Circumcision and Venereal Disease

Hand, Eugene A.

doi:10.1001/archderm.1949.01530030037004

Cited by 18 publications

(12 citation statements)

References 2 publications

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“…7 30 38-42 Six of seven studies found a reduced risk of chancroid among circumcised men, and this was statistically significant in four studies (table 3). 7 38 41 42 No meta-analysis for the chancroid studies was carried out because (1) the definition and ascertainment of the outcome varied between studies, and (2) the comparison groups varied considerably and some included men with other STIs (mainly urethritis) against which circumcision may also be protective. 12 13 The single study with a serological outcome found no association with circumcision (table 3).…”

Section: Association Of Male Circumcision and Chancroidmentioning

confidence: 99%

“…37 Three early studies that compared chancroid patients (diagnosed by clinical diagnosis or microbiology) or penile ulcer patients with asymptomatic controls found that circumcised men were at much lower risk (RR from 0.04 to 0.40). 7 38 39 Two more recent studies compared H ducreyi culture positive patients 40 or GUD patients (89% clinically diagnosed as having chancroid) 41 with urethritis patients. Each found a slightly weaker association than those with asymptomatic controls.…”

Section: Association Of Male Circumcision and Chancroidmentioning

confidence: 99%

“…The five studies that reported response rates were retrospective record based studies, and so had 100% responses. 7 …”

Section: Association Of Male Circumcision and Chancroidmentioning

confidence: 99%

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Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis

Weiss

Thomas

Munabi

et al. 2006

Sexually Transmitted Infections

333

249

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Objectives: Male circumcision is associated with reduced risk of HIV infection. This may be partly because of a protective effect of circumcision on other sexually transmitted infections (STI), especially those causing genital ulcers, but evidence for such protection is unclear. Our objective was to conduct a systematic review and meta-analyses of the associations between male circumcision and infection with herpes simplex virus type 2 (HSV-2), Treponema pallidum, or Haemophilus ducreyi. Methods: Electronic databases were searched using keywords and text terms for herpes simplex, syphilis, chancroid, ulcerative sexually transmitted diseases, or their causative agents, in conjunction with terms to identify epidemiological studies. References of key articles were hand searched, and data were extracted using standardised forms. Random effects models were used to summarise relative risk (RR) where appropriate. Results: 26 articles met the inclusion criteria. Most syphilis studies reported a substantially reduced risk among circumcised men (summary RR = 0.67, 95% confidence interval (CI) 0.54 to 0.83), although there was significant between study heterogeneity (p = 0.01). The reduced risk of HSV-2 infection was of borderline statistical significance (summary RR = 0.88, 95% CI 0.77 to 1.01). Circumcised men were at lower risk of chancroid in six of seven studies (individual study RRs: 0.12 to 1.11).Conclusions: This first systematic review of male circumcision and ulcerative STI strongly indicates that circumcised men are at lower risk of chancroid and syphilis. There is less association with HSV-2. Potential male circumcision interventions to reduce HIV in high risk populations may provide additional benefit by protecting against other STI. Male circumcision is one of the oldest surgical procedures and is almost universal among Muslim and Jewish men and in some ethnic groups in subSaharan Africa. In the late 19th century, lower disease prevalence among Jews in the United Kingdom was ascribed to circumcision, which became increasingly common in English speaking industrialised countries as physicians advocated it for preventing a range of conditions.1 By the mid-20th century, neonatal male circumcision was routine in many parts of the United States and New Zealand, and was common in Australia 2 and Canada. 3 Rates in these countries subsequently fell as medical organisations found no clear medical indication for neonatal circumcision. 4 The potential association between male circumcision and sexually transmitted diseases (STDs) was first reported in 1855, in a study where 61% of non-Jewish compared with 19% of Jewish STD patients had syphilis.5 Later studies supported this finding, reporting higher than expected proportions of uncircumcised men among case series of genital herpes, 6 syphilis, 3 7 chancroid, 7-9 and gonorrhoea. Similar observations were reported at a meeting of traditional healers in South Africa in 1992 10 and in a study of circumcision practices in Mwanza. 11In 1998, Moses et al 12 reviewed the evide...

