The study was conducted by the Indiana University and has painted a scary picture of the claim of HIV prevention.
A study has shown that circumcised men in the Mpumalanga province have a higher rate of HIV than those who are not circumcised.
The findings appear to suggest that it needs to be communicated to both men and women that circumcision does not offer 100% protection against HIV, according to reports.
Published in the PLOS ONE journal this month, it surveyed over 2 300 men across the province who were 40 years and older.
It was conducted by professors from the Indiana and Wits Universities.
One of the professors Molly Rosenberg and Till Barnighausen say it is important to note that circumcision still works to reduce the risk of contracting HIV – with over 27 studies have proved this.
But in this latest study, the result has showed the opposite.
Men who reported being circumcised in hospital through voluntary medical male circumcision when older had an HIV prevalence rate of 31%, meaning that almost one in three men were positive.
There are three possible theories for the counterintuitive finding, Rosenberg and Barnighausen explained.
The first of their three theories is that HIV positive men are opting for circumcision at higher rates.
This may be because they may already be going to clinics and getting antiretrovirals, and then make use of other services available at the clinic.
The second theory is that men who are at higher risk of contracting HIV because they have many sexual partners or do not like using condoms, opt for circumcision because they think it is a safe solution.
However, they then still get HIV from unprotected sex.
It could also be, still in accordance with the second theory, that men engage in riskier sexual behaviour after circumcision because they know they are at a decreased risk.
But the researchers say the second theory is probably the least likely explanation because multiple studies have showed no evidence for this kind of risk compensation after medical male circumcision.
Deputy director of the Wits Reproductive Health and HIV Institute, said if men are taking greater sexual risks after circumcision, communication about it needs to change.
“This well-conducted study should make us carefully look at our messaging around circumcision, so that we don’t lose some of the impact of this effective intervention,” professor Francois Venter from Wits said.
And the third theory is that HIV-positive men are more likely to get circumcised. The study says government policy that HIV-negative men must get circumcised and awareness about its protective effects “gives the false impression that circumcised men are safer sex partners”.
“If HIV-positive men actually take up the circumcision procedure at high rates … [and are seen by women as safer], it may have the unintended consequence of increasing HIV transmission,” reads the statement of the finding.
The study also found that uncircumcised men 40 years and older in Mpumalanga showed an HIV prevalence rate of 24% – which means that 1 in 4 men above 40 was HIV positive.
Those circumcised through initiation while they were young, had a prevalence of 16%, showing that getting circumcised younger really does reduce the risk of HIV.
The researchers wrote: “In our study population of over 2,000 men, only a quarter reported being circumcised, which is actually lower than the national estimate of circumcision rates. So any social desirability bias potentially distorting our findings is unlikely to be very large.
“We strongly support universal circumcision of all HIV-men in SA, because it is known with certainty that circumcision biologically protects against HIV-based on three large well-conducted randomised controlled trials.”
(edited by MLM, with Business Day)
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