Feasibility of Measuring Immune Resp, Activation in Foreskin/Mucosa in HIV-, Uncircumcised High-HIV-risk MSM, Lima Peru

Inclusion Criteria: 1. Male, age 21 to 30 years, who, in the 6 months prior to screening, experienced 1 or both of the following HIV risk criteria: * unprotected anal intercourse with 1 or more male or MTF transgender partner(s); or * anal intercourse with 2 or more male or MTF transgender partners. Note: Volunteers who have been in a monogamous relationship with an HIV-seronegative partner for \> 6 months are excluded. 2. Ability and willingness to provide informed consent 3. Assessment of understanding: volunteer demonstrates understanding of the procedures and purpose of this study. Participants will complete a questionnaire prior to enrollment with verbal demonstration of understanding of all questionnaire items answered incorrectly. 4. Willingness to receive HIV test results 5. Willingness to discuss HIV infection risks (including sexual behavior and drug use) and amenable to HIV risk reduction counseling 6. Willingness to undergo phlebotomy, rectal swab, sigmoidoscopy, and circumcision 7. Willingness to adhere to safety protocols before and after sigmoidoscopy and circumcision 8. Agrees not to enroll in another study of an investigational research agent prior to completion of the last required protocol clinic visit 9. Hemoglobin ≥ 13.0 g/dL 10. White blood cell (WBC) count = 3300 to 12,000 cells/mm3 11. Total lymphocyte count ≥ 800 cells/mm3 12. Remaining differential either within institutional normal range or with site physician approval 13. Platelets = 125,000 to 550,000/mm3 14. Prothrombin time (PT) or partial thromboplastin time (PTT) ≤ 1.25 institutional upper limit of normal; International Normalized Ratio (INR) ≤ 1.5 15. Negative HIV-1 and -2 blood test: May use locally available assays that have been approved by HVTN Laboratory Operations. Exclusion Criteria: 1. Volunteers who, in the six months prior to screening, have had sexual partners known to be HIV-infected 2. Volunteers who, for the 6 months prior to screening, have been in a monogamous relationship with an HIV-seronegative partner 3. History of immunodeficiency 4. Foreskin covering less than half the glans 5. Absolute medical indication for circumcision (balanitis or phimosis) 6. Bleeding disorder diagnosed by a doctor (eg, factor deficiency, coagulopathy, or platelet disorder requiring special precautions). \[This exclusion also applies to therapeutic anticoagulation that results in a prolonged PT/INR or PTT.\] 7. HIV vaccine(s) received in a prior HIV vaccine trial. For potential participants who received control/placebo in an HIV vaccine trial, the HVTN 914 PSRT will determine eligibility on a case-by-case basis 8. Untreated clinical signs or symptoms of genitourinary or colonic infection 9. Any medical condition contraindicating circumcision or flexible sigmoidoscopy with biopsies 10. History of transactional sex (ie, exchange of sex for money, shelter, food, or drugs) in the preceding 6 months 11. Any medical, psychiatric, occupational, or other condition that, in the judgment of the investigator, would interfere with, or serve as a contraindication to, protocol adherence, assessment of safety, or a participant's ability to give informed consent 12. History of keloid scarring