Circumcision and STDs: Difference between revisions
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m wikify Robert S. Van Howe |
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|first=Robert S. | |first=Robert S. | ||
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|author-link=Robert Van Howe | |author-link=Robert S. Van Howe | ||
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|title=Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis | |title=Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis | ||
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</blockquote> | </blockquote> | ||
Van Howe (1999) carried out a review of the medical literature concerning sexually transmitted infection. He referenced no fewer than 104 published papers in his review and concluded: | [[Robert S. Van Howe|Van Howe]] (1999) carried out a review of the medical literature concerning sexually transmitted infection. He referenced no fewer than 104 published papers in his review and concluded: | ||
<blockquote> | <blockquote> | ||
''What began as speculation has resulted a century later in 60-75% of American boys being circumcised with no clearly confirmed medical benefit. In the interim, no solid epidemiological evidence has been found to support the theory that circumcision prevents STDs or to justify a policy of involuntary mass circumcision as a public health measure. While the number of confounding factors and the inability to perform a random, double-blind, prospective trial make assessing the role of circumcision in STD acquisition difficult, there is no clear evidence that circumcision prevents STDs. The only consistent trend is that [[uncircumcised]] males may be more susceptible to GUD, while circumcised men are more prone to urethritis. Currently, in developed nations, urethritis is more common than GUD [34]. In summary, the medical literature does not support the theory that circumcision prevents STDs''.<ref name="vanhowe1999">{{REFjournal | ''What began as speculation has resulted a century later in 60-75% of American boys being circumcised with no clearly confirmed medical benefit. In the interim, no solid epidemiological evidence has been found to support the theory that circumcision prevents STDs or to justify a policy of involuntary mass circumcision as a public health measure. While the number of confounding factors and the inability to perform a random, double-blind, prospective trial make assessing the role of circumcision in STD acquisition difficult, there is no clear evidence that circumcision prevents STDs. The only consistent trend is that [[uncircumcised]] males may be more susceptible to GUD, while circumcised men are more prone to urethritis. Currently, in developed nations, urethritis is more common than GUD [34]. In summary, the medical literature does not support the theory that circumcision prevents STDs''.<ref name="vanhowe1999">{{REFjournal | ||
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|first=Robert S. | |first=Robert S. | ||
|init=RS | |init=RS | ||
|author-link=Robert Van Howe | |author-link=Robert S. Van Howe | ||
|etal=no | |etal=no | ||
|title=Does circumcision influence sexually transmitted diseases?: A literature review | |title=Does circumcision influence sexually transmitted diseases?: A literature review | ||
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}}</ref> | }}</ref> | ||
Van Howe (1999) commented: | [[Robert S. Van Howe|Van Howe]] (1999) commented: | ||
<blockquote> | <blockquote> | ||
''Beaugé suggests that the loss of [[penile skin]] from circumcision frequently results in tightened [[skin]] over the erect penis. This increases friction during intercourse and increases the likelihood of abrasions through which a pathogen can be introduced systemically, making the circumcised penis more likely to contract an STD. The increased likelihood of circumcised men engaging in active anal sex may also increase a circumcised man's susceptibility to STDs''.<ref name="vanhowe1999" /> | ''Beaugé suggests that the loss of [[penile skin]] from circumcision frequently results in tightened [[skin]] over the erect penis. This increases friction during intercourse and increases the likelihood of abrasions through which a pathogen can be introduced systemically, making the circumcised penis more likely to contract an STD. The increased likelihood of circumcised men engaging in active anal sex may also increase a circumcised man's susceptibility to STDs''.<ref name="vanhowe1999" /> | ||
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The idea that circumcision could prevent sexually transmitted infection started with the subjective speculations of Victorian doctors in the 19th century and was reinforced by military orders to have servicemen subjected to circumcision during the 20th century. | The idea that circumcision could prevent sexually transmitted infection started with the subjective speculations of Victorian doctors in the 19th century and was reinforced by military orders to have servicemen subjected to circumcision during the 20th century. | ||
Professor Van Howe (2013) has provided a magisterial systematic review and meta-analysis citing 199 documents relating to circumcision and STDs. Van Howe's paper appears to be conclusive. His meta-analysis concludes as follows: | Professor [[Robert S. Van Howe|Van Howe]] (2013) has provided a magisterial systematic review and meta-analysis citing 199 documents relating to circumcision and STDs. [[Robert S. Van Howe|Van Howe]]'s paper appears to be conclusive. His meta-analysis concludes as follows: | ||
<blockquote> | <blockquote> | ||
''Most specific STIs are not impacted significantly by circumcision status. These include chlamydia, gonorrhea, HSV, and HPV. Syphilis showed mixed results with prevalence studies suggesting intact men were at great risk and incidence studies suggesting the opposite. Intact men appear to be at greater risk for GUD while at lower risk for GDS, NSU, genital warts, and the overall risk of any STIs. It is also clear that any positive impact of circumcision on STIs is not seen in general populations. Consequently, the prevention of STIs cannot be rationally interpreted as a benefit of circumcision, and a policy of circumcision for the general population to prevent STIs is not supported by the evidence currently available in the medical literature''.<ref name="vanhowe2013" /> | ''Most specific STIs are not impacted significantly by circumcision status. These include chlamydia, gonorrhea, HSV, and HPV. Syphilis showed mixed results with prevalence studies suggesting intact men were at great risk and incidence studies suggesting the opposite. Intact men appear to be at greater risk for GUD while at lower risk for GDS, NSU, genital warts, and the overall risk of any STIs. It is also clear that any positive impact of circumcision on STIs is not seen in general populations. Consequently, the prevention of STIs cannot be rationally interpreted as a benefit of circumcision, and a policy of circumcision for the general population to prevent STIs is not supported by the evidence currently available in the medical literature''.<ref name="vanhowe2013" /> | ||