Division of Infectious Disease Medicine, Rush University College of Medicine, Chicago, IL, USA.
Division of Epidemiology & Biostatistics, University of Illinois Chicago School of Public Health, Chicago, IL, 60612, USA.
Curr HIV/AIDS Rep. 2022 Dec;19(6):501-507. doi: 10.1007/s11904-022-00638-6. Epub 2022 Nov 11.
PURPOSE OF REVIEW: Voluntary medical male circumcision (VMMC) reduces the risk of HIV acquisition by 60% among heterosexual men, provides protection against certain sexually transmitted infections (STI), and leads to penile microbiome composition changes associated with reduced risk of HIV infection. Intuitively, the benefits of VMMC for female sex partners in relation to STI are likely and have been evaluated. The purpose of this review is to examine emerging findings of broader sexual and reproductive health (SRH) benefits of VMMC for female sex partners. RECENT FINDINGS: Systematic reviews find strong evidence for beneficial effects of VMMC on female sex partners risk of HPV, cervical dysplasia, cervical cancer, and with likely protection against trichomoniasis and certain genital ulcerative infections. Few studies assess the direct impact of VMMC on the vaginal microbiome (VMB), though several studies demonstrate reductions in BV, which is mediated by the VMB. Studies are lacking regarding male circumcision status and outcomes associated with non-optimal VMB, such as female infertility and adverse pregnancy outcomes. VMMC has positive effects on women's perceptions of sexual function and satisfaction, and perceptions of disease risk and hygiene, without evidence of risk compensation. VMMC has consistent association with a broad range of women's SRH outcomes, highlighting the biological and non-biological interdependencies within sexual relationships, and need for couples-level approaches to optimize SRH for men and women. The paucity of information on VMMC and influence on VMB is a barrier to optimizing VMB-associated SRH outcomes in female partners.
目的综述:自愿男性包皮环切术(VMMC)可使异性恋男性感染 HIV 的风险降低 60%,可预防某些性传播感染(STI),并导致与降低 HIV 感染风险相关的阴茎微生物组组成变化。直观地说,VMMC 对女性性伴侣在 STI 方面的益处是可能的,并已对此进行了评估。本综述的目的是探讨 VMMC 对女性性伴侣更广泛的性健康和生殖健康(SRH)益处的新发现。
最近的发现:系统评价发现,VMMC 对 HPV、宫颈发育不良、宫颈癌、可能预防滴虫病和某些生殖器溃疡性感染的女性性伴侣的风险具有很强的有益影响的证据。很少有研究评估 VMMC 对阴道微生物组(VMB)的直接影响,尽管有几项研究表明,BV 减少,这是由 VMB 介导的。关于男性包皮环切状态以及与非最佳 VMB 相关的结果(如女性不孕和不良妊娠结局)的研究尚缺乏。VMMC 对女性的性功能和满意度感知产生积极影响,并对疾病风险和卫生感知产生积极影响,而没有风险补偿的证据。VMMC 与广泛的女性 SRH 结果密切相关,突出了性关系中生物学和非生物学的相互依存关系,以及需要采取夫妻层面的方法来优化男性和女性的 SRH。关于 VMMC 对 VMB 的影响以及 VMMC 对 VMB 的影响的信息不足,是优化女性伴侣中与 VMB 相关的 SRH 结果的障碍。
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