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Mar 25, 2009 05:01 PM | 33
Circumcision is often touted for its potential health benefits: reduced risk of urinary tract infections for baby boys, and lower rates of HIV in teens and men. Now a new study shows that it may also cut a man's chances of contracting two more common, incurable sexually transmitted diseases.
Two randomized, controlled trials in Uganda involving 5,534 men found that those who underwent circumcision as adults were 25 percent less likely to become infected with herpes and more than 30 percent less likely to catch human papillomavirus (HPV) than their uncircumcised peers. (Eight percent of circumcised men and 10 percent of uncircumcised men in the study caught herpes; 18 percent of circumcised men and 28 percent of uncircumcised men contracted HPV.) The research published today in the New England Journal of Medicine didn't, however, find that getting circumcised reduced the risk of contracting syphilis. Previous research has shown that circumcision reduces a man's risk of acquiring HIV by as much as 60 percent.
"The data are very clear that not only does circumcision help prevent HIV, but also has a significant, positive impact on prevention of herpes and HPV," says Anthony Fauci, director of the National Institute of Allergy and Infectious Disease (NIAID), which helped fund the research. He added that reducing men's risk of herpes and HPV would likely cut rates of the infections in women.
Circumcision, the removal of a male's foreskin, may lower the risk a man will catch the infections, Fauci tells ScientificAmerican.com, because its moist environment provides the "perfect breeding ground for viruses and bacteria." It can tear and develop sores easily, and if it becomes inflamed, he said, "it gives you much more fertile ground for HIV to be transmitted."
Judith Wasserheit, vice chair and professor of global health at the University of Washington in Seattle who co-wrote an editorial accompanying the study, called the findings a "game-changer" that should make frank discussions with parents about the health benefits of circumcision part of routine medical practice. Rates of newborn circumcision in the U.S. have declined over the past three decades: about 56 percent of baby boys were circumcised in 2006, down from about 65 percent in 1979, according to the 2006 National Hospital Discharge Survey.
There are 50 percent fewer newborn circumcisions in hospitals in the 16 states where Medicaid doesn't cover the procedure than there are in the covered states, research published in November in the American Journal of Public Health shows. Despite growing evidence of its benefits, the American Academy of Pediatrics doesn’t endorse routine infant circumcision, though it's currently reviewing its position. As a result, Wasserheit tells ScientificAmerican.com, "depending on which pediatrician or OB or midwife, either nothing may be mentioned unless the parent asks or the option of circumcision is not presented in terms of potential benefits in protecting the son from these three common, currently incurable sexually transmitted infections."
About 17 percent of people in the U.S. are infected with herpes, at least half will experience HPV at some point and an estimated 3,800 U.S. women died last year of cervical cancer, which is linked to HPV.
"The major message here is that this is really terrific news that ought to shift the way we think about the potential role of male circumcision," Wasserheit says, "from prevention of HIV to this being a great opportunity to protect boys and men from these three currently incurable, viral STIs that are so common."
Transmission electron micrograph showing herpes/Fred Murphy and Sylvia Whitfield, CDC via Public Health Image Library
Tags:
herpes,
HPV,
circumcision,
AIDS,
HIV
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33 Comments
Add CommentHow about not having sex with people who have STIs? Did anyone think of that? Maybe we can also find a way to mutilate women's genitals at birth as well that slightly reduces risk of getting infected while having sex with diseased people. Sounds as justified to me!
Reply | Report Abuse | Link to thisYeah Pivo i can tell you've been rejected by plenty of girls for being uncircumcised. I on the other hand am circumcised and have no recollection of it ever happening because I was just born. Knowing that it helps fent off STDs and Infections makes me happy that my parents made that decision because any boy old enough to understand STDs and Infections would never let a knife near his privates. I think circumcision should be done on all men, the benefits are amazing and nobody who's had it done at birth remebers this "traumatizing experience"
Reply | Report Abuse | Link to thisAren't men who undergo circumcision as men usually of a higher socio-economic class & more educated? Are there other factors that could be affecting these studies? I think if they made it more clear in the articles as to the types of controls they used, we would a have better understanding as to what these findings mean.
Reply | Report Abuse | Link to thisDo yo think the religious right will be as outraged about this as they were when it was suggested their daughters should use Guardasil?
Reply | Report Abuse | Link to thisDo you think they will actually say that circumcision is going to encourage premarital sex because it can prevent hpv and therefore discourage it?
