Self-Assessment of Circumcision Status by Adolescents

Risser, Jan M. H.; Risser, William L.; Eissa, Mona A.; Cromwell, Polly F.; Barratt, Michelle S.; Bortot, Andrea T.

doi:10.1093/aje/kwh149

Cited by 44 publications

(46 citation statements)

References 9 publications

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“…A study of the validity of a self-report of circumcision status among adolescent males demonstrated high sensitivity (91%) and high specificity (95%) among those who knew their circumcision status. 22 In that study of largely Black and Hispanic boys, 27% did not know their circumcision status, whereas in our study only 0.1% did not know their status, perhaps reflecting our predominantly adult sample. We therefore consider substantial misclassification unlikely.…”

Section: Discussioncontrasting

confidence: 65%

Circumcision in Australia: prevalence and effects on sexual health

et al. 2006

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The results from a telephone survey in 2001-02 of a probability sample of Australian households including 10,173 men aged 16-59 (response rate 69.4%) are used to assess the prevalence of circumcision across social groups in Australia and examine lifetime history of sexually transmissible infection (STI), sexual difficulties in the last year, sexual practices including masturbation, and sexual attitudes. More than half (59%) of the men were circumcised. Circumcision was less common among younger men (32% aged <20) and more common among the Australian born (69%). After correction for age, circumcision was unrelated to reporting STI, but appeared to protect against penile candidiasis. Circumcision was unrelated to most sexual difficulties, but circumcised men were less likely to report physical pain during intercourse or trouble keeping an erection; reasons for this are unknown. There were no significant differences in practices at last sexual encounter with a female partner or in masturbation alone. Circumcised men had somewhat more liberal sexual attitudes. Neonatal circumcision was routine in Australia until the 1970s. It appears not to be associated with significant protective or harmful sexual health outcomes. This study provides no evidence about the effects on sexual sensitivity.

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Section: Discussioncontrasting

confidence: 65%

Circumcision in Australia: prevalence and effects on sexual health

et al. 2006

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“…7,8 These findings underscore the necessity of using a standardized clinical examination for establishing circumcision status for the purpose of research on circumcision. It also highlights the potential difficulty of advising on care of the circumcised and uncircumcised penis when an individual and/or clinician may not know which condition is present.…”

