Circumcision effective way to reduce risk of AIDS, herpes and genital warts, UW researchers say
Healthcare providers should make it clear to patients and parents that male circumcision substantially reduces a man’s risk of contracting AIDS, genital herpes and the virus that causes genital warts and cervical cancer, two University of Washington researchers write in today’s issue of the New England Journal of Medicine.
In recent years, the value of circumcision has been subject to debate with opponents arguing the procedure is of little benefit and may be potentially harmful, and circumcision rates have been on the decline.
Uncertainty over the value of the procedure, for example, has led the American Academy of Pediatrics to state that there is not enough evidence of benefits for doctors to recommend circumcision routinely for newborns, though the Academy is currently reviewing its position.
In today’s New England Journal of Medicine article, Drs. Matthew R. Golden and Judith N. Wasserheit argue that “the evidence now strongly suggests that circumcision offers an important prevention opportunity and should be widely available.”
Among the studies they cite to back up their argument, Drs. Golden and Wesserheit, point to a study conducted in Uganda and that appears in the same issue of the journal finding that men who were circumcised as adults reduced their risk of contracting herpes simplex virus (HSV-2), the virus that causes genital herpes, by 25 percent, and reduced their infection rates with the human papilloma virus (HPV) by 35 percent.
HSV-2 and HPV infections are common. Roughly one in five U.S. adults have been infected with the herpes virus, which can cause painful, recurring genital sores and which can endanger newborns if the virus is present during birth. And roughly three out of four U.S. adults have had at least one infection with the human papilloma virus, which include strains that cause cervical cancer.
Other studies conducted in Kenya, South Africa and Uganda have found that adult men who underwent circumcision cut their risk of HIV infection by half, Drs. Golden and Wesserheit note.
Reducing infections by these viruses in men, in turn, can help reduce not only infections in women but the rate of cervical cancer as well, Dr. Golden and Wesserheit write.
Despite the benefits of circumcision,policies concerning circumcision should vary in different countries depending on the prevalence of these infections and the countries’ resources, Drs. Golden and Wesserheit write:
- In countries with HIV infection rates among heterosexuals there is access to safe circumcision should be expanded.
- In low- and middle-income countries, where HIV infection is less common and access to safe circumcision services is limited, the decision to promote circumcision needs to be based of on a careful cost-benefit analysis.
- In higher-income countries like the United States healthcare providers need to at least provide patients and parents with information about the potential of circumcision to reduce the risk of infection by “the three most important sexually transmitted viral infections”: HIV, HSV-2 and HPV.
“Male circumcision will remain a personal decision for patients and parents, and some unanswered questions persist, ” Drs. Golden and Wesserheit conclude. “However, evidence now strongly suggests that circumcision offers and important prevention opportunity and should be widely available.”
PHOTO: Herpes Simplex Virus by Dr. Fred Murphy & Sylvia Whitfield of the CDC
To learn more:
- Read the article by Drs. Golden and Wasserheit in the New England Journal of Medicine (fee or subscription may be required).
- Visit the National Library of Medicine’s MedlinePlus Web site which has information about circumcision, HIV, herpes and human papilloma virus.
- Visit the Public Health – Seattle & King County Sexually Transmitted Disease information page, which has information in English and Spanish and links to clinics and other resources.
Category: Cervical Cancer, HIV/AIDS, Infections, Newborn and Infant Health, Prevention, Sexual Health
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