Original article
Circumcision and Risk of Sexually Transmitted Infections in a Birth Cohort

https://doi.org/10.1016/j.jpeds.2007.07.044Get rights and content

Objective

To determine the impact of early childhood circumcision on sexually transmitted infection (STI) acquisition to age 32 years.

Study design

The circumcision status of a cohort of children born in 1972 and 1973 in Dunedin, New Zealand was sought at age 3 years. Information about STIs was obtained at ages 21, 26, and 32 years. The incidence rates of STI acquisition were calculated, taking into account timing of first sex, and comparisons were made between the circumcised men and uncircumcised men. Adjustments were made for potential socioeconomic and sexual behavior confounding factors where appropriate.

Results

Of the 499 men studied, 201 (40.3%) had been circumcised by age 3 years. The circumcised and uncircumcised groups differed little in socioeconomic characteristics and sexual behavior. Overall, up to age 32 years, the incidence rates for all STIs were not statistically significantly different—23.4 and 24.4 per 1000 person-years for the uncircumcised and circumcised men, respectively. This was not affected by adjusting for any of the socioeconomic or sexual behavior characteristics.

Conclusions

These findings are consistent with recent population-based cross-sectional studies in developed countries, which found that early childhood circumcision does not markedly reduce the risk of the common STIs in the general population in such countries.

Section snippets

Methods

We studied subjects in the Dunedin Multidisciplinary Health and Development Study, a longitudinal study of a cohort born in Dunedin, New Zealand, between Apr 1, 1972, and Mar 31, 1973. The sample was first followed up at 3 years of age when 1037 (535 male) of 1139 eligible children were seen.13 Subsequently they were assessed biannually until the age of 15 years, then at 18, 21, and 26 years and most recently at 32 years in 2004 to 2005. Wherever possible, those no longer living in Dunedin

Results

Of the original 535 male cohort members seen at age 3 years, 477 (90.7% of survivors) completed the age 21-year assessment of sexual behavior; 490 (93.3% of survivors) completed the age 26-year assessment; and 487 (93.1% of survivors) completed the age 32-year assessment. Overall, 499 men who were sexually experienced and for whom early circumcision information was available attended at least 1 of these assessments.

Of these 499 men, 201 (40.3%) had been circumcised by age 3 years. There were no

Discussion

The main finding of this study is that in this New Zealand birth cohort we found no evidence to support the hypothesis that circumcision has a major protective effect against the STIs commonly experienced there.

Socioeconomic characteristics of the circumcised men and uncircumcised men were similar. Examination of sexual behavior showed that the circumcised men had slightly lower risk behavior—a lower annual number of sexual partners overall up to age 32 years and less same-sex contact up to age

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    (2005)
  • Cited by (0)

    Supported by the Health Research Council of New Zealand.

    1

    Dr Nigel Dickson wrote the first draft of the manuscript and received no honorarium, grant, or other form of payment to produce the manuscript.

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