A series of randomized controlled trials conducted in africa from 2005 to 2007 have shown that vmmc can reduce the risk of vaginaltopenile. Hence, eliminating the foreskin diminishes some of the targets for the virus, and allows for a more protective skin surface barrier against hiv. Similar effects on sti risk may exist for females, although this may result from an indirect. During this time, the overall percentage of newborns circumcised during their birth hospitalization was highest in 1981 at 64. According to the american academy of pediatrics aap, 1999. According to looli 2004 the word circumcision has its roots in two latin words circum which means around and coed ere which literally means to cut. It is one of the most common procedures in the world. Circumcision policy statement american academy of pediatrics. Male circumcision is a common procedure, generally performed during the newborn period in the united states. Scientific studies show some medical benefits of circumcision. Circumcision is identified by icd9cm procedure code 64. Circumcision is the surgical removal of the foreskin, which is the skin covering the tip of the penis.
A form of circumcision was also practiced in oceania and aboriginal australia using sea shells as the cutting instrument. Answers to your questions about circumcision and mrsa 1107 references 1. The newest data related to the human immunodeficiency virus hiv acquired immune disease syndrome aids epidemic is primarily positive, but many areas of the world, especially subsaharan africa, remain disproportionately affected. Based on three large randomized controlled trials rcts conducted in africa, it can clearly be stated that circumcision lowers the risk of infection with the human immunodeficiency virus hiv and some sexually transmitted infections stis among males in settings of high hiv and sti endemicity. Pdf female circumcision is a very important health problem affecting about 140 million people all around the world. Male circumcision, peer effects and risk compensation. Female circumcision now more commonly known as female genital mutilation fgm is a cultural practice performed most often in africa and the middle east. Young adults stated that circumcision reduces friction during sexual intercourse, enhances the sexual pleasure of both partners, and likened the presence of a foreskin to wearing a condom in that it reduced sensitivity kebaabetswe et al.
Standard errors for years before 1988 are not currently available. The studies that uncovered this finding were conducted in africa, and the world health organization who is attempting to increase circumcision rates throughout the continent in a bid to contain an outofcontrol aids epidemic. Male circumcision for hiv prevention in young men in kisumu, kenya. Involvement of pantonvalentine leukocidinproducing staphylococcus aureus in primary skin infections and pneumonia.
Acceptability of male circumcision for prevention of hiv. An overview of female genital mutilation in nigeria. The knmg therefore emphasises that circumcision is a surgical procedure. Trends in circumcision for male newborns in us hospitals cdc. In the usa 1 in 6 men get prostate cancer during their lifetime american, 2005a. South african national guidelines for medical male circumcision. Circumcisions psychological damage psychology today. Between 2007 and 2010, the percentage of circumcised men increased from 16% to.
Report 10 of the council on scientific affairs, 2000. The authors concluded that male circumcision has no deleterious effect on female sexual satisfaction. The diagram below is a stepbystep illustration of circumcision using a gornco clamp, the most commonly performed method. Male circumcision is defined as the partial or total surgical removal of the foreskin also called prepuce, which is specialized tissue that covers the head or glans of the penis. Technical report male circumcision abstract male circumcision consists of the surgical removal of some, or all, of the foreskin or prepuce from the penis. This change has been significantly influenced by past recommendations from the canadian paediatric society and the american academy of pediatrics, who both affirmed that the procedure was not medically indicated. Furthermore, hivinfected circumcised men can still transmit hiv to female and. Estimates of the biological prophylactic e ect of male circumcision range from a 51 to 76 percent reduction in the femaletomale hiv transmission rate auvert et al 2005, bailey et al 2007, gray et al 2007. If you are unable to see the pdf link please follow the. Estimated number of male newborn infants, and percent circumcised during birth hospitalization, by geographic region.
Male circumcision, peer effects and risk compensation1. There are many relative indications for circumcision in childhood, but the. Evidence from hospital episode statistics data 2007. Health benefits and associated risks male circumcision involves the surgical removal of the foreskin, the tissue covering the head of the penis. An extended clinical trial of the role played by circumcision in the prevention of prostate cancer is needed oliver, 2009. Randomized controlled trials in africa have shown that male circumcision can reduce the risk of hiv transmission in men by 51% to 60%. Risk reduction was 60 percent in the south african trial auvert et al. It originated over 15 000 years ago, being performed for religious, ritualistic, and cultural reasons, and it was not until the 19th century that the procedure was medicalised. Circumcision is the removal of some or the entire foreskin prepuce from the penis.
Research implications for policy and programming montreux, 6 8 march 2007. In 2007, the american academy of pediatrics aap formed a multidisciplinary task force of aap members and other stakeholders to evaluate the recent evidence on male circumcision and update the academys 1999 recommendations in this area. In 2005, circumcision was the third most common inpatient surgery. Circumcision prostate cancer benefits of circumcision. Male circumcision for hiv prevention in young men in rakai, uganda. Ascending passage of a particular sti to the prostate could be a causative factor in prostate cancer. Circumcision in oceania and australia was a rite of passage into manhood as well as a. Three studies from african nations published in 2005 and 2007 provide convincing. Drs tobian and gray1 highlight the medical benefits of male circumcision, especially protection against infection with the sexually transmitted viral pathogens hiv, herpes simplex. Racp has prepared this statement on circumcision of infant boys for doctors and to assist parents. Across the 32year period from 1979 through 2010, the national rate of newborn circumcision declined 10% overall, from 64.
