Dear Nurse Felicia,
I read the part in your latest column about male circumcision with much interest but also some confusion. Reducing risk by 50 per cent is good but doesn’t it mean that a circumcised man still has a 50 per cent chance of contracting HIV if he has unprotected sex? To Cut or Not to Cut
Dear To Cut or Not,
You are very correct, at least in terms of your thinking if not exactly in your math. The risk of transmission would not be 50 per cent as that would mean the risk of transmission if you were uncircumcised would be 100 per cent which is never the case.
Actual risk depends on a number of factors related to a specific partner. What the studies show is that this risk was decreased by 50-60 per cent with circumcision. Thus, if the risk for an uncircumcised man having unprotected sex with a given HIV+ woman was 10 per cent, the risk for a circumcised man would be 4-5 per cent.
Mathematics not withstanding, your point is valid. Circumcision does not provide 100 per cent protection from contracting HIV. Circumcised men should absolutely continue to minimise their risk using tried and true methods like condoms and monogamy.
However, in incidences of condom failure, for example breakage or slipping off, or lapses in good judgment, circumcision would provide additional protection.
Furthermore, in a recent study presented at the Mexico conference, respondents who underwent adult circumcision reported increased ease in using condoms after having the procedure.
Multiple studies also demonstrated no loss of sexual function or decrease in sexual satisfaction. Whether or not circumcision is right for you is a very personal decision and one you should discuss with your health care provider.
When done properly, the procedure has a low risk of complications and a relatively short recovery period. Circumcisions performed by traditional practitioners outside the health care setting may be done incorrectly or under less than sterile conditions and can lead to infection and other problems so it is imperative that you seek out a qualified, well-trained doctor or nurse if you are considering this procedure. Be well and be safe! Nurse Felicia
Felicia Price is an American Registered Professional Nurse working in Kigali.
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