Early circumcision in males may be a positive step in slowing the spread of both HIV and the human papillomavirus (HPV) In South Africa, researchers say.
Anna R. Giuliano, Ph.D., program leader in cancer epidemiology at Moffitt Cancer Center in Tampa, Fla., and colleagues note that studies have shown that circumcision of HIV-infected men does not reduce HPV transmission to their female partners, citing that many factors may account for this lack of efficacy.
However, they suggest that the high prevalence of HPV among the HIV-infected men (73 percent in the intervention group and 69 percent in the control group) and the high prevalence of HIV among the female partners of greater than 60 percent, relates to the lack of efficacy of male circumcision.
In that study, it was pointed out that the high and sustained prevalence of HPV among the HIV-infected individuals is “likely to overwhelm any preventative effect of circumcision.”
“Male circumcision is important for reduction of not only HIV infection but also HPV infection in HIV-negative men and their female partners,” said Giuliano.
“However, its efficacy seems limited to HIV-negative men. These results suggest the need for early circumcision to achieve maximum effectiveness in populations with a high incidence of HIV and cervical cancer,” he added.
For maximum reductions in HIV and HPV infections and related diseases in women, such as cervical cancer, the researchers recommend that both circumcision and HPV vaccination of the male population should be delivered prior to sexual debut.
The study has been published in the British medical journal The Lancet Infectious Diseases.