Circumcision Prevents Sexual Transmitted Diseases (STDs)

Is there a reason why Catholic nuns and Jewish women have a decreased incidence of cervical cancer and the opposite applies to groups such as blacks and Hispanics, where rates of HIV, herpes, and cervical cancer are disproportionately high?

Johns Hopkins scientists, along with researchers in Uganda, are saying that "circumcision significantly reduces the risk of contracting herpes (HSV-2) and human papillomavirus (HPV)," contributing more hard data to a pool of "growing scientific evidence that the procedure helps stem the spread of some sexually transmitted diseases." A little "over half of male newborns in the US get circumcised, according to research published earlier this year in the American Journal of Public Health." It’s ironic that apparently, that "percentage has declined over the past decade, in part because the American Academy of Pediatrics said in 1999 that the evidence is 'not sufficient to recommend routine neonatal circumcision.'" But, pathologist and Hopkins' team member Aaron Tobian, MD, PhD, said, "The scientific evidence for the public-health benefits of male circumcision is overwhelming now."

For example, "landmark studies from three African countries, including Uganda, previously found circumcision lowered men's chance of catching the AIDS virus by up to 60 percent. The new work "stems from the Uganda research and looked at protection against three other STDs" -- herpes, HPV, and syphilis.

The research teams set up two parallel, but independent, trials comprised of "a total of 5,534 uncircumcised men between the ages of 15 and 49 who were negative for the AIDS virus. Then, "1,684 of the 3,393 men who tested negative for herpes were circumcised immediately, and the others received a medical circumcision after 24 months." In addition, "352 men in the circumcised group and 345 in the delayed circumcision group were evaluated for HPV at the start of the trial and at 24 months."

Two years later, investigators noted that "circumcised volunteers were one-fourth less likely to have genital herpes and one-third less apt to carry a type of HPV that causes cervical cancer, compared with the still-uncircumcised males." Even "when all HPV types were assessed, including those causing genital warts, the circumcised volunteers were still nearly one-third less likely to carry one of the types.”

COMMENT:
There are "several reasons that removing the foreskin of the penis might help reduce transmission of certain infections. The foreskin, has two different sides," with the outside being very much like "regular skin cells," but "the inside is mucosal, similar to a woman's vagina." And, "during intercourse, the skin side is pulled back and the mucosal side is open and exposed." One researcher opines that "it's likely that there are viral receptors on that mucosal side that make it easier for a virus to get into the cells." Moreover, "if a woman has passed along viral cells, they're now trapped inside the foreskin, in a moist environment that's conducive for the virus to replicate."

The study authors say their findings "should guide public health policies for neonatal, adolescent, and adult male circumcision programs," according to MedPage Today (3/25/09, Smith), particularly since "circumcision rates in the US are falling, especially among groups such as blacks and Hispanics, where rates of HIV, herpes, and cervical cancer are 'disproportionately high.'"

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