Got to love these African studies.... Yes, in Africa circumcised males generally are less likely to engage in risky sex. But, I bet, so are circumcised women.
Reply | Report Abuse | Link to thisFor the rest of the world, things are often different. East Asia, where most are intact, has a third of the STD rate of the US, which is the only large developed country where a majority of the male population is circumcised.
Western Europe, where the vast majority are intact, has roughly the same incidence of STD, as the US.
At the same time, AIDS infections in circumcised US are higher, than in intact Western Europe.
Circumcision, apart from religious support, is also big business (the most common surgical procedure in the US.) So, there are a lot of money to be made in Africa, if they can convince governments to support it. But, in reality, most studies supporting circumcision are flawed, as is this nonsensical article.
Modulerics: You are totally ignorant, but, I guess, happy. Good for you, but you really don't have a clue.
Evolving Ape, just because there's big business in something doesn't mean that should detract from the benefits of it. There is also big business in drinkable water, housing, clothing and organ transplants, just because people can make money off of it doesn't mean it's a bad thing especially when there's obvious benefits. The only positive thing I've heard about not being circumcised is that your privates are more sensitive and seeing as a vast majority of men claim they wish they lasted longer in bed why would you shoot down something that wards off infections and diseases and makes your lady friend happier and you more self confident in bed?
Reply | Report Abuse | Link to thisOh and if anyone wants to give the"sensitivity speech" just acknowledge that those findings are only with adult men who were circumcised well after puberty and there bodies development, nobody actually knows if being circumcised right after birth affects sensitivity because for all we know the body heals itself and goes back to pre circumcision sensitivity when it's done at such a young age and the body is still growing and developing. Check and mate, if anybody wants to sign me up for a book deal on this topic or to speak out just hit me up because my logic is flawless.
Reply | Report Abuse | Link to thisStudies done in Uganda that are not supported cross-culturally should not be used to support policy or procedure in the U.S. These numbers are only relevant to nations who share the sexual practices and sexual education level common in Uganda.
Reply | Report Abuse | Link to thisAt the very least, further research among the U.S. population is needed to verify the broad ranging assertions made by this article. The bold statement found in the title is simply not founded.
Has anyone considered what other parts of the body we can remove at infancy to reduce the risk of disease contraction?
Yes, Umbilical Cord. It's often cut to a short length then tied into a knot. I know so inhuman to tie human skin into a not, someone should put an end to that so traumatizing to our youth who will never remeber it and only benefit form the practice. Or how about the Mucus that's lodged in a baby's mouth at birth? Maybe doctors and nurses shouldn't just go ramming their fingers or turkey baster in a baby's mouth to clear that out so they can breath. Obviously these are gross exagerations compared to circumcision but there only seems to be benefits as a result of circumcision. I'm not a pro in the field but from personal research I don't see why anyone would argue against it other then saying it's traumatizing which is ludacris because nobody ever remebers it.
Reply | Report Abuse | Link to thisModulerics: I am guessing you are circumcised, and "sensitive" about the issue, thus you feel passionate about it, and wish everyone else had undergone the same mutilation.
Reply | Report Abuse | Link to thisI bet, the scribbler of this 60 seconds nonsense, is the same.
Circumcision, which began as a religious blood ritual, came to the States in the 19th century from England, largely as a "cure" for masturbation, quickly employed against such terrible sin by the religious. In the 20th century, and particularly with the influx of highly educated Jews (many physicians) after WW2, it spread among the general population.
But today, most medical authorities advise against it, even in the US.
Nobody is arguing that it is as bad as female circumcision. But then, neither is cutting off your earlobe. (And some argue that it is, in fact, of measurable harm: http://www.doctorsopposingcircumcision.org/DOC/statement06.html)
Anyway, the bottom line is, that this is a particularly badly researched article, and full of "bad" science.
Evolving Ape I entirely respect that and yes the science is far from perfect. I am circumcised but I am not sensitive about the issue. I just can not understand why people so fervently argue against being circumcised when there only seems to be benefits of having the procedure done. Obviously there are risks involved with it as there are any procedure but I believe the benefits are well worth the risk. That's why i try n push people on the topic when they argue against it because I really don't understand why to be so against it. The only thing people seem to say is the minor risk of having it done and the desensitized arguement which I believe doens't apply when it's done at birth because nobody has ever told me they have a problem Climaxing or don't enjoy sex because of being circumcised. And Even here in these comments nobody seems to be able to give a valid reason why not being circumcised is better then being circumcised. it's just the same broo haha about it being traumatic and put inplace but whack job religious people. So Basically I'm being really stern here because i'm trying to find that counterpoint that will make me reconsider my views on circumcision because I do know people that think it's wrong but I can't understand why when looking at it rationally.
