Washing Penis Soon After Sex Increases Risk Of HIV Among Uncircumcised Men

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Washing the penis minutes after sex might increase the risk of HIVinfection among uncircumcised men, according to a study funded by NIH's National Institute of Allergy and Infectious Diseases and presented on July 25 at the 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Sydney, Australia, the New York Times reports. According to the Times,the washing analysis was the secondary part of a study undertaken todetermine the effectiveness of male circumcision as an HIV preventionmethod.

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For the study, Fredrick Makumbi of the Makerere University Institute of Public Healthand colleagues examined 2,552 uncircumcised, HIV-negative men ages 15to 29 in the Rakai district of Uganda. Eighty-three percent of theparticipants said they washed their penises with all sex partners, the Timesreports. The researchers asked the men when and how they washed theirpenises -- including if they washed with or without cloths -- after sexat the beginning of the study and at six, 12 and 24 months after thestudy began. According to Ronald Gray, a study co-author and professorof population and family planning at Johns Hopkins Bloomberg School of Public Health,the researchers did not ask details about how the washing was conductedor if soap was used because of an oversight. Some soaps used in Africaare more irritating than soaps used in other places, according to the Times.

Theresearchers found that men who washed within three minutes after sexhad a 2.3% risk of HIV infection, compared with a 0.4% risk among menwho delayed washing for 10 minutes or more. Makumbi and other AIDSexperts said they do not know why washing might increase vulnerabilityto HIV, but they offered some explanations. One is that delayingwashing and prolonging exposure to vaginal secretions might reduceviral infectivity. Another explanation is that the acidity of vaginalsecretions might impair the ability of HIV to survive on the penis, theTimes reports. In addition, the use of water, which has aneutral pH, might prolong viral survival and possible infectivity,according to the Times. HIV likely needs to be in a fluidto cross the mucosa and infect cells, Gray said, adding that ifHIV-infected fluid dries, its infectivity could decrease. Adding water,therefore, could resuspend HIV and increase its infectivity, the Times reports.

Onemessage from the study is that "there ought to be a little time leftfor postcoital cuddling before you go and wash," Gray said, adding,"Don't just finish and jump out of bed." Merle Sande -- an infectiousdisease expert at the University of Washington-Seattle and president of the Academic Alliance Foundation,a group that trains health workers to treat HIV/AIDS and otherinfectious diseases in Uganda -- said the study's findings arecounterintuitive and "show why you have to do the studies, becauseuntil you do them, you just don't know." He added, "There is still somuch we don't understand about the complex factors that influence HIVtransmission in the genital tract, but this important study will help"(Altman, New York Times, 8/21).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . TheKaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service ofThe Henry J. Kaiser Family Foundation.

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