Voluntary medical male circumcision may protect against HIV in men who have sex with men, especially those who primarily practice insertive anal sex, according to a presentation at the international AIDS society conference on HIV.
Previous research has found that voluntary male circumcision reduces HIV acquisition by at least 60% in heterosexual men. However, when it comes to men who have sex with men, there have been quite mixed results.
For this study, Dr. Huachan Zou and colleagues recruited 18- to 49-year-old men from eight cities in China who self-reported having had at least two male sexual partners in the past six months and frequently practiced insertive anal sex to study the benefits of circumcision against HIV in men who have sex with men. In addition, the men in the study had to be willing to undergo circumcision.
The men were tested for HIV 1 month before enrollment and at enrollment, and only those who remained HIV-negative qualified. Enrollment included additional testing for syphilis, herpes simplex virus (HPV), and human papillomavirus (HPV).
The researchers randomly assigned 124 participants to the intervention group, which received voluntary medical male circumcision and weekly web-based follow-up for 6 weeks, and 123 to the control group, which did not receive circumcision. All participants were tested for HIV at 3, 6, 9, and 12 months, reported sexual behaviors, and underwent HSV-2 and HPV testing at 6- and 12-month follow-ups.
The researchers observed that of the 124 men assigned to undergo circumcision, none tested positive for HIV during the 12-month observational period, while 5 of the 123 in the control group became infected with HIV (P=0.025).
“Voluntary medical male circumcision is very likely to be efficacious in preventing incident HIV acquisition among men who have sex with men who predominantly practice insertive anal sex,” Dr Zou said, suggesting that a large-scale study may be needed to confirm these findings.