Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries.

Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. Research Abstract Details 

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Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. Abstract Text:

Paul K Drain,Daniel T Halperin,James P Hughes,Jeffrey D Klausner,Robert C Bailey,

BACKGROUND: Both religious practices and male circumcision (MC) have been associated with HIV and other sexually-transmitted infectious diseases. Most studies have been limited in size and have not adequately controlled for religion, so these relationships remain unclear. METHODS: We evaluated relationships between MC prevalence, Muslim and Christian religion, and 7 infectious diseases using country-specific data among 118 developing countries. We used multivariate linear regression to describe associations between MC and cervical cancer incidence, and between MC and HIV prevalence among countries with primarily sexual HIV transmission. RESULTS: Fifty-three, 14, and 51 developing countries had a high (>80%), intermediate (20-80%), and low (<20%) MC prevalence, respectively. In univariate analyses, MC was associated with lower HIV prevalence and lower cervical cancer incidence, but not with HSV-2, syphilis, nor, as expected, with Hepatitis C, tuberculosis, or malaria. In multivariate analysis after stratifying the countries by religious groups, each categorical increase of MC prevalence was associated with a 3.65/100,000 women (95% CI 0.54-6.76, p = 0.02) decrease in annual cervical cancer incidence, and a 1.84-fold (95% CI 1.36-2.48, p < 0.001) decrease in the adult HIV prevalence among sub-Saharan African countries. In separate multivariate analyses among non-sub-Saharan African countries controlling for religion, higher MC prevalence was associated with a 8.94-fold (95% CI 4.30-18.60) decrease in the adult HIV prevalence among countries with primarily heterosexual HIV transmission, but not, as expected, among countries with primarily homosexual or injection drug use HIV transmission (p = 0.35). CONCLUSION: Male circumcision was significantly associated with lower cervical cancer incidence and lower HIV prevalence in sub-Saharan Africa, independent of Muslim and Christian religion. As predicted, male circumcision was also strongly associated with lower HIV prevalence among countries with primarily heterosexual HIV transmission, but not among countries with primarily homosexual or injection drug use HIV transmission. These findings strengthen the reported biological link between MC and some sexually transmitted infectious diseases, including HIV and cervical cancer.

Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. Publishing Authors By Initials

PK Drain,DT Halperin,JP Hughes,JD Klausner,RC Bailey,

For similar neoplasms: neoplasms by site: urogenital neoplasms: genital neoplasms, female: uterine neoplasms: uterine cervical neoplasms research abstracts see: neoplasms: neoplasms by site: urogenital neoplasms: genital neoplasms, female: uterine neoplasms: uterine cervical neoplasms research

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Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: BMC infectious diseases

VOLUME: 6

Page Numbers: 172

Journal Abbreviation: BMC Infect. Dis.

ISSN: 1471-2334

DAY: 30

MONTH: 11

YEAR: 2006

Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. Information

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LANGUAGE: eng

NlmUniqueID: 100968551

Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. Keywords Mesh Terms:

KEYWORDS: Uterine Cervical Neoplasms

MESH TERMS: epidemiology

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Grant and Affiliation Information for Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries.

AFFILIATION: University of Washington School of Medicine, Seattle, USA. pkdrain@u.washington.edu <pkdrain@u.washington.edu>

Country: England

AGENCY: United States NIAID

GRANT: AI 31448

ACRONYM: AI

MEDLINETA: BMC Infect Dis

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