The first microbiome study of the penis offers some clues as to why removing foreskin cuts the risk of HIV infection in circumcised men

By Carina Storrs
Source: Scientific American

The World Health Organization declared three years ago that circumcision should be part of any strategy to prevent HIV infection in men. The organization based its recommendation on three randomized clinical trials in Africa that found the incidence of HIV was 60 percent lower in men who were circumcised. Although this “research evidence is compelling,” wrote the WHO panel assigned to the topic, there was little evidence explaining how circumcision might reduce a man’s risk of acquiring HIV.

Now comes an answer in a new study, published in the January 6 issue of PLoS ONE, which found that there are gross changes in the penis’s microbiome following circumcision, suggesting that shifts in the bacterial environment could account, in part, for the differences in HIV infection. Families of anaerobic bacteria, which are unable to grow in the presence of oxygen, are abundant before circumcision but nearly disappear after the procedure. The researchers suspect that in uncircumcised men, these bacteria may provoke inflammation in the genitalia, thereby improving the chances that immune cells will be in the vicinity for HIV viruses to infect.

“We never knew that there were that many anaerobic bacteria on the uncircumcised penis before [this study],” says Ronald Gray, a reproductive epidemiologist at Johns Hopkins Bloomberg School of Public Health and one of the lead authors on the current study. According to a 2006 survey, 56.1 percent of boys in the U.S. are circumcised. In its recommendation, the WHO panel stated that circumcision efforts would be most beneficial in parts of the world where less than 20 percent of boys are circumcised.

[...]
Read more Scientific American

Little evidence that world’s most common surgical procedure can prevent sexually transmitted infections, urinary tract infections and penile cance

André Picard
Tuesday, Jan. 12, 2010
Source: The Globe and Mail

While it is the most common surgical procedure in the world, there is virtually no demonstrable health benefit derived from circumcision of either newborns or adults, a new study concludes.

The sole exception seems to be using circumcision to reduce the risk of transmission of HIV-AIDS in adult males in sub-Saharan Africa, though it is unlikely that benefit carries over to other parts of the world where rates of HIV-AIDS are much lower.

The research, published in Tuesday’s edition of the Annals of Family Medicine, shows that, despite claims, there is little evidence that circumcision can prevent sexually transmitted infections, urinary tract infections and penile cancer.

There are also risks to the surgery that, while rare, range from sexual dissatisfaction through to penile loss.

“Patients who request circumcision in the belief that it bestows clinical benefits must be made aware of the lack of consensus and robust evidence, as well as the potential medical and psychosocial harms of the procedure,” said Guy Maddern, of the department of surgery at The Queen Elizabeth Hospital in Adelaide, Australia, and lead author of the study.

In newborns, he said, the surgery is “inappropriate” because it offers no therapeutic benefit.

About one-third of males worldwide undergo circumcision, the surgical removal of the prepuce (or foreskin).

The procedure is done principally for religious, cultural and social reasons.

Religious male circumcision is practised under both Jewish and Islamic law, and it is an integral part of some aboriginal and African cultural practices.

The main social reasons the practice has continued is a widespread desire that boys resemble their fathers, and a belief that boys who undergo circumcision have fewer health problems.

The new study, a systematic review (a compilation and analysis of previously published research), looked only at the latter point.

Dr. Maddern and his research team found no evidence that uncircumcised men have higher rates of penile cancer. In fact, they noted penile cancer is extremely rare and seemingly unrelated to the presence of a prepuce.

[...]
Read more The Globe and Mail

Monday, January 11, 2010
Source: CBC News

People being treated for HIV are less likely now to develop drug-resistant infections, according to a British Columbia study on changes in drug therapy.

“Our results demonstrate that there has been a drastic decrease in the incidence of new cases of HIV-1 drug resistance,” Dr. Richard Harrigan of the B.C. Centre for Excellence in HIV/AIDS and his colleagues concluded in a study reported in the journal Clinical Infectious Diseases.

The researchers attributed the success to new highly active antiretroviral therapy, known as HAART — usually a combination of three anti-retroviral drugs that are taken to suppress HIV infection.

Before 1996, when people with HIV were prescribed just one or two HIV drugs, their infections were more likely to become drug-resistant and develop into full-blown AIDS.

The research involved 5,422 patients who received antiretroviral therapy from the British Columbia drug treatment program between July 1996 and December 2008. The researchers looked at more than 24,600 tests done on these patients over the years to determine whether their HIV had become resistant to drugs.

They found that during this time, the rate of patients developing new drug resistance fell 12-fold. In one measure of the change, the researchers said that in 1996, the number of cases resistant to each class of antiretroviral drug was on average 571, but in 2008, it was 71.
[...]
Read more: CBC News

Bob LaMendola
11 Jan 2010
Source: Sun Sentinel

Although local film officials say they know nothing of a pornography business in South Florida, a California HIV/AIDS organization Monday said it is filing complaints with Florida health officials about Miami-made films in which sex actors did not use condoms.

AIDS Healthcare Foundation, which offers services and a health plan in South Florida, said it had identified 10 DVDs shot at least partly in Miami with no condom use, which it says encourages unsafe sex. Three Miami-based companies were involved, said group President Michael Weinstein, which indicates an adult film business exists here.

The complaints declare the condom-less films to be “sanitary nuisances” that lead to the spread of disease and should be stopped. The Florida Department of Health is looking into the matter, a spokeswoman said.

For more information about HIV/AIDS prevention, see cdc.gov/hiv.