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Cited by 73Genital Health and DiseaseCervical Cancer and HPV ResearchHIV/AIDS Research and Interventions

Association between male circumcision and women’s biomedical health outcomes: a systematic review.

Open access
Grund, Jonathan M, Bryant, Tyler S, Jackson, Inimfon, Curran, Kelly, Bock, Naomi, Toledo, Carlos, Taliano, Joanna, Zhou, Sheng +6 more·2017·The Lancet Global Health
DOI 10.1016/s2214-109x(17)30369-8PMC PMC5728090
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Abstract

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.

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  • MMC can be associated with decreased risk for HSV-2 acquisition among adult heterosexual men and with decreased risk for HSV-2 transmission from male to female partners.

    “These data indicate that MMC can be associated with decreased risk for HSV-2 acquisition among adult heterosexual men and with decreased risk for HSV-2 transmission from male to female partners.”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [491]

    The Introduction reports reduced HSV-2 incidence in circumcised men, and the Results find a protective association for HSV-2 infection in female partners. But the Discussion says evidence for a direct effect on HSV-2 transmission was mixed: one study supported it and another contradicted it. The claim therefore overstates the evidence for reduced male-to-female transmission. (LLM, conf=0.85)

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Research works printed but not linked: 3

  1. [52]Auvert B Lissouba P Taljaard D Peytavin G Singh B Puren A Male circumcision: association with HIV prevalence knowledge and attitudes among women Conference on retroviruses and opportunistic infections 2015 Seattle Feb 23–26 962
  2. [54]Jean K Lissouba P Taljaard D HIV incidence among women is associated with their partners’ circumcision status in the township of Orange Farm (South Africa) where the male circumcision roll-out is ongoing (ANRS-12126) International AIDS Society 2014 Conference Melbourne, Australia July 20–25 FRAE0105LB
  3. [81]The Partnership for Maternal, Newborn & Child Health A global review of the key interventions related to reproductive, maternal, newborn and child health (RMNCH) Geneva The Partnership for Maternal, Newborn & Child Health 2017

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Authors
Grund, J. M., Bryant, T. S., Jackson, I., Curran, K., Bock, N., Toledo, C., Taliano, J., Zhou, S., del Campo, J. M., Yang, L., Kivumbi, A., Li, P., Pals, S., & Davis, S. M.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Johns Hopkins University (US)
  • Jhpiego (US)
Corresponding author
Davis, Stephanie M
ORCID
Venue
The Lancet Global Health
Publisher
Elsevier BV
Published
2017-11
Volume
5
Issue
11
Pages
e1113-e1122
ISSN
2214-109X (ISSN-L)
DOI
10.1016/s2214-109x(17)30369-8
PMC
PMC5728090
OpenAlex
W2761030839
Cited by
73
References
70
Citations by year
2026: 1 · 2025: 7 · 2024: 5 · 2023: 12 · 2022: 10 · 2021: 9 · 2020: 11 · 2019: 10 · 2018: 7 · 2017: 1
FWCI
1.68
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Global Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institutes of Health (CC999999)
Topics
  • Health Sciences › Medicine › Surgery › Genital Health and Disease
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
male circumcision, women's health outcomes, cervical cancer, cervical intraepithelial neoplasia, herpes simplex virus type 2, chlamydia, syphilis, human papillomavirus, HIV, sexually transmitted infections, HIV prevention, sub-Saharan Africa
MeSH terms
Circumcision, Male, Female, Humans, Male, Randomized Controlled Trials as Topic, Women's Health

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