PubMed offers what they call an "alert" facility. It allows you to save a search, and then PubMed will automatically notify you once new entries match that search. It's wonderfully convenient, and ensures that you always have the latest information.
Anyway, today's alert included two new studies that investigated the effect of circumcision against genital herpes.
Jerath and Mahajan performed a fairly small study, but an interesting one. Their study population consisted of forty patients with recurrent genital herpes. Half were circumcised, half were not, and all (except 12 drop outs) were monitored afterwards. What they found was rather interesting. Prior to circumcision, 0.20 recurrences were noted per year, which is similar to the 0.17 that was recorded in the (uncircumcised) control group. But after circumcision, this fell to 0.0080 recurrences per year - a startling decrease to a mere 4% of the pre-circumcision figure. Now this is a small study, and as far as I can tell there was no randomisation process, but nevertheless the results are interesting.
Also of interest is a study by Van Wagoner et al. This was a fairly straightforward study of 460 African American heterosexual men. This study found an association between lack of circumcision and HSV-1 seroprevalence (OR: 1.85; CI: 1.15-2.96), but not HSV-2.
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8 comments:
Jake,
I am new to your blog. Do you mind my asking if this is a personal quest? Also, why amputate part of your penis to prevent or reduce incidence of sexually transmitted disease, rather than teaching, cultivating and practicing safe, respectful, healthy sexual habits?
It seems a bit like cutting out a tongue to prevent talking dirty...
Hi Lori,
I don't think that the two are mutually exclusive, and consequently another option is to circumcise (or "amputate part of the penis" if you prefer to use dramatic language) and utilise safe, respectful, healthy sexual habits.
It seems to me, though, that there are several separate questions here. One of these questions is a scientific question: what effect does circumcision have? Another is a policy question: should circumcision be performed, and if so in what contexts and in conjunction with what other disease-prevention strategies?
Personally, I just find the scientific questions fundamentally more interesting. But I think there's a rational basis, too, for focusing on this matter, and that's that policy questions depend on good scientific information. Before you even consider recommending anything to anyone, you have to know what are its benefit(s), how those benefits can be quantified, and how they weigh up against the risks. And those questions are largely scientific in nature.
Jake,
Thanks for the response. What I am most curious about is your experience with circumcision?
Before you answer my question, or decide not to answer, please let me assure you that while I do have some very personal experience with circumcision (which I would be willing to share), and I do have some very strong convictions regarding this issue, I am also a Reiki Master. This means that I am morally, ethically, and spiritually bound to respect others' convictions, as I do my own.
I will likely not agree, but I will be willing to listen, respect, and debate civilly.
Thank you.
Lori Hall
I'm not entirely sure why this is relevant, Lori, but you asked a civil question so I'll answer.
My personal experience with circumcision dates back to 2003, when I underwent elective circumcision. Being the sort of person who enjoys learning, and also of course finding that information helps facilitate decisions, and to reduce anxiety, I spent months (or possibly years) beforehand reading everything I could find on the subject. I learned a lot, and have continued to do so in the six years since then.
At first my interests were purely scientific, since I wanted to find out information to assist in my own decision. I was mildly opposed at first to circumcision of infants, but - to be blunt - the focus on the circumcision debate in the US wasn't that interesting to me, since I'm British and what goes on in foreign hospitals isn't my first priority.
I found it extremely irritating, though, that it was so difficult to find genuinely neutral information. I became very annoyed with propaganda (mostly but not entirely of an anti-circumcision nature), often Internet-based, which seemed more interested in selling a point of view than in taking a genuine interest in scientific questions. It made it unnecessarily difficult to find unbiased information.
My own choice is made now, and in the past, but I'm still interested in the issue of circumcision in general, and have become more interested in the issue of infant circumcision. Over time, as I learned more, my views on infant circumcision shifted somewhat. As a result of what I had learned, specifically the balance between benefits and risks, I now characterise myself as "pro-parental choice", indicating that I regard myself as supportive of both choices.
Whether or not to circumcise is a very personal and adult decision. The question is relevant to me, as a parent of 6 children, 3 of them boys. (2 are intact and one was circumcised at 8 months of age.)
I was curious if you had a son, and if so, had you had made the decision to circumcise him.
It's interesting to me that you elected to undergo the procedure as an adult. We have a very good friend who is gay and who was advised by his MD, as an adult, to circumcise for sanitary reasons, which he did. After his procedure he was very candid in telling me that he sorely wished he had not elected to have the surgery. He reported extensive loss of sensation, stamina and pain during, not only sex, but even with fellatio. His partner also reported entry pain, where none had been experienced prior to the surgery. Both said they were exceptionally sanitary and monogamous and were mildly surprised by the recommendation.
Are you saying that you opted to circumcise purely for empirical purposes?
Whether or not to circumcise is a very personal and adult decision. The question is relevant to me, as a parent of 6 children, 3 of them boys. (2 are intact and one was circumcised at 8 months of age.)
I quite agree with you, and hope that I didn't suggest that the question is not relevant to you; if I did I assure you it was accidental.
I was curious if you had a son, and if so, had you had made the decision to circumcise him.
No, I don't have a son. If I ever do, I think he'll be circumcised.
It's interesting to me that you elected to undergo the procedure as an adult. We have a very good friend who is gay and who was advised by his MD, as an adult, to circumcise for sanitary reasons, which he did. After his procedure he was very candid in telling me that he sorely wished he had not elected to have the surgery. He reported extensive loss of sensation, stamina and pain during, not only sex, but even with fellatio. His partner also reported entry pain, where none had been experienced prior to the surgery. Both said they were exceptionally sanitary and monogamous and were mildly surprised by the recommendation.
I'm sorry to hear of your friend's negative experience.
Are you saying that you opted to circumcise purely for empirical purposes?
I think the most accurate way to put it is this: my initial interest in circumcision was personal preference for the form & function, but I set out to investigate the scientific literature with a reasonably open mind and willingness to be dissuaded by it. As it turned out, however, I found scientific data encouraging.
I have a question Jake. Why were you circumcised? Was it that you had phimosis?
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