Reply | Report Abuse | Link to thisWe're talking about cutting off part of the human body. Right? Anyone? Just as it doesn't make sense to you why people are opposed to it, I just can not undertand why someone would be in favor of this arbitrary, archaic, outdated tradition. Even though this article claims that there is some lower risk of STDs, it's obviously not comprehensive, exhautive or globally relevant due to socio-economic and many other factors.What sense is there in cutting away parts of the human body? Frankly, your reasons for being in favor of it seem very weak as well. As far as I can tell, the benefit is that you are still capable of having intercourse. Well congratulations. I guess my opinion is that we evolved to have skin protecting our "privates" for a reason and this tradition is outdated and irrelevant.
Reply | Report Abuse | Link to thisAnd you said without foreskin you can last longer in bed? That's a pretty clear sign that you are not getting anywhere near the sensitivity you could have if all of those nerve endings were still attached.
Pros:
Still capable of intercourse
Data about lower STD rates in Uganda
Cons:
Loss of body parts
Sex doesn't feel as good
I'm also guessing that given your style of reactions here, if you had foreskin and were raised under a different tradition, you would argue just as strongly for the other side. Please think about that. Please.
Scientific American has lower standards today than the golden years of the 60s and 70s. This article, like the other recent circumcision articles, makes no sense for anybody who thinks about statistics. What does "60% reduction" mean in the highly touted African HIV studies? Nothing, because the findings of these studies, conducted over a period of 2 years, are actually percentage *rates*, not absolute lifetime risks. Suddenly these numbers don't look so good. For example, if the infection rate for circumcised men is 50% in 2 years compared to those uncircumcised, then after 4 years half the men spared infection in the first two year period will now be infected. That's because in these sexually transmitted diseases, men don't have sex just once: it's repeated, pretty much until death. You don't catch HIV or HPV the way you catch a cold.
Reply | Report Abuse | Link to thisUntil people understand this, the confusion will continue. For example, I recently read an article that compared the lifetime risk reduction of polio vaccine with the aforementioned percentage rates, and the statistically clueless authors concluded that circumcision is as good a vaccine. What's inexcusable is the poor understanding of statistics by so-called researchers who don't understand percentage rates.
Pivo there are many complications with an uncircumcised penis. As a male gets older and uses it less frequently there is actually a risk of it closing up. Also a male is much more likely to get an infection in that area if he is uncircumcised. As for your ridiculous con section there is no study showing circumcision at birth results in a loss of sensitivty and every guy I know who was circumcised at birth is still able to climax and enjoy sex. I think if you can reach peak physical pleasure, the orgasm, then you're clearly sensitive enough even with the circumcision. And I really don't even think you should be commenting on this because with circumcision you don't lose anything. It's a cut so that the hood of the penis falls back. There is no removal of anything, so please at least know what you're even talking about before talking about it. I've though about it plenty jut like you ask and there's no cons to having it done. Nothing is removed and you can still climax, so both of your cons are refuted. And really with the "we've evolved to have skin protecting our privates" We've evolved to grow hair on our faces and heads as well to keep us warm but plenty of people shave their faces and heads, do you speak out to them about the evolutionary value of their hair? Because we all know at some point in your life you've shaved.
Reply | Report Abuse | Link to thisI'm not trying to be a dick I'm trying to find one valid arguement on why being uncircumcised is any better than being circumcised. Still to this day sensitivity is the only even nearly valid arguement and that's only according to adult males, nobod knows if there's a difference when done at birth and every mae who's had it done at birth can still climax so they're sensitive enough.
And once again yes the science of this article is not perfect, no study will ever encompass every aspect of a topic as wide ranging as circumcision and it' benefits over a lifetime, that's like trying to reproduce evolution in a lab. It can't be done but is most likely what's really going on.
And Pivo don't you think if circumcision results in lower STD rates in Uganda that you should support that? Or would you rather go on an anti circumcision crusade and hope that people in Uganda who could benefit from this procedure don't get it because you think it's archaic, but you don't even know what it is I geuss you heard that it's removing a fold of skin and didn't compute that you remove a fold by unfolding it which is done by a simple cut of the small section of skin that holds the skin in a folded position.
