Male circumcision involves removing a loose fold of skin that covers the head of the penis (foreskin). While it is often a mark of belonging to a particular tribe or religious group such as the Jewish, Moslem and Xhosa communities, there are also sound medical reasons for men to be circumcised.

Circumcision and condoms

Scientific trials show that male circumcision can reduce a man’s risk of becoming infected with HIV during heterosexual intercourse by up to 60%. The foreskin creates a moist environment where HIV can survive for longer in contact with the most delicate parts of the penis, and the inner surface of the foreskin contains cells that are especially vulnerable to infection by HIV. In addition, any small tear in the foreskin that occurs during sex makes it easy for the virus to enter the body, while removing the foreskin toughens the skin on the head of the penis making it more resistant to infection.

Note that circumcision does not seem to have a substantial effect in reducing HIV transmission from an infected man to a woman. However, women would benefit indirectly, as they would be less exposed to men who were infected with the virus.

Other advantages are that circumcision is a once-off procedure with no ongoing costs or supply issues. Male circumcision can be carried out during infancy, childhood, adolescence or adulthood, and having had the procedure, the male benefits from the preventive effect for the rest of his life.

However, circumcision is much less effective than condom use at preventing HIV transmission. If used correctly every time you have sex, condoms provide highly effective protection against HIV infection, whereas circumcision only prevents about 50% of infections. Even if a man has been circumcised, he must still abstain, be faithful, or use condoms to substantially cut his risk of infection. Moreover, unlike condoms, circumcision does not prevent pregnancy, and it is unclear whether it reduces the risk from other sexually transmitted infections.

It is very important that a doctor perform the procedure, otherwise it can be very risky. If not performed properly, circumcision could actually spread HIV, cause serious bleeding, fatal infections, and damage the rest of the penis. Newly circumcised men must also wait a few weeks for their wounds to heal before having sex. If they don’t, they may increase the risk of HIV infection through their broken skin.

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