Back in 2002, three separate sexual health studies began with the aim of assessing the link between circumcision and a lower risk of getting AIDS. The first set of results came in 2005 from a study conducted in Orange Farm township, South Africa, and the research revealed an amazing 63% decrease HIV infection in circumcised, heterosexual men compared to uncircumcised, heterosexual men. According to the French and South African scientists heading up the study, the research had to end on ethical reasons; they were so convinced by their results that they stopped the study in order to offer circumcision procedures to the men in the uncircumcised group.
In Africa, about 70% of men are circumcised either when they’re born or during puberty, although the rates of circumcision will vary drastically between regions due to differing cultures. The medical procedure involves the removal of the foreskin of your penis, be it due to religious or wellness reasons. However, the wide range of circumcision rates in Africa is what first tipped researchers off to the possible protective effect to your wellbeing that circumcision has, as rates of AIDS were much lower in regions with much higher circumcision rates. Although the results of the Orange Farm findings were exciting to the medical community, scientists still awaited the results of the other two trials before getting all worked up.
In the Orange Farm study, 3273 men had taken part, and all scientific controls were observed tightly, making this the first large-scale trial to report its findings. The second study, undertaken in Kenya, had 3000 subjects while the third, Ugandan trial had 5,000. In this latter research, the researchers found a 48% reduction in AIDS infection in the circumcised group, while that reduction was 53% in the Kenyan findings. Following on from these results, the researchers ended their studies early to offer the men in the control group the opportunity to get circumcised, just like the Orange Farm study. This is because the results were even more positive than the researchers had anticipated, as AIDS vaccine investigators typically aim for a 30% decrease in risk of infection from intercourse with an infected partner.
So why does circumcision offer such protection against AIDS? Your foreskin is delicate and very susceptible to tears during sex, providing an easy access point for the AIDS virus to creep in through the torn blood vessels. Moreover, in your foreskin there is a high concentration of a type of white blood cell known as the Langerhans cell, or the “sentinel cell” of the immune system. These cells, which are located in the skin (and on the underside of the foreskin in particular) are some of the first to detect and pick up an antigen or foreign substance for processing.
Because there are so many Langerhans cells in the foreskin, and because these particular cells seem to be excellent at binding to HIV antigens, these blood cells are very likely to contact and bind to the virus. Usually, Langerhans cells trigger your body’s antibody response to fight off viruses, but once HIV gets into your system, your body can’t seem to fight it off effectively. Therefore, by removing the foreskin in which these Langerhans cells reside, men lose that increased risk of blood exposure and the higher concentration of HIV-receptors in that blood. This is why researchers believe that encouraging circumcision and offering the procedure for little or no cost could put a serious dent in the spread rate of HIV and AIDS. Thankfully, following the success of the Kenyan and Ugandan studies the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Emergency Plan for AIDS Relief – the two largest AIDS-fighting organizations in the world – have agreed to begin funding circumcision procedures in Africa.
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