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Section: Association Of Male Circumcision and Chancroidmentioning

confidence: 99%

Section: Association Of Male Circumcision and Chancroidmentioning

confidence: 99%

See 1 more Smart Citation

Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis

Weiss

Thomas

Munabi

et al. 2006

Sexually Transmitted Infections

333

249

View full text Add to dashboard Cite

show abstract

“…Van Howe's “Methods” Section (page 2, column 2, paragraph 2) states, “ several older studies had inappropriate control groups ” [82–84], going on to say, “ For example, Hand used men without any exposure to STIs as controls, ” and later that, “ Wilson compared seasoned soldiers with new recruits ” (page 33, column 2, paragraph 2). Taking the latter as an example, the article rejects Wilson's control group and instead compares men with a particular STI with all men in the STI population.…”

Section: Flaws In Particular Methods Usedmentioning

confidence: 99%

Does Male Circumcision Protect against Sexually Transmitted Infections? Arguments and Meta-Analyses to the Contrary Fail to Withstand Scrutiny

et al. 2014

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We critically evaluate a recent article by Van Howe involving 12 meta-analyses that concludes, contrary to current evidence, that male circumcision increases the risk of various common sexually transmitted infections (STIs). Our detailed scrutiny reveals that these meta-analyses (1) failed to include results of all relevant studies, especially data from randomized controlled trials, (2) introduced bias through use of inappropriate control groups, (3) altered original data, in the case of human papillomavirus (HPV), by questionable adjustments for “sampling bias,” (4) failed to control for confounders through use of crude odds ratios, and (5) used unnecessarily complicated methods without adequate explanation, so impeding replication by others. Interventions that can reduce the prevalence of STIs are important to international health. Of major concern is the global epidemic of oncogenic types of HPV that contribute to the burden of genital cancers. Meta-analyses, when well conducted, can better inform public health policy and medical practice, but when seriously flawed can have detrimental consequences. Our critical evaluation leads us to reject the findings and conclusions of Van Howe on multiple grounds. Our timely analysis thus reaffirms the medical evidence supporting male circumcision as a desirable intervention for STI prevention.

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“…Segundo Hand, 24 o primeiro a levantar a hipótese de que os incircuncisos são mais vulneráveis à sífilis foi Jonathan Hutchinson, em 1855, ao observar a raridade desta condição entre os judeus. Já em 1947, Wilson 46 apontava uma maior susceptibilidade dos incircuncisos à aquisição de sífilis (90% dos casos contra 52% do grupo-controle) em militares canadenses.…”

Section: O Prepúcio E As Origens Da Circuncisão Masculinaunclassified

A circuncisão masculina e a transmissão heterossexual do HIV

Eyer-Silva¹

2003

Rev. Saúde Pública

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ResumoDesde os primeiros anos da epidemia de Aids, grandes diferenças geográficas na prevalência de infecção pelo HIV foram registradas entre países vizinhos e regiões vizinhas dentro de um mesmo país na África subsaariana. Tais diferenças não podiam ser completamente explicadas por fatores como o comportamento sexual e o uso de preservativos. Um acúmulo de dados epidemiológicos vem mostrando que a circuncisão masculina desempenha um efeito protetor contra a aquisição heterossexual do HIV pelo homem na África subsaariana e provavelmente contribui para as acentuadas diferenças de prevalência de HIV. Assim, realizou-se uma atualização dos estudos conduzidos em solo africano sobre a associação entre circuncisão masculina e infecção pelo HIV, as origens da prática da circuncisão entre as populações humanas, os mecanismos pelos quais a presença do prepúcio aumentaria a susceptibilidade de aquisição heterossexual do HIV pelo homem, sua associação com outras doenças infecciosas e também neoplásicas, o debate sobre a conveniência da adoção de práticas de circuncisão como estratégia de controle da epidemia de HIV na África, a escassa literatura brasileira sobre circuncisão masculina e as perspectivas de investigações futuras. Abstract Since the early years of the AIDS epidemic significant geographic differences in HIV prevalence were reported within neighboring countries and neighboring regions within the same country in sub-Saharan Africa. These differences could not be fully explained by factors such as sexual behavior and condom use. Mounting epidemiological data have demonstrated that male circumcision is a major protective factor against male heterosexual HIV infection in sub-Saharan Africa and probably contributes to these significant differences in HIV prevalence. This is a review of African studies on the association between male circumcision and HIV infection

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Circumcision and Venereal Disease

Cited by 18 publications

References 2 publications

Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis

Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis

Does Male Circumcision Protect against Sexually Transmitted Infections? Arguments and Meta-Analyses to the Contrary Fail to Withstand Scrutiny

A circuncisão masculina e a transmissão heterossexual do HIV

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