Fergusson David M, Boden Joseph M, Horwood L John
Christchurch Health and Development Study, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand.
Pediatrics. 2006 Nov;118(5):1971-7. doi: 10.1542/peds.2006-1175.
Previous research suggests that male circumcision may be a protective factor against the acquisition of sexually transmitted infections; however, studies examining this question have produced mixed results. The aim of this study was to examine the association between circumcision status and sexually transmitted infection risk using a longitudinal birth cohort study.
Data were gathered as part of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children. Information was obtained on: (1) the circumcision status of males in the cohort before 15 years old, (2) measures of self-reported sexually transmitted infection from ages 18 to 25 years, and (3) childhood, family, and related covariate factors.
Being uncircumcised had a statistically significant bivariate association with self-reported sexually transmitted infection. Adjustment for potentially confounding factors, including number of sexual partners and unprotected sex, as well as background and family factors related to circumcision, did not reduce the association between circumcision status and reports of sexually transmitted infection. Estimates of the population-attributable risk suggested that universal neonatal circumcision would have reduced rates of sexually transmitted infection in this cohort by 48.2%.
These findings suggest that uncircumcised males are at greater risk of acquiring sexually transmitted infection than circumcised males. Male circumcision may reduce the risk of sexually transmitted infection acquisition and transmission by up to one half, suggesting substantial benefits accruing from routine neonatal circumcision.
先前的研究表明，男性包皮环切术可能是预防性传播感染的一个保护因素；然而，针对这一问题的研究结果不一。本研究的目的是通过一项出生队列纵向研究来检验包皮环切状态与性传播感染风险之间的关联。
数据收集于克赖斯特彻奇健康与发展研究，这是一项对新西兰儿童出生队列进行的为期25年的纵向研究。获取了以下信息：（1）该队列中15岁之前男性的包皮环切状态；（2）18至25岁期间自我报告的性传播感染情况；（3）童年、家庭及相关协变量因素。
未进行包皮环切术与自我报告的性传播感染在统计学上存在显著的双变量关联。对包括性伴侣数量、无保护性行为以及与包皮环切术相关的背景和家庭因素等潜在混杂因素进行调整后，并未降低包皮环切状态与性传播感染报告之间的关联。人群归因风险估计表明，普遍实施新生儿包皮环切术可使该队列中的性传播感染率降低48.2%。
这些发现表明，未进行包皮环切术的男性比进行了包皮环切术的男性感染性传播感染的风险更高。男性包皮环切术可能会将性传播感染的获得和传播风险降低多达一半，这表明常规新生儿包皮环切术有显著益处。
