I went into this in an earlier post(s), but found this paper while doing some background reading on HPV-related items. A number of studies have shown that circumcision reduces the transmission of HIV, but does it reduce other infectious ...
I went into this in an earlier post(s), but found this paper while doing some background reading on HPV-related items. A number of studies have shown that circumcision reduces the transmission of HIV, but does it reduce other infectious diseases as well? Maybe:
Circumcision Cuts HPV Risk for Both Sexes
Male circumcision can reduce the risk that female partners will acquire human papillomavirus (HPV), researchers reported.
Women in two large trials of circumcision had a lower incidence and prevalence of HPV if their partners got the procedure, according to Aaron Tobian, MD, of Johns Hopkins University, and colleagues.
Summary and some comments below the fold. . . .
Here’s the summary:
Background Randomised trials show that male circumcision reduces the prevalence and incidence of high-risk human
papillomavirus (HPV) infection in men. We assessed the effi cacy of male circumcision to reduce prevalence and
incidence of high-risk HPV in female partners of circumcised men.
Methods In two parallel but independent randomised controlled trials of male circumcision, we enrolled HIV-negative
men and their female partners between 2003 and 2006, in Rakai, Uganda. With a computer-generated random
number sequence in blocks of 20, men were assigned to undergo circumcision immediately (intervention) or after
24 months (control). HIV-uninfected female partners (648 of men from the intervention group, and 597 of men in the
control group) were simultaneously enrolled and provided interview information and self-collected vaginal swabs at
baseline, 12 months, and 24 months. Vaginal swabs were tested for high-risk HPV by Roche HPV Linear Array.
Female HPV infection was a secondary endpoint of the trials, assessed as the prevalence of high-risk HPV infection
24 months after intervention and the incidence of new infections during the trial. Analysis was by intention-to-treat.
An as-treated analysis was also done to account for study-group crossovers. The trials were registered,
numbers NCT00425984 and NCT00124878.
Findings During the trial, 18 men in the control group underwent circumcision elsewhere, and 31 in the intervention
group did not undergo circumcision. At 24-month follow-up, data were available for 544 women in the intervention
group and 488 in the control group; 151 (27·8%) women in the intervention group and 189 (38·7%) in the control
group had high-risk HPV infection (prevalence risk ratio=0·72, 95% CI 0·60–0·85, p=0·001). During the trial,
incidence of high-risk HPV infection in women was lower in the intervention group than in the control group
(20·7 infections vs 26·9 infections per 100 person-years; incidence rate ratio=0·77, 0·63–0·93, p=0·008).
Interpretation Our findings indicate that male circumcision should now be accepted as an efficacious intervention for
reducing the prevalence and incidence of HPV infections in female partners. However, protection is only partial; the
promotion of safe sex practices is also important.
They say it’s only “partial” because it only reduced transmission by a fairly modest amount. It’s a practice that seems to be fairly common throughout history, though at times it’s tough to determine whether what is being referred to is really “circumcision” or just some sort of ritual scarring or the like. But the selectionist argument that it provides some benefit and is thus fixed in certain populations has been largely based on the supposed health effects for the male and now also the female — which may end up being the key. Remember, you don’t need people to necessarily be aware of the benefits (though they certainly could be) but just that the results of said behavior are greater reproductive fitness which may well be the case if it is protecting the bearer of children from debilitating infections.
