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Researchers from the Translational
Genomics Research Institute in Flagstaff, Ariz., report that a study conducted
in Uganda indicates that removal of the foreskin deprives anaerobic bacteria of
a place to thrive and gives the immune system a better opportunity to fight off
the human immunodeficiency virus (HIV). The study may explain why circumcision
cuts HIV risk by 50 to 60 percent. Previous theories attributed increased HIV
risk for uncircumcised men to the potential for tears of the foreskin or the
increased amount of surface area.
Study leader Dr. Cindy Liu compared
removal of the foreskin to clear-cutting a forest, which changes the community
of animals living there. Similarly, circumcision deprives anaerobic bacteria of
the opportunity to thrive in the coronal sulcus, the groove behind the head of
the penis. Liu stated that bacteria—especially anaerobic bacteria—cause
inflammation that triggers the immune system to respond with T4 cells, which
are necessary for HIV to survive and replicate. Populations of bacteria in an uncircumcised
man attract T4 cells that give HIV an entry point. Without bacteria to mobilize
HIV-susceptible T4 cells, other immune cells can destroy the virus.
The study engaged 156 Ugandan men
aged 15 to 49 in a year-long randomized study where half of the men received
circumcision and half did not. Because one in six people in Uganda are
HIV-infected, 5,000 Ugandan men volunteered to participate in the study. After
one year, bacteria—especially anaerobic bacteria—had dropped by 81 percent for
the circumcised men. Bacteria on the coronal sulcus had dropped by 33 percent.
Further studies will look at ways to alter bacterial populations without
circumcision.
The full report, “Male Circumcision
Significantly Reduces Prevalence and Load of Genital Anaerobic Bacteria,” was
published online in the journal mBio (2013; doi: 10.1128/mBio.00076-13).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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