Angela Merkel intervenes over court ban on circumcision of young boys (in Germany)

[Tuesday Afternoon]

176. interesting article about this subject:

Clean-Cut: Study Finds Circumcision Helps Prevent HIV and Other Infections
The first microbiome study of the penis offers some clues as to why removing foreskin cuts the risk of HIV infection in circumcised men

What's Next for AIDS: New Approaches for Tackling HIV in the Developing World The surprise success this summer of a clinical trial on an antiretroviral-based vaginal microbicide provides new traction for efforts to combat AIDS in the developing world. Here are some new directions to expect for treatment and prevention of this widespread killer »August 25, 2010.

CUTTING HIV RISK: A new study suggests that bacterial changes following circumcision could help protect circumcised men from HIV infection. Image: ISTOCKPHOTO/LUTHERHILL

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 ," 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.

Gray, who is also working with one of the three randomized clinical trials on which WHO based its recommendation, adds that, "If we can show that these anaerobic bacteria are associated with HIV, then one could develop microbicides—antiseptics or targeted antibiotics —that might provide protection."

more at link:
http://www.scientificamerican.com/article.cfm?id=circumcision-penis-microbiome-hiv-infection