Does circumcision prevent HIV?

There is some evidence to suggest that circumcision can help reduce (but not eliminate) rates of HIV infections in heterosexual men, particularly in Sub-Saharan Africa.

According to the World Health Organisation, three randomised trials in Kenya, Uganda and South Africa show that circumcised men have a 48% – 60% lower chance of becoming infected with HIV. This means there is still a 40% to 52% chance of contracting HIV during unprotected sex.

Since 2007, the WHO has recommended circumcision as a way to reduce the spread of HIV in Southern and Eastern Africa where infections are particularly high. It re-iterated this advice in 2020.

It is not clear if circumcision can help reduce HIV infections outside of sub-Saharan Africa as there have not been enough studies.

Circumcision, by itself, is not a good way to prevent transmission of HIV. You should always use a condom to prevent transmission of sexually transmitted infections including HIV.

Why could circumcision help reduce HIV infections?

According to studies cited by the WHO circumcised men generally have a lower risk of contracting penile infections tha uncircumcised men.

The area under the foreskin is a warm and moist environment, creating perfect conditions for most bacteria to reproduce, particularly if the area isn’t cleaned properly.

In addition, the inner skin of the foreskin is mucosal, which means it is like the skin inside your mouth. This type of skin is much thinner and more susceptible to cuts and grazers than the skin on the outside of the penis and could act as an entrypoint into the body for any bacteria or viruses.

Circumcision is likely to be less effective in preventing HIV in areas with access to clean water and where it is easier to take regular showers to clean the penis. Unfortunately, no studies have been undertaken to evaluate the effectiveness of circumcision on HIV transmission in Europe, the United States or other developed countries.

Penile hygiene is important

Making sure you wash and clean your penis is important regardless of whether your are uncircumcised or not.

Whilst circumcision removes a potential area for bacteria and viruses to live you should still wash your penis every time you take a shower or bath.

It is also important for uncircumcised men to wash under the foreskin as there is an increased risk of dead skin cells, skin oils, bacteria and secretions such as urine or pre-cum to accumulate. These can often build to cause a thick white substance called smegma.