Section: Nhanesmentioning

confidence: 90%

Male Circumcision

Blank¹,

Brady²,

Buerk³

et al. 2012

Pediatrics

297

149

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Male circumcision consists of the surgical removal of some, or all, of the foreskin (or prepuce) from the penis. It is one of the most common procedures in the world. In the United States, the procedure is commonly performed during the newborn period. In 2007, the American Academy of Pediatrics (AAP) convened a multidisciplinary workgroup of AAP members and other stakeholders to evaluate the evidence regarding male circumcision and update the AAP’s 1999 recommendations in this area. The Task Force included AAP representatives from specialty areas as well as members of the AAP Board of Directors and liaisons representing the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the Centers for Disease Control and Prevention. The Task Force members identified selected topics relevant to male circumcision and conducted a critical review of peer-reviewed literature by using the American Heart Association’s template for evidence evaluation. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks; furthermore, the benefits of newborn male circumcision justify access to this procedure for families who choose it. Specific benefits from male circumcision were identified for the prevention of urinary tract infections, acquisition of HIV, transmission of some sexually transmitted infections, and penile cancer. Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction. It is imperative that those providing circumcision are adequately trained and that both sterile techniques and effective pain management are used. Significant acute complications are rare. In general, untrained providers who perform circumcisions have more complications than well-trained providers who perform the procedure, regardless of whether the former are physicians, nurses, or traditional religious providers. Parents are entitled to factually correct, nonbiased information about circumcision and should receive this information from clinicians before conception or early in pregnancy, which is when parents typically make circumcision decisions. Parents should determine what is in the best interest of their child. Physicians who counsel families about this decision should provide assistance by explaining the potential benefits and risks and ensuring that parents understand that circumcision is an elective procedure. The Task Force strongly recommends the creation, revision, and enhancement of educational materials to assist parents of male infants with the care of circumcised and uncircumcised penises. The Task Force also strongly recommends the development of educational materials for providers to enhance practitioners’ competency in discussing circumcision’s benefits and risks with parents. The Task Force made the following recommendations:Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and the benefits of newborn male circumcision justify access to this procedure for those families who choose it.Parents are entitled to factually correct, nonbiased information about circumcision that should be provided before conception and early in pregnancy, when parents are most likely to be weighing the option of circumcision of a male child.Physicians counseling families about elective male circumcision should assist parents by explaining, in a nonbiased manner, the potential benefits and risks and by ensuring that they understand the elective nature of the procedure.Parents should weigh the health benefits and risks in light of their own religious, cultural, and personal preferences, as the medical benefits alone may not outweigh these other considerations for individual families.Parents of newborn boys should be instructed in the care of the penis, regardless of whether the newborn has been circumcised or not.Elective circumcision should be performed only if the infant’s condition is stable and healthy.Male circumcision should be performed by trained and competent practitioners, by using sterile techniques and effective pain management.Analgesia is safe and effective in reducing the procedural pain associated with newborn circumcision; thus, adequate analgesia should be provided whenever newborn circumcision is performed.Nonpharmacologic techniques (eg, positioning, sucrose pacifiers) alone are insufficient to prevent procedural and postprocedural pain and are not recommended as the sole method of analgesia. They should be used only as analgesic adjuncts to improve infant comfort during circumcision.If used, topical creams may cause a higher incidence of skin irritation in low birth weight infants, compared with infants of normal weight; penile nerve block techniques should therefore be chosen for this group of newborns.Key professional organizations (AAP, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American Society of Anesthesiologists, the American College of Nurse Midwives, and other midlevel clinicians such as nurse practitioners) should work collaboratively to:Develop standards of trainee proficiency in the performance of anesthetic and procedure techniques, including suturing;Teach the procedure and analgesic techniques during postgraduate training programs;Develop educational materials for clinicians to enhance their own competency in discussing the benefits and risks of circumcision with parents;Offer educational materials to assist parents of male infants with the care of both circumcised and uncircumcised penises.The preventive and public health benefits associated with newborn male circumcision warrant third-party reimbursement of the procedure. The American College of Obstetricians and Gynecologists has endorsed this technical report.

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“…It should be noted that circumcision status may be subject to misclassification. In a study of adolescents¸ only 69% of circumcised and 65% of uncircumcised young men correctly identified their circumcision s tatus as verified by physical exam [68].…”

Section: Status Of Male Circumcision In the Usamentioning

confidence: 92%

Considerations in the Role of Male Circumcision in the Prevention of HIV Transmission in the USA

2009

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Male circumcision (MC) has been associated with a reduced risk for female–male HIV transmission in observational and ecological studies, as well as clinical trials. Three recent randomized, controlled trials in sub-Saharan Africa demonstrated a 50–60% reduction in HIV incidence among men randomized to circumcision compared with uncircumcised men. In 2007, WHO/UNAIDS recommended that MC be recognized as an additional efficacious intervention to prevent sexual transmission of HIV from women to men. This article reviews information on the potential role of MC for HIV prevention in the USA where, compared with the African clinical trial countries, the prevalence of HIV infection is lower, the main route of HIV transmission is male–male sex rather than heterosexual sex and the prevalence of MC is higher.

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Self-Assessment of Circumcision Status by Adolescents

Cited by 44 publications

References 9 publications

Circumcision in Australia: prevalence and effects on sexual health

Circumcision in Australia: prevalence and effects on sexual health

Male Circumcision

Considerations in the Role of Male Circumcision in the Prevention of HIV Transmission in the USA

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