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Lancet. 2004 Mar 27;363(9414):1039-40.

Male circumcision and risk of HIV-1 and other sexually transmitted infections in India.

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Division of Infectious Diseases, Johns Hopkins University Medical School, Ross 1150, 720 Rutland Avenue, Baltimore, Maryland 21205, USA.


Circumcised men have a lower risk of HIV-1 infection than uncircumcised men. Laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. However, some data suggest that circumcision could simply be a marker for low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0.15; 95% CI 0.04-0.62; p=0.0089); however, we noted no protective effect against herpes simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1.

[Indexed for MEDLINE]

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