From the Guidelines
Circumcision is recommended for sexually active heterosexual males, especially in areas with high background HIV prevalence, as it reduces the risk of HIV acquisition by 53% to 60%. The procedure involves removing the foreskin that covers the head of the penis, which eliminates the need to clean under the foreskin and prevents potential infections from poor hygiene. For infants, circumcision is typically performed within the first few days of life, while for adults, it requires local or general anesthesia followed by a healing period of 2-3 weeks.
Key Benefits of Circumcision
- Reduced risk of urinary tract infections in infancy
- Decreased risk of penile cancer
- Lower rates of certain sexually transmitted infections including HIV
- Prevention of genital human papilloma virus (HPV) and herpes simplex virus 2 (HSV-2) These benefits occur because removing the foreskin eliminates a warm, moist environment where bacteria can grow, and removes cells with specific receptors that certain viruses target.
Considerations for Circumcision
- The American Academy of Pediatrics states that the health benefits outweigh the risks, though they don't recommend universal circumcision
- Circumcision remains a personal decision that should consider cultural, religious, and family preferences alongside medical factors
- Parents and guardians should be informed of the preventive benefits of male infant circumcision 1
- Voluntary medical male circumcision may be associated with decreased risk of HSV-2 acquisition in adult, heterosexual men and may be associated with a decreased risk of HSV-2 transmission from men to women 1
- The WHO and UNAIDS recommend voluntary male circumcision for HIV prevention in priority countries in sub-Saharan Africa with generalized epidemics and low male circumcision prevalence 1
From the Research
Benefits of Circumcision
- The health benefits of newborn male circumcision outweigh the risks, and the benefits justify access to this procedure for families who choose it 2.
- Specific benefits from male circumcision include:
- Prevention of urinary tract infections
- Acquisition of HIV
- Transmission of some sexually transmitted infections
- Penile cancer
- Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction 2, 3.
- The preventive and public health benefits associated with newborn male circumcision warrant third-party reimbursement of the procedure 2.
Protection from Infections and Diseases
- Circumcision protects males from:
- HIV infection
- Penile carcinoma
- Urinary tract infections
- Ulcerative sexually transmitted diseases 4
- Circumcision also provides substantial protection from cervical cancer and chlamydia in women whose male partner is circumcised 3.
Socio-Sexual Benefits
- Circumcision has socio-sexual benefits and reduces sexual problems with age 3.
- Most women prefer the circumcised penis for appearance, hygiene, and sex 3.
Recommendations
- The American Academy of Pediatrics and the American Academy of Family Physicians recommend continued access to circumcision on an elective basis and conclude that the benefits outweigh the risks 5.
- Voluntary medical male circumcision should be promoted as an important alternative intervention to reduce reproductive tract infections and prevent both males and females from reproductive tract cancers 6.