Reply | Report Abuse | Link to thisUhhh. First you said you are circumcised, but then you said that circumcision does not remove anything. You might want to double check, but it sounds like you're not circumcised. LOL.
Reply | Report Abuse | Link to thisUgh why don't you look up what circumcision is and then apologize, nothing is removed.
Reply | Report Abuse | Link to thisFunny how a practice originally intended to prevent the safest form of sex (i.e. masturbation) is being revived based on a few studies from Uganda. Like most epidemiological studies, a small sample size yields a low-moderate relative risk (1.25-1.3) and this translates into headlines that circumcision "prevents" HIV, and now HPV and Herpes. I wonder how much of this has to do with hospitals losing money now that circumcision has been in decline in the US. Yes, money is behind everything, even public health.
Reply | Report Abuse | Link to thisIS THIS A scam?
Reply | Report Abuse | Link to thisI looked back at recent US data and surveys and they did not get much press. This Uganda study with the low % difference is all over the media. A recent US cohort study published in the Journal of Infectious Diseases showed only the total number of lifetime sexual partners affected the risk of new (incident) HPV infections and there was no difference in the risk of new (incident) HPV between circumcised and natural men.
In May of 2008 a medical survey showed Uncircumcised (natural) Fared Better as Circumcision appeared to have an effect on rates of genital warts:
* 4 �% of circumcised men reported having genital warts
* 2.4% of uncircumcised men reported having genital warts-- again in the US.
How do they make such a big deal; out of the Africa study when the US data shows at least infant circumcsion does not help avoid new HPV infections?
I think the aim of studies like this is not to promote circumcision in countries like the US. I view it as they are trying to show in countries where basic hygiene is not the norm that circumcision has many benefits for men who have the procedure done.
Reply | Report Abuse | Link to thisWhether or not there is money behind circumcision in Africa I think the people doing these studies most likely have genuine good intentions to help prevent STDs and infections in countries where it is a serious problem. So these studies are done to help create support for circumcision programs abroad. Unfortuntely so many people are opposed to circumcision that they don't support it where it truely can benefit people. That's why I speak out in favor of circumcision because I believe it really can benefit people and yet many people will act like I'm crazy an my opinions are unfounded when they don't realize that killing support for circumcision decreases the quality of life for millions in Africa.
I think the story here is that some US medical professionals are so obsessed with trying to find a purpose for circumcision that they are fudging data and overestimating insignificant facts. This particular study was partially funded by our tax dollars and by Bill and Malinda Gates. Odd that this 20 -30 % change of risk, where cut men used condoms more and cut men certainly did not have sex some of the time is considered at all. In another Gates funded study HIV positive men and their wives showed CIRCUMCISED men were passing HIV to women at a higher rate. But that study was a dead end so they don’t talk about it. The end of course is to promote circumcision. In particular it is to widen the base in the USA. The US, due to the internet was slowly realizing that not only does circ not make you healthy, it can cause all sorts of problems. People also realized (and in the pre-internet days natural men did not talk about it) that circ removes about 20,000 fine touch nerve endings and the most sensitive part of the male genitals. It is like losing your lips or your fingertips. You may ask why do these people push this barbaric ritual as a health practice?
Reply | Report Abuse | Link to thisIf you had advocated something, and done something to thousands and it was revealed as bad, it is a natural reaction to defend it. This also applies to men that have been cut. NO man wants to hear that there member somehow has a problem. This also applies to mothers that had their son cut. There is this huge body of resistance to natural in the US. People must recognize the obsession of the medical people. None of this data, if it was not cooked up (and it is at least indefinite as condoms, behavior, sex - they did not know everything) is worth ripping and chopping off a baby boys most sensitive part in a developed country that has good water.
Someone said this obsession and this push for mutilation is hate or anti male sexuality, I think it based on embarrassment and an obsession with trying to find a reason to do this amputation. Let us Americans at least ask the American Academy of Pediatrics Task Force on Neonatal [male] Circumcision when they review the policy on circ to have at least one natural male doctor (Someone that knows first hand the joy of these body parts that are amputated) included in the review as well as at least some consideration for the function and make up (thousands of fine touch nerve endings) of these parts.
Modulerics does not know, like women circumcised, what is missing. What is missing is the main pleasure site of the male genitals.
I think Modulerics is confused because he believes he is circumcised, though apparently nothing has been removed. Circum = around, cision = cut. All definitions of the word concur... our classic friend Webster's says circumcising is "to cut off the foreskin of (a male) or the clitoris of (a female)", no ambiguity there.
