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Trick or Treat!?

Posted by Project NEON on October 30, 2014 10:42 AM

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Posted by Project NEON on October 8, 2014 12:16 PM

Dear Dr. Dick,

As someone who just recently entered the gay dating scene, I haven't been with too many guys. Still, I was a little surprised when during my last hookup, "Mac" dropped his pants and revealed that he wasn't snipped. How is it that I've never seen an uncircumcised dick in real-life? (It was beautiful by the way). Anyway, I've heard that if you're not snipped, it's easier to get an infection in your dick, because it doesn't stay as clean. Any insight would be much appreciated.

-Snipped in Seattle


Dear Snipped,

Like a circumcised dick, an uncircumcised dick is as clean as its owner wants it to be. With that said, research shows that circumcision--surgical removal of some or all of the foreskin from the penis (usually done during infancy), can provide certain protective benefits during sex. However, these benefits probably mainly affect guys who have vaginal sex.

Men who are circumcised have a reduced chance of getting HIV, HPV and herpes from FEMALE-bodied partners during vaginal sex. They are also probably less likely to spread HPV to their partners and circumcision protects their female partners from bacterial vaginosis.  Circumcised men also have a reduced chance of cancer of the penis.   

So what's the deal with the foreskin? Foreskin is lined with mucosa (moist tissue), that may make it easier for HIV to get in the body. Here's why:

  • Foreskin may be more likely to tear during sex, creating more entry-ways for infection.
  • Foreskin may be more susceptible to HIV infection than other tissues of the penis.
  • There may be more target cells for HIV (cells that HIV invades, like T-Cells) in the mucosa of the foreskin.

Does circumcision reduce HIV transmission in guys who have sex with guys? Studies show mixed results. Most studies - including research done in Seattle - suggest that circumcision doesn't protect MSM (Men who have Sex with Men) against HIV. At least in part, this likely reflects the fact that most MSM in the U.S. are versatile, and the risk of getting HIV is highest when men bottom.  Being circumcised doesn't protect you from getting HIV through your rectum.  Some studies suggest that circumcision is protective in MSM who only top, but that is not certain. More research needs to be done on this important topic. Still, there are many ways to reduce the likelihood of HIV transmission during sex:


  • If the insertive partner is HIV-positive and taking antiretroviral therapy consistently and correctly, they are less likely to transmit HIV to a partner.
  • If one partner is HIV-negative and taking PrEP (Pre-Exposure Prophylaxis), they have additional protection against HIV taking hold in the body. http://projectneon.org/learn/drdick/hiv/that-little-pill/  If you decide to take PrEP, it is important to take your medication every day, to assume that the PrEP is not really effective for the first 2-4 weeks you are taking it, and to realize that PrEP is not 100% effective.


  • "Male condoms," insertive "female" condoms, oral sex condoms, and dams all provide a barrier against contact with genital fluids. Use water-based lube with condoms to prevent friction that could tear skin or the condom.


  • Test every 3 months for HIV, chlamydia, gonorrhea, and syphilis. If you test positive, connect with your medical provider right away for treatment. Getting treatment keeps you healthy and reduces your chance of transmitting an infection to a partner. Many agencies in Seattle offer FREE testing:  http://www.kingcounty.gov/healthservices/health/communicable/hiv/resources/testing.aspx#test

*A NOTE ON CLEANLINESS: hygiene is especially key for uncircumcised males. Men who aren't snipped should gently pull back the foreskin during a bath or shower, and clean and dry the area well, to prevent infection.  


Take care,

Dr. Dick




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