Condoms, yes; foreskins, no

| Mon Jul. 3, 2000 12:00 AM PDT

In recent years fewer and fewer baby boys have had their privates snipped as more people come to regard the practice of circumcision as unnecessary at best, barbaric at worst. But epidemiological evidence that male circumcision lowers HIV infection risk could turn that trend around.

A story in SALON.COM reports that HIV transmission rates vary widely between African countries due to all kinds of reasons, including different strains of the disease, different rates of condom use and, apparently, different traditions regarding male circumcision. HIV infection rates are considerably lower in west Africa, where it's traditional to circumcise, than in eastern and southern Africa, where it's not. The same pattern holds in Asia: Both Thailand and the Philippines have an active sex trade, but Thailand's HIV rate is much higher than that of the Philippines. Circumcision is traditional in the Philippines; in Thailand it is not.

It may be that the fragile foreskin itself is particularly vulnerable to infection. In one study looking at HIV negative men married to HIV positive women, after two and a half years 40 of 137 uncircumcised men had become infected. Of 50 circumcised men, not one was positive.

If true, it's ominous news for China and India, where the population is largely uncircumcised and HIV infection is just getting started.

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