Looking at those links - I'm not finding any scientific explanation as to why or why not circumcision would or would not reduce HIV transmission. I posted the scientifically determined process by which the foreskin is found to encourage HIV transmission. The actual biological process.
The articles stating statistical studies such as "In Malawi, 20% of the male population is circumcised. The ratio of circumcised vs. intact men who contracted HIV was 13.2 vs 9.5." are not demonstrating whether or not circumcision changes HIV infection probability.
As one of the other articles pointed out, men who were circumcised were far more likely to engage in risky behaviors.
The articles are describing the effects of behavior, not circumcision. You know, kinda like some men rape virgin girls because they were convinced that's the way to cure their HIV. Guess what that does to the HIV transmission rate?
I am looking for scientific analysis of the biological processes of HIV infection and how those processes are affected by circumcision. I already posted the results of one biological study.
Infection rates are skewed by behaviors, therefore not reliable.
Here's the biological information again:
The Scientific American article describes the study showing the great effectiveness of circumcision and provides detail as to WHY it works:
"It was striking that the trials were in very different settings, but yielded consistent results," says Ronald Gray, study leader for the Uganda trial and epidemiologist at Johns Hopkins Bloomberg School of Public Health in Baltimore. "This was the largest protective effect ever seen next to condom use," adds Sten Vermund, director of the Institute for Global Health at Vanderbilt University School of Medicine in Nashville, Tenn. But the question remained: Why?
Microscopic examination of the foreskin yielded important clues for unraveling the benefits of circumcision. Normally, the skin provides a thick protective barrier stemming from
keratin—a tough structural protein also found in hair and fingernails. But on the inner surface of the foreskin, the keratin layer is much thinner, resembling the inner lining of the mouth or eyelid more than the palm of the hand.
In uncircumcised men Langerhans cells—immune cells that are primary targets for HIV transmission—"are more richly concentrated near the surface of the foreskin," says
Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases in Bethesda, Md. Without the keratin barrier, HIV can easily access these cells in the foreskin. Following infection, Langerhans cells not only serve as reservoirs for replicating virus, but also transport the virus to nearby
lymph nodes where HIV spreads to other immune cells.
In fact, the foreskin's anatomical function actually amplifies the risks. In uncircumcised men the foreskin covers and protects the tip of the penis, paradoxically making the skin there more delicate and prone to microscopic abrasions. These tiny injuries promote inflammation, Fauci says, allowing the virus to come into closer contact with target
immune cells. The moist environment that forms under the foreskin also enhances the growth of microbes on the penis's tip,
Fauci adds, further stimulating immune responses near the skin's surface.