Reply | Report Abuse | Link to thisModulerics, what you're talking about sounds like you've had your frenulum snipped, allowing the foreskin to move freely. Not circumcision, which actually removes tissue. I'm sure you can find a video of it on youtube if you still don't believe the definition.
So Modulerics, do you still have foreskin?
http://www.webmd.com/hw-popup/circumcision-5191
Reply | Report Abuse | Link to thisDefinitions (not that you will read them):
Reply | Report Abuse | Link to thishttp://www.nlm.nih.gov/medlineplus/ency/article/002998.htm
http://dictionary.webmd.com/terms/circumcision
Images:
http://services.epnet.com/GetImage.aspx/getImage.aspx?ImageIID=7343
http://img.tfd.com/GEM/gem_0003_0002_0_img0174.jpg
Im uncircumsized but my father is circumsized, I never really had an opinion on the whole thing till i had my son. I almost had him circumsized because the doctor told me he would look wierd in the showers if he didnt have it done, I did wrestling & football in high school we never showerd together,and I never went out of my way to get naked with other dudes, except one time i went streaking but i wasnt really comparing penisis like the doctor sugested lol,so I didnt know if that was true. I figured if i got him done I would too. But after opting to wait and research it only 15% of men worldwide have this operation done. Only in the u.s. is circumsision a majority. Sexual pleasure decrease for me and my partner no thanks i dont care whats cosmeticaly in these days. I feel bad for the sons of single mothers who are influenced by these doctors who many were born in the 70s and 80s are probably circumsized when this became a standard to keep young boys from masturbating. many times people feel forced to argue & defend a undoable desision. Mothers dont question the perfection of god and nature, your son and the less common daughter dont need thier genitals mutilated.
Reply | Report Abuse | Link to thisIt seems interesting. many thanks about the herpes information. http://www.herpessymptoms1.com/what-does-herpes-look-like, which is about What Does Herpes Look Like
Reply | Report Abuse | Link to thisIt is interesting. many thanks for the herpes information. http://www.herpessymptoms1.com/what-does-herpes-look-like, which is about What Does Herpes Look Like.
Reply | Report Abuse | Link to thisActually, a big joke!!
Reply | Report Abuse | Link to this<a href="http://www.herpessos.com/herpes-outbreak.html" target="_blank">herpes outbreak</a>
Actuallly, a big joke!!
Reply | Report Abuse | Link to this<a href="http://www.herpessos.com/herpes-outbreak.html" target="_blank">herpes outbreak</a>
This is a "game changer" in "frank discussions" with parents about the "health benefits" of "routine medical practice"???
Reply | Report Abuse | Link to thisWhat a joke Judith Wasserheit is. "Frank" discussion would include the fact that American Medicine has been on a "fishing expedition" for 150 years looking for reasons to demonize and remove the male foreskin. Something they do bill for, -and then often sell to Pharmaceutical companies.
The only benefit occurring from male infant circumcision goes to the doctor: it's one less car payment they have to make. Now that is a FRANK discussion with one's doctor!
Follow the money.
Children have right NOT to be assaulted, - even at the request of their parents -who may have suffered similar assault in their childhood. Tradition is nothing but cultural slavery, -at least in this case.
Doctors are complicit and active proponents of circumcision because it is billable, -but it also reassures them there's nothing wrong with them, for having a substantially incomplete penis.
And why is it that there is no discussion of ethics? Since when is forced amputation of the genitals of ANY individual, ethical? It may be legal, it may be tradition, but these were once true of foot binding as well and nobody misses that "tradition."
American Medicine: Ethics free pursuit of profit for 150 years.
thanks for this well written article. it is very informative.
Reply | Report Abuse | Link to thisThe more information you have, the better your chances of preventing a std and staying healthy.
http://simplestdtesting.com/resources
Most people don't know they have herpes. You can find out that you have herpes a few days or as late as years after getting it. Herpes usually affects the mouth and the area around the penis or vagina, buttocks or upper thighs.
Reply | Report Abuse | Link to this<a href="http://www.herbaldiet.com/herbalife/formula-1-nutritional-shake/69.aspx">herbalife formula 1</a>
Is this really the answer so that herpes will be avoided? I think circumcision also was the answer for some problems.
Reply | Report Abuse | Link to thishttp://www.nutrahealthwise.com/herpes/herpaflor-herpes-treatment-and-relief/