Association between male circumcision and women's biomedical health outcomes: a systematic review
Background: Male circumcision reduces men's risk of acquiring HIV and some sexually transmitted infections from heterosexual exposure, and is essential for HIV prevention in sub-Saharan Africa. Studies have also investigated associations between male circumcision and risk of acquisition of HIV...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-11-01
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| Series: | The Lancet Global Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214109X17303698 |
| _version_ | 1828763366775062528 |
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| author | Jonathan M Grund, MPH Tyler S Bryant, MHS Inimfon Jackson, MPH Kelly Curran, MPH Naomi Bock, MD Carlos Toledo, PhD Joanna Taliano, MLS Sheng Zhou, MBBS Jorge Martin del Campo, MD Ling Yang, ScM Apollo Kivumbi, MPH Peizi Li, MD Sherri Pals, PhD Dr Stephanie M Davis, MD |
| author_facet | Jonathan M Grund, MPH Tyler S Bryant, MHS Inimfon Jackson, MPH Kelly Curran, MPH Naomi Bock, MD Carlos Toledo, PhD Joanna Taliano, MLS Sheng Zhou, MBBS Jorge Martin del Campo, MD Ling Yang, ScM Apollo Kivumbi, MPH Peizi Li, MD Sherri Pals, PhD Dr Stephanie M Davis, MD |
| author_sort | Jonathan M Grund, MPH |
| collection | DOAJ |
| description | Background: Male circumcision reduces men's risk of acquiring HIV and some sexually transmitted infections from heterosexual exposure, and is essential for HIV prevention in sub-Saharan Africa. Studies have also investigated associations between male circumcision and risk of acquisition of HIV and sexually transmitted infections in women. We aimed to review all evidence on associations between male circumcision and women's health outcomes to benefit women's health programmes.
Methods: In this systematic review we searched for peer-reviewed and grey literature publications reporting associations between male circumcision and women's health outcomes up to April 11, 2016. All biomedical (not psychological or social) outcomes in all study types were included. Searches were not restricted by year of publication, or to sub-Saharan Africa. Publications without primary data and not in English were excluded. We extracted data and assessed evidence on each outcome as high, medium, or low consistency on the basis of agreement between publications; outcomes found in fewer than three publications were indeterminate consistency.
Findings: 60 publications were included in our assessment. High-consistency evidence was found for five outcomes, with male circumcision protecting against cervical cancer, cervical dysplasia, herpes simplex virus type 2, chlamydia, and syphilis. Medium-consistency evidence was found for male circumcision protecting against human papillomavirus and low-risk human papillomavirus. Although the evidence shows a protective association with HIV, it was categorised as low consistency, because one trial showed an increased risk to female partners of HIV-infected men resuming sex early after male circumcision. Seven outcomes including HIV had low-consistency evidence and six were indeterminate.
Interpretation: Scale-up of male circumcision in sub-Saharan Africa has public health implications for several outcomes in women. Evidence that female partners are at decreased risk of several diseases is highly consistent. Synergies between male circumcision and women's health programmes should be explored.
Funding: US Centers for Disease Control and Prevention and Jhpiego. |
| first_indexed | 2024-12-11T01:59:54Z |
| format | Article |
| id | doaj.art-92284133866c4b998e1af775230191eb |
| institution | Directory Open Access Journal |
| issn | 2214-109X |
| language | English |
| last_indexed | 2024-12-11T01:59:54Z |
| publishDate | 2017-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Global Health |
| spelling | doaj.art-92284133866c4b998e1af775230191eb2022-12-22T01:24:31ZengElsevierThe Lancet Global Health2214-109X2017-11-01511e1113e112210.1016/S2214-109X(17)30369-8Association between male circumcision and women's biomedical health outcomes: a systematic reviewJonathan M Grund, MPH0Tyler S Bryant, MHS1Inimfon Jackson, MPH2Kelly Curran, MPH3Naomi Bock, MD4Carlos Toledo, PhD5Joanna Taliano, MLS6Sheng Zhou, MBBS7Jorge Martin del Campo, MD8Ling Yang, ScM9Apollo Kivumbi, MPH10Peizi Li, MD11Sherri Pals, PhD12Dr Stephanie M Davis, MD13US Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJhpiego, Baltimore, MD, USAUS Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA, USAUS Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA, USAUS Centers for Disease Control and Prevention, Library Science Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services, Atlanta, GA, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USAUS Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA, USAUS Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA, USABackground: Male circumcision reduces men's risk of acquiring HIV and some sexually transmitted infections from heterosexual exposure, and is essential for HIV prevention in sub-Saharan Africa. Studies have also investigated associations between male circumcision and risk of acquisition of HIV and sexually transmitted infections in women. We aimed to review all evidence on associations between male circumcision and women's health outcomes to benefit women's health programmes. Methods: In this systematic review we searched for peer-reviewed and grey literature publications reporting associations between male circumcision and women's health outcomes up to April 11, 2016. All biomedical (not psychological or social) outcomes in all study types were included. Searches were not restricted by year of publication, or to sub-Saharan Africa. Publications without primary data and not in English were excluded. We extracted data and assessed evidence on each outcome as high, medium, or low consistency on the basis of agreement between publications; outcomes found in fewer than three publications were indeterminate consistency. Findings: 60 publications were included in our assessment. High-consistency evidence was found for five outcomes, with male circumcision protecting against cervical cancer, cervical dysplasia, herpes simplex virus type 2, chlamydia, and syphilis. Medium-consistency evidence was found for male circumcision protecting against human papillomavirus and low-risk human papillomavirus. Although the evidence shows a protective association with HIV, it was categorised as low consistency, because one trial showed an increased risk to female partners of HIV-infected men resuming sex early after male circumcision. Seven outcomes including HIV had low-consistency evidence and six were indeterminate. Interpretation: Scale-up of male circumcision in sub-Saharan Africa has public health implications for several outcomes in women. Evidence that female partners are at decreased risk of several diseases is highly consistent. Synergies between male circumcision and women's health programmes should be explored. Funding: US Centers for Disease Control and Prevention and Jhpiego.http://www.sciencedirect.com/science/article/pii/S2214109X17303698 |
| spellingShingle | Jonathan M Grund, MPH Tyler S Bryant, MHS Inimfon Jackson, MPH Kelly Curran, MPH Naomi Bock, MD Carlos Toledo, PhD Joanna Taliano, MLS Sheng Zhou, MBBS Jorge Martin del Campo, MD Ling Yang, ScM Apollo Kivumbi, MPH Peizi Li, MD Sherri Pals, PhD Dr Stephanie M Davis, MD Association between male circumcision and women's biomedical health outcomes: a systematic review The Lancet Global Health |
| title | Association between male circumcision and women's biomedical health outcomes: a systematic review |
| title_full | Association between male circumcision and women's biomedical health outcomes: a systematic review |
| title_fullStr | Association between male circumcision and women's biomedical health outcomes: a systematic review |
| title_full_unstemmed | Association between male circumcision and women's biomedical health outcomes: a systematic review |
| title_short | Association between male circumcision and women's biomedical health outcomes: a systematic review |
| title_sort | association between male circumcision and women s biomedical health outcomes a systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2214109X17303698 |
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