Circumcision among men who have sex with men in Scotland

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Wednesday 30th June 2010

Three randomised controlled trials have shown that male circumcision reduces the risk of HIV acquisition among heterosexual men by approximately 60%.

Three randomised controlled trials have shown that male circumcision reduces the risk of HIV acquisition among heterosexual men by approximately 60%, and male circumcision is now recommended as an additional HIV prevention strategy for this population. However, the evidence for such an association among men who have sex with men (MSM) is weak and inconsistent. Biologically, circumcision may provide partial protection against HIV acquisition among MSM practising unprotected insertive anal intercourse (UIAI), in a similar way as it protects against vaginalepenile transmission. Possible mechanisms include the fact that the thin inner surface of the foreskin is susceptible to microtears and abrasions, and contains a high density of superficial Langerhans cells and the preputial space provides an environment thought to favour pathogen survival and replication.

In the UK, MSM are the group most at risk of acquiring HIV, with an estimated prevalence of 5%, and new HIV prevention strategies are needed. Circumcision is not common in the UK, and attitudes towards circumcision are largely unknown. One recent survey of London MSM found only one in 10 uncircumcised men were willing to participate in future research on circumcision for HIV prevention. The aim of our study was to describe sexual practices by circumcision status, and to explore the feasibility of conducting research on male circumcision for HIV prevention among MSM in Scotland.

See attachment to read the full article.