Foreskin surface area and HIV acquisition in Rakai, Uganda (size matters)

Kigozi et al. AIDS • 2009 • Volume 23 - Issue 16

Special Author Introduction
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Medical Male circumcision (MMC) has been shown to reduce the risk of HIV acquisition in men by ~60% and is now recommended by UNAIDS WHO as one of the proven HIV prevention methods for HIV negative men. A number of hypotheses have been advanced to explain mechanisms through which MMC reduces the risk of HIV acquisition.

Our paper explores the possible relationship between the size of the foreskin and the risk of HIV acquisition among HIV negative men who participated in a longitudinal community cohort as well as in a randomized controlled clinical trial of Medical Male circumcision for HIV prevention conducted in Rakai, Uganda. The paper suggests that  the surface area  of the foreskin is associated with  HIV acquisition and it is likely that foreskin area reflects the number of HIV target cells.

It is however important to note that these data come from an observational study and there is therefore need to be replicate  the findings before applying them to  MMC policy.

Godfrey Kigozi, MBCHB, MPH
Head of studies
Rakai Health Sciences Program
Uganda

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