Male circumcision reduces men's risk of contracting HPV, herpes, study says

Mar 30 2009

Male circumcision can reduce a man's risk of contracting the sexually transmitted infections human papillomavirus and herpes, according to a study published this week in the New England Journal of Medicine, the Wall Street Journal reports.

The new research "adds to the growing scientific evidence that the procedure helps stem the spread of some" STIs, according to the Journal. It follows studies showing that the procedure can reduce a man's risk of contracting HIV through heterosexual sex. The new study -- conducted by researchers from Johns Hopkins University and Makerere University in Uganda -- used data from trials that were part of these studies about male circumcision and HIV in Africa.

In the new study, researchers compared 1,684 men who were circumcised with a control group of 1,709 uncircumcised men for two years ending in 2007. They found that circumcised men were 35% less likely to contract HPV compared with the uncircumcised men. The circumcised men also were 25% less likely to contract herpes (Shishkin, Wall Street Journal, 3/25). The study found no effect on the transmission of syphilis. The researchers accounted for condom use, the number of sex partners and additional factors when calculating the men's STI risk.

According to the researchers, male circumcision should become an accepted method to help reduce the risk of STIs from heterosexual sex among men, the AP/Google.com reports. "It must be emphasized that protection was only partial, and it is critical to promote the practice of safe sex," the researchers wrote (Chang, AP/Google.com, 3/25). They added that they hope the new evidence will lead to male circumcision becoming a more widespread medical practice, the Journal reports. Researcher Aaron Tobian from Johns Hopkins said, "The scientific evidence for the public health benefits of male circumcision is overwhelming now" (Wall Street Journal, 3/25). The researchers said that they plan to study whether male circumcision reduces the spread of HPV to female sex partners.

About 30% of men worldwide are circumcised. In the U.S., about 79% of men have undergone the procedure, according to the National Center for Health Statistics (AP/Google.com, 3/25). The American Academy of Pediatrics in 1999 issued a statement that said evidence is "not sufficient to recommend routine neonatal circumcision," the Journal reports. According to a study published in the American Journal of Public Health, Medicaid plans in 16 states do not cover circumcision as a result of the academy's stated position on the procedure. In states where Medicaid coverage for circumcision is available, rates are near 70%. In states without such coverage, rates are around 31%. The academy says that it is reviewing its guidelines on circumcision in light of the new data, expecting to complete the review by the end of this year. Susan Blank, chair of the task force on neonatal circumcision at the academy, said, "There's no argument that the trials that have been done are really compelling," adding that the study is "one piece in the discussion on circumcision." Some opponents of male circumcision say that the procedure is not medically necessary and can cause unnecessary distress. They add that proper hygiene and safer-sex practices can prevent STIs (Wall Street Journal, 3/25).

In an accompanying editorial, University of Washington researchers Matthew Golden and Judith Wasserheit write, "Evidence now strongly suggests that circumcision offers an important prevention opportunity and should be widely available" (AP/Google.com, 3/25).

The study is available online. The related editorial also is available online.