Researchers have reported that there is not enough evidence to show that circumcision reduces the risk of AIDS in gay or bisexual men. Previous studies in Africa had shown considerable reduction in AIDS in cases of heterosexual sex.

The study conducted by behavioral scientist Gregorio A. Millett of the Centers for Disease Control and Prevention analyzed data of 15 different studies involving 54,000 gay /bisexual men on circumcision and HIV.  A small reduction of 14 % was noted and this reduction could be due to chance. “Over all, we’re not finding a protective effect associated with circumcision for gay and bisexual men,” said Millett.

Prior to 1997, when treatment for the disease wasn’t as effective as it is today, circumcision cut the risk of HIV by 53 %. "There has been an increase in sexual risk behavior in men who have sex with men since the availability of highly effective treatment for HIV," said Millett. "If a man is engaged in unprotected sex or has lots of sex partners, that contributes more to his risk of HIV than being uncircumcised. So in recent years, the benefit of circumcision may have been overridden by the risks of unsafe sex."

Studies that specifically focused on men who mostly engaged in insertive anal sex got more benefit from circumcision and the effect was stronger in populations where fewer men are circumcised.  Sten Vermund, MD, PhD, director of Vanderbilt University's Institute for Global Health said, "The prospect that predominantly insertive men might derive considerably more benefit from circumcision is as logical as the day is long. What benefit is a predominantly receptive man going to gain from circumcision?"

Vermund and Millett agree that a clinical trial is needed to test this approach. "To add one more tool to our HIV prevention toolbox -- even if it affects only 40% of a risk group -- would be substantial," Vermund says. The Millett study with an accompanying editorial by Vermund, appear in the Oct. 8 issue of The Journal of the American Medical Association.