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Adult Circumcision, HIV and Pleasure

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

Despite past reports of the benefits of adult circumcision in preventing the spread HIV many male commenters on this site have written that they are sceptical because they are convinced that adult circumcision would be harmful to their sexual pleasure and to their ability to sexually function. There are others who are critical of childhood circumcision, stating that they are certain that circumcised men have less sexual pleasure than uncircumsized men.

However,  two studies presented at the 104th Annual Scientific Meeting of the American Urological Association show that adult circumcision reduces the risk of contracting HIV. It also reduces the risk the risk of injury resulting from intercourse. Of equal importance to all men is that adult circumcision does not reduce pleasure and does not cause sexual dysfunction.

The first study, done by researchers in Australia, (Hallamore, S; Yow, M; Webb, D; Pask, A; Bolton, D. "Remnant foreskin contains fewer Langerhans’ cells—implications for human immunodeficiency transmission in circumcised men, Journal of Urology, supplement, 2009: 181, 4), shows that the inner foreskin of the penis has the largest concentration of Langerhans’ cells. These cells are the initial cellular targets in the sexual transmission of HIV. After studying biopsy samples from 10 uncircumcised and 10 circumcised men, researchers found that the inner foreskin has a significantly higher density of Langerhans’ cells than other areas of the foreskin. By removing the inner foreskin, circumcision removes the skin surface which is most susceptible to HIV infection. This reduces but does not totally eliminate the risk of contracting HIV. 

The second study was done by researchers in Seattle; Chicago; and Winnepeg, Canada; North Carolina; and Kisumu, Kenya, shows that circumcised men had a significantly lower risk of injuries from sexual intercourse (bleeding, scratches, cuts, abrasions or “getting sore”) compared to uncircumcised men. They also reported that there was no difference in sexual function between circumcised and uncircumcised men.

The researchers emphasize that circumcision must be combined with other techniques of HIV prevention, such as safe sex and voluntary testing. Circumcision alone does not prevent HIV, according to the researchers.

Clarifying statements:

1. It is not my intention as the reporter of these finding to advocate or oppose adult circumcision. Instead, my intention is to reveal some of the latest findings. The reader is invited to do further research on this topic if that is of interest.

2. The international nature of these studies show indicate that, in my opinion, the results must be viewed in light of the fact that disease prevalence and behavior vary from nation to nation.

3. It should be stated that for those men who are in stable and monogamous relationships need not worry about being vulnerable to HIV. However, those men who are either not in monogamous relationships, or have many sexual partners, or who are in monogamous relationships but behave otherwise, be very careful about their exposure to HIV.

4. Doubt about adult circumcision is more than understandable. In so many ways, circumcision stands for castration. This is a primal fear not based on reality but that is entirely within the ability of all men and women to understand and feeling sympathetic toward.

One does not have to be circumcised in order to be safe by using protection.

Your comments are always welcome and encouraged.

Allan N. Schwartz, PhD

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