Does Male Circumcision cut it for Gay Men?

By Jim Pickett

In the last couple of months, I have found myself in the middle, or on one side, of passionate debates with other gay men concerning the potential implementation of male circumcision as an HIV prevention intervention among gay and other men who have sex with men. These conversations have been marked by frustration, stridency for each position, and comparisons to female genital mutilation. More than once, they have devolved into yelling matches. I decided to take the gloves off and chat with a few folks in the community and learn their reactions.

“Wait, what about condoms?” asks Bill Stackhouse, Director of the Institute for Gay Men’s Health at Gay Men’s Health Crisis. “Have we done enough to support and encourage the use of condoms? Circumcision for adults is a serious, medically invasive procedure which does not eliminate the risk of HIV transmission. We clearly do not know how the research out of Africa is relevant to gay men,” he says, highlighting a chief concern among many in the community.

Can we interpret research done with African heterosexual men for gay guys in the Bronx, Berlin or Buenos Aires? While he has reservations and is not enthusiastic about the idea of male circumcision for gay men, Stackhouse would support a sufficiently powered multinational trial with sites in the West, Central and South America to determine if male circumcision would have an effect on the domestic and global HIV/AIDS epidemic.

Karl Grant is a party promoter and the Chair of the Chicago Black Gay Men’s Caucus. “If we had data to prove that this would be effective among the MSM population, and my partner of 10 years wanted to talk about it, I would definitely be willing to talk about it,” he says. “But I don’t like pain or anything associated with it. As an uncircumcised top man, I am used to being uncircumcised and understand the importance of hygiene.”

“I think some people in our community are excited about circumcision because they are grasping for the answer, the silver bullet,” says Simone Koehlinger, the Director of LGBT Health for the City of Chicago. “I would definitely like to have the question answered about its relevance for our community, but also want to remain mindful of the important cultural implications of such an intervention. And we must not dismiss the fact that removing the foreskin also removes a significant degree of sexual pleasure for men. That is not something to take lightly.”

Jim Pickett is the Director of Public Policy for the AIDS Foundation of Chicago

The Caucus for Evidence-Based Prevention is comprised of dozens of diverse organizations.The group monitors HIV prevention programs and policies, reports on HIV prevention-related conference proceedings to a wide audience, and alerts the community when ideology, prejudice, or opinion interferes with evidence-based approaches to reducing the further spread of HIV/AIDS. The article above was published in a newsletter that was distributed May 22, 2007 at the HIV Prevention Leadership Summit in New Orleans.