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

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-23 ◽  
Author(s):  
Brian J. Morris ◽  
Catherine A. Hankins ◽  
Aaron A. R. Tobian ◽  
John N. Krieger ◽  
Jeffrey D. Klausner
Keyword(s):  
Sexually Transmitted Infections ◽  
Male Circumcision ◽  
Critical Evaluation ◽  
International Health ◽  
Sampling Bias ◽  
Original Data ◽  
Current Evidence ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Meta Analyses

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.

MALE CIRCUMCISION AND SEXUALLY TRANSMITTED INFECTIONS IN BOTSWANA

2004 ◽  
Vol 37 (1) ◽  
pp. 75-88 ◽  
Author(s):  
TABITHA LANGENI
Keyword(s):  
Sexually Transmitted Infections ◽  
Male Circumcision ◽  
Rural Areas ◽  
Vital Role ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Urethral Discharge ◽  
Independent Variables ◽  
Genital Ulcers ◽  
Religion And Ethnicity

This study set out to investigate the influence of male circumcision and other factors on sexually transmitted infections in Botswana. A syndromic approach, which diagnoses a sexually transmitted infection based on the presence of urethral discharge or genital ulcers rather than on laboratory tests, was used. The data were from the 2001 Botswana AIDS Impact Survey where a nationally representative, randomly selected sample of men and women aged 10–64 years were interviewed in both urban and rural areas. The sample selected for this study consisted of 216,480 men aged 15–64 years who had ever had sexual intercourse. The logistic regression technique was executed to examine the association between male circumcision and self-reported urethral discharge or genital ulcers, while controlling for all other independent variables in the analysis. The main finding of this study was that among men who are circumcised, the odds for self-reported urethral discharge or genital ulcers are significantly lower than for those men who are not circumcised in both urban and rural Botswana. The analysis also showed that the odds in favour of self-reported urethral discharge or genital ulcers, for men who drink alcohol, are twice as large as those for men who do not drink alcohol, controlling for all other independent variables in the analysis. Religion and ethnicity also came through as factors exerting a protective influence against self-reported symptoms of sexually transmitted infections. The conclusion is that while male circumcision appears to be significantly associated with the risk for self-reported urethral discharge or genital ulcers, it is man’s behaviour, irrespective of ethnicity or religious dictates, that continues to play a vital role in protection against self-reported symptoms of sexually transmitted infections in Botswana.

scholarly journals Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting

2015 ◽  
Vol 2 ◽  
pp. 2333794X1558911
Author(s):  
Noah Kojima ◽  
Claire C. Bristow ◽  
Neil Pollock ◽  
Pierre Crouse ◽  
Harry Theodore ◽  
...  
Keyword(s):  
Training Program ◽  
Sexually Transmitted Infections ◽  
Male Circumcision ◽  
Adult Health ◽  
Sexually Transmitted ◽  
Urogenital Infections ◽  
Inflammatory Conditions ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Tract Infections

Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers. We aimed to reintroduce newborn male circumcision through the creation of a training program in Port-au-Prince, Haiti—an area with a considerable burden of preventable urogenital infections, sexually transmitted infections, and low circumcision rate—after an earlier study reported that a majority of Haitian medical providers were in need of and wanted newborn circumcision training. The program was conducted at the GHESKIO Health Centers, a large, non-governmental clinic offering comprehensive pediatric and adult health services. Two Haitian obstetricians and seven nurses learned circumcision procedures. On training completion, one of two obstetricians achieved surgical competence. Introduction of a newborn male circumcision training program was feasible, achieving an acceptable rate of procedural competency and high-quality services. Permanent resources now exist in Haiti to train additional providers to perform newborn male circumcisions.

