"The goal is to circumcise 20 million African men by 2015..."

[Spider Jerusalem]

32. A combination of factors:

From the South African Journal of Obstetrics and Gynaecology:

The biological reasons for decreased susceptibility to HIV in circumcised men are thought to be multifactorial. Firstly, the internal mucosal layer of the prepuce has been shown to have a greater concentration of Langerhans cells and other HIV target cells such as macrophages and CD4 dendritic cells than cervical mucosa. It therefore has the ability to absorb the HIV more efficiently, and it is plausible that removal of the foreskin is a likely mechanism in reducing the chances of HIV infection. Secondly, the foreskin is susceptible to tears, abrasions and infections, particularly near the frenulum, facilitating HIV transmission. Thirdly, circumcision results in increased keratinisation of the glans when not protected by the foreskin; this acts as a protective keratin layer, minimising HIV penetration of the surface epithelium.3-6 Lastly, it is also hypothesised that male circumcision leaves only a small mucosal surface area in the urethral meatus open to recurrent infective exposures, which may induce a mucosal immune response and further protection above that of circumcision.

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