COMMENTARY |
a Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee
b Division of Infectious Diseases, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
c Department of Pediatrics, Columbus Children's Hospital, Columbus, Ohio
d Department of Pediatrics, University of South Florida, Tampa, Florida
e Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, Rockville, Maryland
f Department of Pediatric Infectious Diseases, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota
g Department of Adolescent and Young Adult Medicine, Stroger Hospital of Cook County, Chicago, Illinois
h Division of Infectious Diseases, Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana
Abbreviations: STD, sexually transmitted disease CI, confidence interval
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A recent commentary in Pediatrics reviewed the documented medical benefits of newborn male circumcision, including protection against balanoposthitis, phimosis, infections of the urinary tract in male infants, and protection against human papillomavirusassociated genital cancers and HIV and Chlamydia infection in adolescents and adults.1 Low rates of minor surgical complications (0.2%0.6%) and safety and efficacy of local anesthesia were noted. The ability of newborn circumcision to protect against sexually transmitted diseases (STDs) was also shown in a recently published cohort study from New Zealand.2 Recent large randomized clinical trials in South Africa, Kenya, and Uganda demonstrated reduction of HIV-acquisition risk by male circumcision performed outside the newborn period, showing the role of adult male circumcision in prevention of STDs in adolescents and adults.3,4
An association between lack of male circumcision and acquisition of HIV infection was first noted in 1986.5 Over the next 10 years, more than 35 studies including ecologic, cross-sectional, case-control, and cohort studies in general and high-risk populations throughout the world evaluated the possible protective effect of male circumcision against HIV acquisition.68 A systematic review summarized the studies from sub-Saharan Africa and showed an estimate of
Address correspondence to Peter Havens, MS, MD, Medical College of Wisconsin, Pediatric Infectious Diseases, Suite C450, PO Box 1997, Milwaukee, WI 53201-1997. E-mail: phavens@mcw.edu
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