Changes

|last=Wolbarst

|first=Abraham L.

|author-link=Abraham L. Wolbarst

|title=Universal Circumcision as a Sanitary Measure

|last=Van Howe

|first=Robert S.

|author-link=Robert Van Howe

|etal=no

|title=Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis

|journal=ISRN Urology

|location=

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

|last=Parkash

|author-link=

|last2=Raghuram

|author2-link=

|etal=yes

|title=Sub-preputial wetness - Its nature.

|journal=Ann Nat Med Sci

|location=

|last=Smith

|first=Gregory L.

|author-link=

|last2=Greenup

|first2=Robert

|author2-link=

|last3=Takafuji

|first3=Ernest

|author3-link=

|etal=no

|title=Circumcision as a risk factor for urethritis in racial groups

|journal=Am J Public Health

|location=

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

|last=Cook

|author-link=

|last2=Koutsky

|author2-link=

|last3=Holmes

|author3-link=

|etal=no

|title=Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic

|journal=Genitourin Med

|location=

|last=Cook

|first=Linda S.

|author-link=

|last2=Koutsky

|first2=Laura A.

|author2-link=

|last3=Holmes

|first3=King K.

|author3-link=

|etal=no

|title=Circumcision and sexually transmitted diseases

|journal=Am J Public Health

|location=

|last=Bassett

|first=Ingrid

|author-link=

|last2=Donovan

|first2=Basil

|author2-link=

|last3=Bodsworth

|author3-link=

|last4=Field

|author4-link=

|last5=Ho

|author5-link=

|last6=Jeanssome

|first6=Stig

|author6-link=

|last7=Cunningham

|author7-link=

|etal=no

|title=Herpes simplex virus type-2 infection of heterosexual men attending a sexual health centre

|journal=Med J Aust

|location=

|last=Donovan

|first=Basil

|author-link=

|last2=Bassett

|first2=Ingrid

|author2-link=

|last3=Bodsworth

|author3-link=

|etal=no

|title=Male circumcision and common sexually transmissible diseases in a developed nation setting

|journal=Genitourin Med

|location=

''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

|last=Laumann

|author-link=

|last2=Masi

|first2=Christopher M.

|author2-link=

|last3=Zuckerman

|author3-link=

|etal=no

|title=Circumcision in the United States.

|journal=JAMA

|location=

''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

|last=Van Howe

|author-link=Robert Van Howe

|etal=no

|title=Does circumcision influence sexually transmitted diseases?: A literature review

|journal=BJU Int

|location=

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

|last=Dave

|author-link=

|last2=Johnson

|author2-link=

|last3=Fenton

|author3-link=

|last4=Mercer

|author4-link=

|etal=no

|journal=Sex Trans Infect

|location=

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

|author-link=

|last2=van der Velde

|author2-link=

|last3=van der Linden

|author3-link=

|last4=van Durnum

|author4-link=

|last5=Coutinho

|author5-link=

|etal=no

|title=The Importance of Ethnicity as a Risk Factor for STDs and Sexual Behaviour Among Heterosexuals

|journal=Genitourin Med

|location=

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

|author-link=

|last2=Wadsworth

|first2=Jane

|author2-link=

|last3=Feirleib

|first3=Joel

|author3-link=

|last4=Johnson

|first4=Anne M.

|author4-link=

|last5=Laumann

|first5=Edward O.

|author5-link=

|last6=Wellings

|first6=Kaye

|author6-link=

|etal=no

|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison

|journal=Am J Public Health

|location=