The Greater the Foreskin, the Higher the HIV Risk

This study did not get quite the play in the media that other health-related circumcision studies have attracted, but it deserves mention on this blog. Still another African study has found that the more foreskin an individual has, the greater his risk of getting HIV.

Perhaps the media didn't report this widely because it's so obvious. The foreskin is a "portal of entry" for deadly diseases, so obviously the more foreskin you have the more portals and the greater the risk. Pretty simple.

As reported in "AIDS Map," here's the gist of the study: "Larger foreskin size is associated with an increased risk of becoming infected with HIV, investigators from the Rakai circumcision study report in the October edition of AIDS. “Larger foreskin size is a risk factor for HIV acquisition in uncircumcised men,” comment the investigators."

"Investigators from the Rakai circumcision study hypothesised that the size of an individual's foreskin may be associated with an increased risk of HIV infection, due to the larger surface area containing cells vulnerable to HIV infection. They therefore analysed men in the clinical trial who had previously taken part in a cohort study to see if they could find an association between the size of the foreskin measured at the time of circumcision and the risk of HIV acquisition in uncircumcised men prior to the removal of their foreskin. They conducted the retrospective analysis in men who had initially been recruited to the Rakai community cohort study, tested for HIV at baseline and followed for a median of four years prior to enrolling in the clinical trial and undergoing medical circumcision. A total of 965 men were included in the study."

"There were 48 new HIV infections. The median foreskin area was larger in those who became infected with HIV compared with those who did not (41.5 vs 35 cm2). Furthermore, the mean foreskin area was significantly higher among those who seroconverted than those who did not (43.3 vs 36.8 cm2). . . . HIV incidence was lowest amongst men with foreskin surface areas in the lowest quartile (0.8 per 100 person years), and incidence increased with foreskin surface area, being 2.48 per 100 person years amongst individuals in the upper quartile (p < 0.01 for the trend). After adjustment for possible confounding factors, the investigators found that individuals with a foreskin area above 45.6 cm2 had a significantly increased risk of becoming infected with HIV compared to men with the smallest foreskin surface area."

The obvious thing about this study is that it confirms that the presence of ANY foreskin carries a risk, but the risk increases as the foreskin grows larger. To me, it suggests that the removal of all foreskin as quickly as possible after birth is most desirable. Why should anyone run the risk of growing a large foreskin later in life? Most importantly, it once again links the foreskin to HIV risk, clarifying that the more you have of a bad thing the greater your chances of getting hurt.