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Partial Traditional Circumcision May Not Lower HIV Risk in Xhosa Men

Author: Mark Mascolini


19 December 2011

Traditional circumcision that removes only part of the foreskin may not protect men from HIV infection, according to results of a study involving Xhosa men in Cape Town, South Africa. Almost all of the men studied had been circumcised, though some of them only partially.

South Africa has about 8 million Xhosa people, who are members of several related tribes that speak the Xhosa language, which is the second most common native language in South Africa after Zulu. Nelson Mandela and Desmond Tutu are Xhosa.

This study involved 473 young Xhosa men in Cape Town who were interviewed to determine their attitude toward circumcision, whether they had been circumcised, and whether they had HIV infection. Three randomized trials in Africa found that medical circumcision lowers the risk of HIV acquisition about 60% in heterosexual men.

A large majority of study participants, 92.5%, had been circumcised, though 10.5% had been only partially circumcised. Most men, 91%, had been circumcised between the ages of 17 and 22 (average 19.2).

Partially circumcised men had a 7% greater risk of being HIV positive than fully circumcised men, a significant difference (P < 0.05). HIV risk in partially circumcised men equaled that of uncircumcised men. The risk of being HIV positive rose with age of circumcision, a finding that approached statistical significance (P < 0.10).

The researchers believe “efforts should be made to encourage earlier circumcisions and to work with traditional surgeons to reduce the number of partial circumcisions.”

Source: Brendan Maughan-Brown, Atheendar S. Venkataramani, Nicoli Nattrass, Jeremy Seekings, Alan W. Whiteside. A cut above the rest: traditional male circumcision and HIV risk among Xhosa men in Cape Town, South Africa. JAIDS. 2011; 58: 499-505.

For the study abstract

(Downloading the complete article requires a subscription to JAIDS or an online payment; the abstract is free.)