Circumcision and STDs: Difference between revisions
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Circumcision advocates had claimed that the sub-preputial space was a filthy cesspool of infection that was eliminated by circumcision. However, Parkash | Circumcision advocates had claimed that the sub-preputial space was a filthy cesspool of infection that was eliminated by circumcision. However, Parkash et al. (1982) showed that the sub-preputial moisture actually contained lytic material with antiseptic qualities that protected against disease.<ref>{{REFjournal | ||
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Smith | Smith et al. (1987) found evidence that the foreskin protected against acquisition of non-gonococcal urethritis, possibly "''by affecting the physiologic milieu of the glans penis, by association with post-coital hygiene behavior, or by local immune defense mechanisms acting against the agent''."<ref name="smith1987">{{REFjournal | ||
|last=Smith | |last=Smith | ||
|first=Gregory L. | |first=Gregory L. | ||
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Cook | Cook et al. (1993) reported their findings that circumcised men were more likely to have genital warts than intact men. The authors concluded, "''the presence of the foreskin may confer nonspecific protection of the proximal penis from acquisition of HPV infection''."<ref name="cook1993A>{{REFjournal | ||
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Cook | Cook et al. (1994) compared the incidence of sexually transmitted disease in intact males with circumcised males who attend the STD clinic at the Harborview Medical Center in Seattle, Washington, USA. They reported that genitally intact men were more likely than circumcised men to have syphilis and gonorrhea and were less likely to have visible warts.<ref name="cook1994">{{REFjournal | ||
|last=Cook | |last=Cook | ||
|first=Linda S. | |first=Linda S. | ||
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Bassett | Bassett et al. (1994) investigated the factors associated with HSV-2 infection in heterosexual men at a sexual disease clinic in Sydney, Australia. They reported that, "''we found no evidence of the presence of an intact foreskin being a risk factor for HSV-2 infection''."<ref name="bassett1994">{{REFjournal | ||
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|first=Ingrid | |first=Ingrid | ||
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Donovan | Donovan et al. (1994) also surveyed men at a sexual disease clinic in Sydney, NSW, Australia. They reported: | ||
<blockquote> | <blockquote> | ||
''In this clinic-based prospectively collected survey we found no association between male circumcision status and STDs that are common in our population. Perhaps importantly, our study group was relatively racially homogeneous, lack of circumcision was not a marker of lower socioeconomic status (using the index of education level; Table 2), and we controlled for a major parameter of sexual behaviour (lifetime number of sexual partners)''.<ref name="donovan1994">{{REFjournal | ''In this clinic-based prospectively collected survey we found no association between male circumcision status and STDs that are common in our population. Perhaps importantly, our study group was relatively racially homogeneous, lack of circumcision was not a marker of lower socioeconomic status (using the index of education level; Table 2), and we controlled for a major parameter of sexual behaviour (lifetime number of sexual partners)''.<ref name="donovan1994">{{REFjournal | ||
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</blockquote> | </blockquote> | ||
Laumann | Laumann et al. (1997) used data from the ''National Health and Social Life Survey'' (NHSLS) (1992) to report on the effects of male circumcision in the United States. With regard to STDs, Laumann et al. reported: | ||
<blockquote> | <blockquote> | ||
''With respect to STDs, we found no evidence of a prophylactic role for circumcision and a slight tendency in the opposite direction. Indeed, the absence of a foreskin was significantly associated with contraction of bacterial STDs among men who have had many partners in their lifetimes. These results suggest a reexamination of the prevailing wisdom regarding the prophylactic effect of circumcision. While circumcision may have an impact that was not picked up by the NHSLS data, it seems unlikely to justify the claims made by those who base their support for widespread circumcision on it''.<ref name="laumann1997">{{REFjournal | ''With respect to STDs, we found no evidence of a prophylactic role for circumcision and a slight tendency in the opposite direction. Indeed, the absence of a foreskin was significantly associated with contraction of bacterial STDs among men who have had many partners in their lifetimes. These results suggest a reexamination of the prevailing wisdom regarding the prophylactic effect of circumcision. While circumcision may have an impact that was not picked up by the NHSLS data, it seems unlikely to justify the claims made by those who base their support for widespread circumcision on it''.<ref name="laumann1997">{{REFjournal | ||
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</blockquote> | </blockquote> | ||
Dave | Dave et al. (2003) studied data from the 2000 ''British National Survey of Sexual Attitudes and Lifestyles'' (Natsal 2000). They found "''no significant associations between circumcision and being diagnosed with any one of the seven specific STIs.''"<ref name="dave2003">{{REFjournal | ||
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==Circumcised men have more risky sexual behavior== | ==Circumcised men have more risky sexual behavior== | ||
Frequently overlooked when considering the effect of circumcision on sexually transmitted infection is the riskier sexual behavior of circumcised men as compared with intact men. Following amputation of the highly erogenous [[foreskin]], circumcised men have significantly reduced sexual sensation, so therefore engage in a wider range of sexual practices in their quest to obtain sexual release. Hooykaas | Frequently overlooked when considering the effect of circumcision on sexually transmitted infection is the riskier sexual behavior of circumcised men as compared with intact men. Following amputation of the highly erogenous [[foreskin]], circumcised men have significantly reduced sexual sensation, so therefore engage in a wider range of sexual practices in their quest to obtain sexual release. Hooykaas et al. (1991) reported that the sexual behavior of migrant circumcised men is more riskier than that of intact Dutch men.<ref>{{REFjournal | ||
|last=Hooykaas | |last=Hooykaas | ||
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|DOI=10.1136/sti.67.5.378 | |DOI=10.1136/sti.67.5.378 | ||
|accessdate=2020-05-24 | |accessdate=2020-05-24 | ||
}}</ref> Laumann | }}</ref> Laumann et al. (1997), in a study of American men, reported that | ||
<blockquote> | <blockquote> | ||
''NHSLS data indicate that circumcised men engage in a somewhat more elaborated set of sexual practices than do men who are not circumcised. For each of the practices examined, lifetime experience of various forms of oral and anal sex and masturbation frequency in the past year, circumcised men engaged in these behaviors at greater rates.<ref name="laumann1997"/> | ''NHSLS data indicate that circumcised men engage in a somewhat more elaborated set of sexual practices than do men who are not circumcised. For each of the practices examined, lifetime experience of various forms of oral and anal sex and masturbation frequency in the past year, circumcised men engaged in these behaviors at greater rates.<ref name="laumann1997"/> | ||
</blockquote>'' | </blockquote>'' | ||
Michael | Michael et al. (1998) compared sexual behavior in Britain with sexual behavior in the United States. They reported that condom use was "significantly higher" in the United Kingdom where most men are intact as compared to the United States where most men are circumcised.<ref>{{REFjournal | ||
|last=Michael | |last=Michael | ||
|first=Robert T. | |first=Robert T. | ||