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Researchers Call For Higher Circumcision Rates To Slow STDs

Posted by Jane Akre
Thursday, March 26, 2009 2:37 PM EST
Category: Major Medical, Protecting Your Family
Tags: HPV, HIV, STDs, Human Papillomavirus, Circumcision, Sexually Transmitted Disease, Johns Hopkins University

Circumcision rates should be increased to decrease stds say researchers.

Ugandan Children, Courtesy, U.S. Agency for International Development

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IMAGE SOURCE:  Wikimedia Commons/ Ugandan children/ author: U.S. Agency for International Development

 

Researchers from Johns Hopkins University believe increasing circumcision rates may help reduce the risk of herpes and human papillomavirus (HPV).

Circumcision is already known to reduce HIV infections.

Writing in the New England Journal of Medicine (NEJM), researchers followed more than 5,500 men in Uganda and monitored their sexual activity for up to two years.  Half of the men were circumcised, the other half were not.

They found herpes was reduced by 28 percent and HPV by one-third, among the circumcised men.

The protective effect is good news for both men and women.

"Men are at risk for genital warts and things like discharge. Women are at risk for cancer," said Dr. Anthony S. Fauci, to ABC News. He is a co-author of the study appearing in the New England Journal of Medicine and the director of the National Institute of Allergy and Infectious Diseases.

Why this happens is uncertain, but dampness may increase the chance of an HIV infection. 

In the UK not everyone is convinced.  BBC News reports that Dr. Colm O’Mahoney, a sexual health expert, says the U.S. has an obsession with circumcision as the answer to reduce sexually transmitted disease (STD). 

He said: "Sure, a dry skinned penis is a bit less likely to contract HIV, herpes and possibly genital warts but it will get infected eventually." Dr. O’Mahoney says that the circumcision argument doesn’t address the use of condoms. 

"And it allows men who don't want to change their irresponsible behaviour to continue to sleep around and not even use a condom." 

Medicaid does not cover circumcision in 16 states.  Private insurance increasingly is not as well. 

The American Academy of Pediatrics considers circumcision a non-essential medical procedure with health benefits. Anywhere from one-third to two thirds of U.S. baby boys are circumcised depending on the region and ethnic background of the family. # 


4 Comments

Anonymous User
Posted by Roger Alvarez
Thursday, March 26, 2009 3:52 PM EST

Interestingly, when you look at the raw data table in the study, there are some issues. While in Table 1, the rates of condom use were similar between the control group and intervention group (demonstrating good randomization), Table 2 of the study demonstrates that condom use was significantly greater in the intervention group (i.e. circumcision group) compared with the control group at 6 months(p<0.001). Without a plausible causal link between circumcision and increased condom use, the issue calls into question, for me, the validity of the results. The authors do state in their methods that "performed an adjustment for baseline characteristics using a Cox proportional-hazards model for the time to detection of HSV-2..." That is, they adjusted for baseline characteristics but not changes in sexual practices (e.g. condom use) in their primary analysis. They did do so in their secondary analysis, which is not presented in the results section of their article, or the online supplement. Interestingly, the Intervention group had lower rates of condom use at baseline, compared with the Control group. It is not clear how adjusting for that may have affected their conclusions. I would like to hear what the authors have to say about those adjustments, and would like to know what they think about the higher condom use at 6 months in men who were circumcised.

Posted by Jane Akre
Thursday, March 26, 2009 4:53 PM EST

Roger-

The NYT has more detailed reporting that you request. Even after adjusting for various sexual practices, the differences were reported to be dramatic. And researchers say there is no reason that these findings should pertain only to Africa.

Thanks for writing

LINK

Anonymous User
Posted by Mark Lyndon
Friday, March 27, 2009 7:34 AM EST

1) Babies aren't going to be getting any STI's before they're old enough to decide for themselves whether or not they want part of their genitals cutting off. It's their body; it should be their decision.

2) These latest studies are from Africa. A 29 year study of males in New Zealand showed a slightly *higher* rate of STI's among circumcised men:
LINK (07)00707-X/abstract

3) If we found out that cutting off part of a girl's genitals reduced her risk of contracting an STI, would that make it acceptable?
This study shows exactly that: LINK

If female circumcision had caught on in the USA (it was promoted in medical papers till at least 1959, and practised till the early 70's), and western researchers were now looking for benefits of female circumcision as enthusiastically as they are looking for benefits of male circumcision, we'd now be getting news articles about how female circumcision help prevent STI's. It wouldn't mean that there aren't better ways to prevent STI's, and it wouldn't make it right.

Anonymous User
Posted by PJ
Wednesday, April 01, 2009 10:40 AM EST

LINK

Circumcision victim gets $2.3 million
By Ty Tagami

The Atlanta Journal-Constitution

Tuesday, March 31, 2009

Comments for this article are closed.

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