researchers enrolled 378 MSM through respondent-driven sampling and surveyed the men about their sexual behavior with their last five partners. Participants were asked whether their sexual role with male partners was insertive, receptive or both. Circumcision status was self-reported, and HIV status was determined by rapid antibody testing. Results were adjusted for network size and recruitment patterns and reported with 95 percent confidence intervals (CI).

Overall, 36.4 percent of MSM were circumcised; HIV prevalence was 13.2 percent (12.4-13.9 percent); and 76.4 percent reported exclusive insertive anal intercourse (75.4-77.3 percent). Among those exclusively insertive, 88.1 percent (87.1-89.1 percent) also reported having female partners. In multivariable analysis, the odds of infection among uncircumcised MSM reporting exclusive insertive anal intercourse with male partners were significantly higher than among insertive circumcised MSM (adjusted odds ratio 4.5; 95 percent CI 3.1-6.7).

"Circumcision may be effective at reducing HIV transmission between men in high-prevalence settings such as Soweto where MSM practice a high degree of sexual role segregation," the researchers concluded. "It may be feasible to conduct a randomized controlled trial of circumcision among MSM in such communities. The acceptability and ethical implications of male circumcision in MSM populations must be assessed prior to initiating clinical trials."


Anonymous said...

Since this is not a 'news story' in that this was first presented reported over three months ago, I would like to request that IRMA explain why it choose to post at this time. I encourage readers to also see "Jury still out on whether circumcision protects gay men against HIV", JAMA (can be seen at
Thank you IRMA for great work.

IRMA said...

Hi there Anon ---

Good question. You are right, it is not "news" anymore. And we have actually posted on this study before, back in July ( But, it is important info and we thought it warranted another posting. We think of the IRMA blog not just as a breaking news source, but also as a place for information and educational resources.


Jim Pickett(IRMA chair)

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