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March 13, 2013

Circumcision May Not Protect White U.K. Gay Men From HIV

A survey of white, British-born men in the United Kingdom suggests that circumcision offers no significant protection against HIV transmission for the insertive partner (top) in anal sex between men, aidsmap reports. Publishing their findings in the Archives of Sexual Behavior, researchers from the School of Health Sciences at City University London surveyed over 17,000 gay and bisexual men both on the website Gaydar and also offline in bars, clubs and sexually transmitted infection clinics in 15 cities throughout the United Kingdom between October 2007 and February 2008.

Almost 12,000 men in the study both reported their HIV status and were white U.K. nationals (fitting the demographic parameters of the study). Among these men, 4,898 (41.5 percent) reported unprotected anal intercourse during the previous three months and also said whether they were the top or bottom (insertive or receptive partner). Tops are generally at lower risk of HIV than bottoms, though both are at risk. A total of 1,521 out of the 4,898 men (31 percent) reported being mainly (960 men, or 20 percent) or exclusively (561 men, or 11 percent) the top.

In order to most accurately determine whether the presence or absence of a foreskin affects HIV transmission to the insertive partner, the paper concerned itself with these 561 exclusive tops. One out of six (16.7 percent) of them were circumcised. Among the 97 men (8.8 percent) who reported having HIV, there was no difference in HIV prevalence if they were circumcised (8.6 percent prevalence) or uncircumcised (8.9 percent).

The study is highly limited by the fact that the ultimate study sample of men who were exclusively tops was too small to yield a highly statistically significant indicator of circumcision’s role in HIV transmission. However, it is clear that among these men, even if circumcision offered a protective factor, it would never be anywhere near the 60 to 70 percent reduction in risk found in randomized controlled studies of heterosexual men in Africa.

Echoing results from previous studies, the paper found that topping exclusively greatly lowered risk of HIV infection.  Five percent of the men who said they were always the insertive partner were infected with the virus, compared with 11 percent of those who were mainly the top.  This represents a 58 percent reduction in risk between topping exclusively and mainly.  

To read the aidsmap story, click here.

To read the study abstract, click here

Search: British, United Kingdom, UK, anal sex, top, bottom, insertive, receptive, circumcision, School of Health Sciences at City University London, Gaydar.

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