IAS 2007: Circumcision is not predictive of HIV infection (seroconversion) in gay men.

But not content with these results, the authors conclude, “More studies, please.”

Edit: Aidsmap has an excellent summary of the study and one other study showing Peruvian gay men would be willing to be test subjects for a future circumcision study in that country. Obviously, the first study would seem to preclude any need for making guinea pigs out of South American men.

Abstract after the break.

Abstract

Circumcision status and risk of HIV seroconversion in the HIM cohort of homosexual men in Sydney

Presented by David James Templeton, Australia.

Templeton D.J.1, Jin F.1, Prestage G.P.1, Donovan B.1, Imrie J.2, Kippax S.C.2, Kaldor J.M.1, Grulich A.E.1

1National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, Australia, 2National Centre in HIV Social Research, University of New South Wales, Randwick, Australia

Objectives: Circumcision substantially lowers the risk of HIV acquisition among heterosexual African men, but there are few data addressing circumcision status as a risk factor for HIV among homosexual men. We examined circumcision status as an independent risk factor for HIV seroconversion in the community-based Health in Men (HIM) cohort of homosexual men in Sydney, Australia.

Methods: Between 2001 and 2004, 1,427 initially HIV-negative men were enrolled. Circumcision status was self-reported at baseline and was validated by clinical examination during study visits in a sub-sample of participants. All participants were tested annually for HIV and offered testing for other sexually transmitted infections (STIs). Demographic information was collected at baseline and detailed information on sexual risk behaviours was collected every 6 months.

Results: At baseline, 66% of participants reported being circumcised; mostly as infants. There were 49 HIV seroconversions through 2006, an incidence of 0.80 per 100PY. On multivariate analysis controlling for non-concordant unprotected anal intercourse (UAI), anorectal STIs and age, being circumcised was not associated with HIV seroconversion (RR = 0.88, 95% CI 0.45-1.74). Among men who reported no receptive UAI, there were nine seroconversions, an incidence of 0.35 per 100PY. When analyses were restricted to this group, there was also no association with HIV seroconversion (RR = 0.99, 95% CI 0.25- .96).

Conclusion:
Circumcision status was not associated with HIV seroconversion in this cohort. Although statistical power was limited, among men who were more likely to acquire HIV by insertive  AI, there was also no relationship. As most HIV infections in homosexual men occur after receptive anal sex, circumcision is unlikely to be an effective HIV prevention intervention in Australian gay men. However, further research in populations where there is more separation into exclusively receptive or insertive sexual roles by homosexually active men is warranted.

Reference

Presented at the 4th Annual IAS Conference, Sydney, Australia. July 22-24, 2007.

http://www.ias2007.org/pag/Abstracts.aspx?SID=55&AID=2465

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