Do Not Rely On Circumsicion To Protect Against HIV.

I just thought I should put this letter to the editor which appeared in the Post Courier, February 13, 2007. To claim that circumcision protects against HIV infection may give a false sense of security  and may in-fact increase promiscuity among PNG males. The letter was written by Professor Glen Mola, Professor of Obstetrics and Gynecology, UPNG.


 The letter.

I would like to congratulate Sr (Dr) Joseph of Wewak Hospital regarding her enthusiasm to assist in our national program to minimise transmission of HIV infections: I refer to the news report on page 5 of the Post-Courier of February 7, headed “Circumcision the new weapon against AIDS”.

It has been known for some time on a population basis that circumcised male populations transmit and catch the HIV infection themselves at a lower rate than uncircumcised male populations.
However, the fact of the matter is that circumcision does NOT assure the individual man that he will not catch HIV with risky sex.

There have been three large research projects carried out in Africa over the past couple of years. I have been invited by the World Health Organisation to attend a meeting next month where experts will review this research and try to work out whether there is a place for recommending circumcision in particular countries. The issue is very complex; however, one thing is clear, circumcision does not protect a man (or his partner) against catching HIV anywhere near as well as a condom does.

If it is found that it could be worthwhile recommending circumcision for men in certain circumstances, then this will NOT mean that men should no longer need to wear a condom when engaging in risky sex. Under the circumstances I think it is somewhat premature to recommend “all health workers from local aid posts in the province will undergo proper training to carry out circumcisions”.

Moreover, circumcision is not a risk-free operation even in expert hands. It would be a great pity to spend a lot of time and energy on a program that could lead to significant numbers of operative complications and then at the end of the day not have any significant impact on the HIV problem.
Also I am somewhat disappointed that the article describing Sr Joseph’s program to teach auxiliary health workers to do circumcisions did not mention the vital need to still use a condom to properly prevent HIV transmission whether one is circumcised or not.

Lastly, it is not correct to say that circumcision prevents cervical cancer by improving male hygiene. The cause of cervical cancer has nothing at all to do with male hygiene. Cancer of the cervix is caused by another STI called the human papilloma virus.

Condoms can help to prevent cancer of the cervix. circumcision does not.

– Professor Glen Mola,
Head of Obstetrics and Gynecology Dept. UPNG, Chief Obstetrician Gynecologist (SSMO) for the Ministry of Health of Papua New Guinea.


About rodney itaki

Medical doctor and public health specialist from Papua New Guinea.
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