Abstract
Unsafe sex with HIV-infected individuals remains a major route for HIV transmission, and protective strategies, such as the distribution of free condoms and pre-or post-prophylaxis medication, have failed to control the spread of HIV, particularly in resource-limited settings and high HIV prevalence areas. An additional key strategy for HIV prevention is voluntary male circumcision (MC). International health organizations (e.g., the World Health Organization, UNAIDS) have recommended this strategy on a larger scale, however, there is a general lack of public understanding about how MC effectively protects against HIV infection. This review aims to discuss the acquisition of HIV through the male genital tract and explain how and why circumcised men are more protected from HIV infection during sexual activity than uncircumcised men who are at higher risk of HIV acquisition.
Highlights
Pathogens 2021, 10, 806. https://Over the past four decades, major global efforts have been initiated to address the HIV/AIDS epidemic, and significant progress has been made in terms of controlling the disease spread and in therapeutics
The infected individuals need to rely on highly active antiretroviral therapy (HAART) for the rest of their life to suppress the viral load in the blood
Based on the literature available to date, this review discusses the acquisition of HIV in the male genital tract and explains how and why circumcised men are well protected from HIV infection during heterosexual activity, unlike uncircumcised men who are at higher risk of HIV acquisition
Summary
Whilst most HIV new infections are due to sexual transmission, prevention strategies like abstinence, using condoms during sex, taking prevention medicines such as pre-exposure prophylaxis and post-exposure prophylaxis are some of the effective options to prevent HIV infection. Medical MC reduced the risk of acquisition of HIV by heterosexual men by 38% to 66% over 24 months [15] Another systematic and meta-analysis study in low and middle-income countries showed that circumcision is more likely to protect (23% reduced odds of HIV infection) men who have sex with men from HIV [16]. To implement this strategy on a larger scale, a wider understanding is needed regarding the exact mechanism for how MC protects against. Based on the literature available to date, this review discusses the acquisition of HIV in the male genital tract and explains how and why circumcised men are well protected from HIV infection during heterosexual activity, unlike uncircumcised men who are at higher risk of HIV acquisition
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