Male circumcision and risk of HIV-1 and other sexually transmitted infections in India

The Lancet ◽  
2004 ◽  
Vol 363 (9414) ◽  
pp. 1039-1040 ◽  
Author(s):  
Steven J Reynolds ◽  
Mary E Shepherd ◽  
Arun R Risbud ◽  
Raman R Gangakhedkar ◽  
Ronald S Brookmeyer ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Male Circumcision ◽  
Sexually Transmitted ◽  
Hiv 1

Critical Evaluation of Adler’s Challenge to the cdc’s Male Circumcision Recommendations

2016 ◽  
Vol 24 (2) ◽  
pp. 265-303 ◽  
Author(s):  
Beth E. Rivin ◽  
Douglas S. Diekema ◽  
Anna C. Mastroianni ◽  
John N. Krieger ◽  
Jeffrey D. Klausner ◽  
...  
Keyword(s):  
Public Health ◽  
Male Circumcision ◽  
Scientific Evidence ◽  
Critical Evaluation ◽  
Well Being ◽  
Scientific Data ◽  
Best Interests ◽  
Sexually Transmitted ◽  
Control And Prevention ◽  
Tract Infections

We evaluate Peter Adler’s challenge to the Centers for Disease Control and Prevention (cdc) draft recommendations on male circumcision (this issue, see pp. 237–262). Thecdcadvocates elective male circumcision (mc) to improve public health in theusabased on strong scientific evidence. In marked contrast to thecdc, Adler’s criticisms depend on speculative claims and obfuscation of the scientific data. Adler’s central argument that circumcision in infancy should be delayed to allow a boy to make up his own mind as an adult fails to appreciate that circumcision later in life is a more complex operation, entails higher risk, is more likely to involve general anaesthesia and presents financial, psychological and organisational barriers. These limitations are avoided by circumcision early in infancy, when it is convenient, safe, quick, low risk, usually involves local anaesthesia and provides benefits immediately. Benefits of male circumcision include: protection against: urinary tract infections that are ten times higher in uncircumcised infants; inflammatory skin conditions; other foreskin problems; sexually transmitted infections and genital cancers in the male and his female sexual partners. Circumcision during infancy is also associated with faster healing and improved cosmetic outcomes. Circumcision does not impair sexual function or pleasure. Some authorities regard the failure to offer circumcision as unethical, just as it would be unethical to fail to encourage paediatric vaccination. Since the benefits vastly outweigh the risks, each intervention is in the best interests of the child. In conclusion, Adler’s criticisms of thecdc’s evidence-based male circumcision policy are flawed scientifically, ethically and legally, and should be dismissed as endangering public health and individual well-being.

scholarly journals Knowledge and perception of young adults in Nigeria on effectiveness of condom use in prevention of sexually transmitted infections

2017 ◽  
Vol 29 (2) ◽  
Author(s):  
Philip Emeka Anyanwu ◽  
John Fulton
Keyword(s):  
Young Adults ◽  
Condom Use ◽  
Sexually Transmitted Infections ◽  
Preventive Measure ◽  
Anal Sex ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
The World ◽  
Negative Perceptions ◽  
Sex With Men

Abstract Background: Although sexually transmitted infections (STIs) are a global health problem affecting every region of the world, the higher prevalence and mortality rate of STIs in developing countries of the world, like Nigeria, make them serious public health issues in this region. Objective: The aim of this study is to assess the knowledge and perception of young adults in Nigeria on the role of condom (both male and female condoms) as a preventive measure against STIs during heterosexual and homosexual intercourse. Materials and methods: Data was collected from participants selected from the northern and southern Nigeria using self-administered questionnaire specifically designed for this study. Results: Knowledge of condom efficacy in STI prevention was satisfactory. However, knowledge and practice of the correct use of condom was poor. Only 47.1% of the 102 participants in this study reported correct condom use of wearing condoms before staring intercourse and removing condoms after ejaculation. As a strategy to include the experiences, knowledge and perception of men who have sex with men, this study asked the question on condom use during anal sex. Only 24.4% of the male participants indicated they have never had anal sex while for females, the percentage was more than half (53.5%). Condom use during anal sex was low with only 20.6% of participants reporting condom use during anal sex. Negative perceptions about condom use – such as that condom use promotes sexual promiscuity, and not using condoms with steady sexual partners – were significant in this study. Also, condom use errors were common in this study. Conclusion: There is a wide gap in knowledge of correct condom use in this population. There is need for interventions that address the issue of condom use during anal and same-sex sexual intercourse in this population.

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