Male circumcision and risk of syphilis, chancroid, and genital herpes. This databank indicator is no longer being updated download report for the past decade, the percentage of male infants who were circumcised in the hospital has remained at about 56 percent, the lowest percentage since records began in 1979. World health organization and joint united nations programme on hivaids, 2007. Circumcision historically was not limited to only africa and the middle east. The medical indications to circumcise prepubertal boys are rare. The acceptability of male circumcision as an hiv intervention among a. Three randomized controlled trials published in 2005 and 2007 2,3 demonstrated that the femaletomale transmission of hiv is reduced by male circumcision. Less commonly, circumcision is sometimes done for healthrelated reasons. The facts male circumcision as hiv prevention on march 28, 2007, the world health organization who and the joint united nations programme on hiv aids unaids recommended that hiv prevention programs and policies recognize male circumcision as an additional, important strategy to prevent men from acquiring hiv from infected female partners. The circumcision of newborn males in canada has become a less frequent practice over the past few decades. Safe, voluntary, informed male circumcision and comprehensive hiv prevention programming 3 although the results of these trials are highly significant, it is essential to emphasize that male circumcision does not provide complete protection against hiv. American academy of pediatrics aap circumcision policy statement. Other issues in the circumcision debate circumcision.
Position statement male infant circumcision pain management. We are currently experiencing intermittent display of pdf links on some article pages. It involves the unnecessary removal of the clitoris or the cutting or. Lancet in february 2007 according to the researchers, randomized trials conducted in kenya and uganda. There is no compelling evidence to justify routine male infant circumcision on medical grounds. Adult male circumcision, though not completely protective against hiv, is a promising preventive tool that will likely have an important role as part of a comprehensive hiv disease prevention strategy. Most men dont have the information on long term effects. Information for parents circumcision is a surgical procedure in which the skin covering the end of the penis is removed. There are some valid medical reasons to circumcise. While scientific evidence suggested potential medical benefits of newborn male circumcision, in 1999 the american academy of pediatrics stated that these findings are not sufficient to recommend routine infant circumcision. As psychologists, we are deeply concerned by the recently announced cdc guidelines promoting circumcision for all males, and in particular children.
The results from the south african study were published in late 2005, and. Pdf an overview of female genital mutilation in nigeria. Manual for male circumcision under local anaesthesia version 3. Its common in the united states and parts of africa and the middle east but less common in. The practice of circumcision has ancient origins, and continues today around the world for various religious and cultural reasons. Doyle, 2005 stated that circumcision began around the 4th millennium bce among the sumerians and the semites who are the fore fathers of the hebrews.
Circumcision as a strategy to minimize hiv transmission. H and tanner, s, trends in childrens surgery 19942005. From its 1971 manual, to the 1975 and 1983 revisions. Nigeria, due to its large population, has the highest absolute number of female genital mutilation fgm worldwide, accounting for about onequarter of the estimated 115 million circumcised women in the world. Understanding behavioral responses to changes in actual or perceived risk is important, because risk. These data led who and unaids to recommend in 2007 that male circumcision should be considered. Healthcare cost and agency for healthcare research and. There is conclusive evidence from observational data and three randomized controlled. The distribution of circumcision and initiation rites throughout africa, and the frequent resemblance between details of ceremonial procedure in areas thousands of miles apart, indicate that the circumcision ritual has an old tradition behind it and in its present form is the result of a long process of development. Studies have shown that circumcision can reduce the risk of contracting the hiv virus by 60 percent source. Manual for male circumcision under local anaesthesia. Circumcision should be a mans choice after he has all the data on the effects.
Potential for an intervention based on male circumcision in a south african town with high levels of hiv infection. American family physician, 1999 accessed september 5, 2007. Scaling up voluntary medical male circumcision for impact three randomized controlled trials have demonstrated that voluntary medical male circumcision vmmc reduces the risk of hiv transmission from women to men by up to 60 percent. In the united states, the procedure is commonly performed during the newborn period. Can circumcision reduce a mans risk of getting hiv. National hospital discharge survey, national center for health statistics, centers for disease control and prevention. Following these trials, the world health organization who and the joint united nations programme on hivaids unaids recommended the use of male circumcision mc as an additional strategy for hiv prevention in. Aap, 2005 there is solid evidence that male infants who undergo circumcision without the benefits of analgesia experience physiologic stress and pain. Womens knowledge and perception of male circumcision. Whounaids technical consultation on male circumcision and hiv prevention. Between 2005 and 2007, three large randomized trials evaluating circumcision for prevention of hiv acquisition in heterosexual african males showed. The demand for medical male circumcision by jobiba chinkhumba, susan godlonton, and rebecca thornton this paper measures the demand for adult medical male circumcision using an experiment that randomly offered varyingpriced subsidies and comprehensive information to 1,600 uncircumcised men in urban malawi. Circumcision for the prevention of urinary tract infection in boys. Althc re cost nd agency for healthcare utilization.