(Page 2 or 4)

The Lancet report capped off a series of other studies—most of them conducted in Africa, where religion and foreskin have little correlation—concluding that HIV-1 is far more likely to infect men with their foreskins intact. Researchers are more or less confident that the explanation for this unusual relationship has to do with the types of cells found in the foreskin, noting that the small piece of flesh possesses a particularly high number of cells—CD4+ T-lymphocytes and Langerhans cells—that are easy access points for the HIV virus. Additionally, the cells on the inside of the foreskin have only a thin layer of keratin to shield themselves from viruses. While the skin cells found on a hand or a back are impenetrable to HIV, foreskin cells are a much thinner and easier target.

This latest study, however, has left many Indians feeling snippy. Hindu nationalists, angry with foreign officials who encourage routinized circumcision as a weapon in the war against HIV, have blasted the study as needless foreign intervention, and some have gone so far as to claim that HIV isn’t an epidemic in South Asia at all. Earlier this year, Richard Feachem, head of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, contended that HIV is already “out of control” in India, and that the failure to circumcise was one of many culprits. “In India,” Feachem noted during this press conference, “you have roughly 800 million Hindus and 150 million Muslims. For a great majority of the population, lack of circumcision is a major risk factor.”

These Hindu nationalists, however, are fighting against fairly sound science. While initially some had suggested that studies linking HIV to the foreskin did not adequately take into account the cultural differences between Hindus and Muslims, the 2004 Lancet study found that rates of other STDs were more or less consistent among circumcised and non-circumcised men regardless of religion, suggesting a biological correlation rather than a behavioral one. In spite of the strength of the science, the study’s authors have never publicly called for routinized circumcision among Hindus, presumably aware that issuing such a proclamation would amplify the deadening Hindu cry of ‘genital imperialism.’ Indeed, though the study’s authors defend their observed link between circumcision and HIV, the researchers have been careful to note that the observational nature of the study “limits the generalisability of the findings to other populations.”