Male circumcision refers to the removal of the foreskin from the head of the penis(glans). Although it has its origin in religious rites, more and more parents nowadays are opting for circumcision for their son(s) for health-related reasons. The health benefits of male circumcision for both the male and female partner are well established and irrefutable thanks to countless studies over the past decades. The science behind it even drove affirmative policy recommendations by the World Health Organisation (WHO), UNAIDS, the World Bank, the American Academy of Pediatrics, and the US Centers for Disease Control and Prevention (CDC).

The benefit of circumcision includes:

  • Significantly reduce their risk of acquiring two common sexually transmitted infections — herpes simplex virus type 2 (HSV-2), the cause of genital herpes, and human papillomavirus (HPV), which can cause cancer and genital warts.
  • Protection against cervical cancer, cervical dysplasia, and sexually transmitted diseases (STDs) chlamydia, and syphilis.
  • Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin).
  • Prevention of phimosis (the inability to retract the foreskin)
  • A decreased risk of urinary tract infections.

Circumcision also makes it easier to keep the end of the penis clean. Compared to circumcised men, uncircumcised men were more likely than circumcised men to have infections detected at multiple genital sites, which may have implications for HPV transmission.

Circumcision and Homosexual Men

While the benefits of heterosexual male circumcision has been made very clear, not much is known about its protective role with regards to the transmission of STDs amongst men who have sex with men (MSM). In other words, the link between the protective effect of circumcision and homosexual men remains to be verified. Fortunately, earlier this month, a systematic review and meta-analysis of global data to investigate the role of circumcision in preventing the spread of STDs and HIV amongst MSM, was recently published in the Global Health Section of The Lancet.

Across 62 observational studies, which included up to 119 248 MSM, what the review found was that circumcision was associated with 23% reduced odds of HIV infection among MSM overall. Furthermore, circumcision was protective against HIV infection among MSM in countries of low and middle income but the same result was not replicated among MSM in high-income countries. Moreover, circumcision was associated with reduced odds of herpes simplex virus (HSV) infection among MSM overall and penile human papillomavirus (HPV) infection among HIV-infected MSM.

The group of researchers interpreted these results as evidence that circumcision is likely to protect MSM from HIV infection, particularly in countries of low and middle income. In important ways, the protective role of circumcision and homosexual men may just share the same benefits as with circumcised heterosexual males. While circumcision does seem to incur protection, that does not mean that homosexual men (MSM) should have unprotected sexual intercourse. Protection and precautionary steps are still very much needed to mitigate the risk of transmitting and acquiring HIV or other STDs.

In view of these extended benefits of circumcision, the researchers suggested that MSM should be included in campaigns promoting circumcision among men in countries of low and middle income. In view of the substantial proportion of MSM in countries of low and middle income who also have sex with women, well designed longitudinal studies differentiating MSM only and bisexual men are needed to clarify the effect of circumcision on male-to-male transmission of HIV and other STDs.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Sources
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