Almost 30 years after HIV was identified as the cause of AIDS, we still have not conquered the epidemic. A recent article in the medical literature provided statistics on how many American men are infected, as well as some ideas for reducing this number.
The lifetime risk of HIV infection for American males is given as 1.87 percent. Uncircumcised males are at higher risk. The distribution of risk by race, ethnicity, and circumcision status is:
1. Uncircumcised white males, 1.03 percent lifetime risk of HIV
2. Circumcised white males, 0.95 percent
3. Uncircumcised Hispanic males, 3.04 percent
4. Circumcised Hispanic males, 2.66 percent
5. Uncircumcised black males, 7.35 percent
6. Circumcised black males, 5.82 percent
The same paper reports that 15.7 percent of American males with AIDS acquired it from high risk heterosexual activity. Homosexual activity accounts for 71.4 percent and intravenous drug use for 12.5 percent of HIV diagnoses in American males. A number of studies have reported that male circumcision reduces the risk of heterosexual HIV transmission to males by 51 to 76 percent, but has no significant effect on homosexual HIV transmission.
Thus, increasing rates of circumcision would decrease rates of HIV infection by a small amount. Currently, 88 percent of white males, 73 percent of black males, and 42 percent of Hispanic males are circumcised in America. Cost is a major issue in the decision for parents to choose this procedure for their babies. Rates for neonatal circumcision are reported to be twice as high in states where Medicaid pays for it, compared to states where Medicaid does not. By doing a detailed cost analysis, the authors concluded that increasing rates of neonatal circumcision would save money in the long run, because even one case of AIDS is very expensive for our health care system as well as for the quality of life of that individual.
When I took a divorce recovery class, our teacher suggested that all of us get an HIV test, for two reasons. First, if you've ever been married, you don't have a 100 percent guarantee that your partner never brought home an infection. Second, when you start dating, you can show your romantic partner your lab test results, and ask him or her to get the test and show you the lab report. I have not seen a cost analysis for single adults getting HIV tests, but like circumcision, it's worth doing a large number of low-cost procedures to prevent even one case of AIDS.
Reference:
Sansom SL et al, “Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males”, PLoS One 2010 Jan; 5(1): e8723.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.