Male Foreskin Size Can Affect Risk of HIV Infection

Study finds larger foreskin surface area linked to higher risk of infection

THURSDAY, Oct. 29 (HealthDay News) -- Men with larger foreskins are at higher risk of being infected with HIV, according to a study in the Oct. 23 issue of AIDS.

Godfrey Kigozi, M.D., from Rakai Health Sciences Program in Entebbe, Uganda, and colleagues examined the association between foreskin surface area and HIV acquisition among 965 initially HIV-negative men who were enrolled in randomized trials of male circumcision. Men were circumcised either immediately or after two years.

The researchers found that 48 men became infected with HIV before circumcision. The mean surface area was significantly larger for men who seroconverted (43.3 versus 36.8 cm2). HIV incidence increased with increasing foreskin surface area, from 0.80 per 100 person-years for the lowest quartile to 2.48 per 100 person-years for the highest quartile. After adjusting for age and other factors, the adjusted incidence rate ratio for HIV infection was 2.37 for the highest compared with the lowest quartile of foreskin surface area.

"A larger foreskin surface area was associated with an increased risk of HIV acquisition, which suggests that providers should avoid leaving excess residual foreskin tissue after circumcision," Kigozi and colleagues conclude. "These observations strongly suggest that larger foreskin size is a risk factor for HIV acquisition in uncircumcised men."

Abstract
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