Does Circumcision Protect Against H.I.V.?

Male circumcision has been shown to protect men from acquiring H.I.V. infection during sex with women - it has reduced female-to-male transmission rates by 48% to 60% in sub-Saharan Africa - but that protective effect appears less reliable among men who have sex with men, according to a new meta-analysis published Oct. 7 in the Journal of the American Medical Association (J.A.M.A.).

The review is the most comprehensive analysis of the subject to date. It encompasses data from 15 studies conducted in seven countries, involving more than 53,000 men, most of whom were Caucasian and approximately half of whom were circumcised. The authors concluded that being circumcised reduced a man's risk of acquiring H.I.V. by 14%. That finding was statistically nonsignificant, but the authors say it should be regarded as a launching point for future trials. "This study gives us a more complete picture than we've ever had before," says Gregorio Millett, the study's lead author and a senior behavioral scientist at the Centers for Disease Control and Prevention (CDC). "The next step is to design better quality studies to see if there is an association we aren't detecting."

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