Advertisement

Neonatal Circumcision and HIV Infection

  • Robert S. Van Howe

Abstract

In the late 198Os, several small African studies suggested an association between the intact (non-circumcised) penis and a greater risk of contracting human immunodeficiency virus (HIV). Some of these studies drew their conclusions by looking at maps, some by looking at high-risk populations, and others by looking at patrons of sexually transmitted disease (STD) clinics. More recently, several large random population surveys performed in Africa have documented that circumcised men are more likely to be HIV-infected. Despite inconsistent findings in the medical literature, a misconception persists among many that the foreskin places a man at greater risk for acquiring an HIV-infection. Thirty-seven studies from peer-reviewed journals have addressed what role, if any, the prepuce plays in the transmission of HIV. Available data from these studies have been combined in a meta-analysis. The corpus of scientific literature concerning the relation of the prepuce with HIV should be the basis for developing assessments for the role of circumcision in HIV prevention.

Keywords

Human Immunodeficiency Virus Type Male Circumcision Sexually Transmitted Disease Sexually Transmitted Disease Clinic Circumcision Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Royce RA, Sena A, Cates W Jr, Cohen MS. Sexual transmission of HIV. N Engl J Med 1997;336:1072–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Van Howe RS. Circumcision and HIV-infection: review of the literature and meta-analysis. Int J STD AIDS 1999;10(1):IN PRESS.Google Scholar
  3. 3.
    Moses S, Bradley JE, Nagelkerke NJ, Ronald AR, Ndinya Achola JO, Plummer FA. Geographical patterns of male circumcision practices in Africa: association with HIV seroprevalence. Int J Epidemiol 1990;19:693–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Bongaarts J, Reining P, Way P, Conant F. The relationship between male circumcision and HIV infection in African populations. AIDS 1989;3:373–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Caldwell JC, Caldwell P. The African AIDS epidemic. Sci Am 1996;274(3):62–3,66–8.PubMedGoogle Scholar
  6. 6.
    Moses S, Bradley JE, Nagelkerke NJ, Ronald AR, Ndinya Achola JO, Plummer FA. Geographical patterns of male circumcision practices in Africa: association with HIV seroprevalence. Int J Epidemiol 1990;19:693–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Bongaarts J, Reining P, Way P, Conant F. The relationship between male circumcision and HIV infection in African populations. AIDS 1989;3:373–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Caldwell JC, Caldwell P. The African AIDS epidemic. Sci Am 1996;274(3):62–3,66–8.PubMedCrossRefGoogle Scholar
  9. 9.
    World Health Organization. Global Programme on AIDS: The Current Global Situation of the HIV/AIDS Pandemic. Quarterly Report. July 3, 1995.Google Scholar
  10. 10.
    Van Howe RS. Circumcision and HIV-infection: review of the literature and meta-analysis. Int J STD AIDS 1999;10(1):IN PRESS.Google Scholar
  11. 11.
    Storms MR. AAFP fact sheet on neonatal circumcision: a need for updating. Am Fam Physician 1996;54:1216–8.PubMedGoogle Scholar
  12. 12.
    Bwayo J, Plummer F, Omari M, Mutere A, Moses S, Ndinya Achola J, Velentgas P, Kreiss J. Human immunodeficiency virus infection in long-distance truck drivers in East Africa. Arch Intern Med 1994;154:1391–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Bwayo JJ, Omari AM, Mutere AN, Jaoko W, Sekkade Kigondu C, Kreiss J, Plummer FA. Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases (STDs). East Afr Med J 1991;68:425–9.PubMedGoogle Scholar
  14. 14.
    Mbugua GG, Muthami LN, Mutura CW, Oogo SA, Waiyaki PG, Lindan CP, Hearst N. Epidemiology of HIV infection among long distance truck drivers in Kenya. East Afr Med J 1995;72:515–8.PubMedGoogle Scholar
  15. 15.
    Bwayo JJ, Omari AM, Mutere AN, Jaoko W, Sekkade Kigondu C, Kreiss J, Plummer FA. Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases (STDs). East Afr Med J 1991;68:425–9.PubMedGoogle Scholar
  16. 16.
    Bwayo JJ, Omari AM, Mutere AN, Jaoko W, Sekkade Kigondu C, Kreiss J, Plummer FA. Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases (STDs). East Afr Med J 1991;68:425–9.PubMedGoogle Scholar
  17. 17.
    Zekeng L, Yanga D, Trebucq A, Sokal D, Salla R, Kaptue L. HIV prevalence in patients with sexually transmitted diseases in Yaounde, (Cameroon) in 1989 and 1990: necessity of an STD control programme. Genitourin Med 1992;68:117–9.PubMedGoogle Scholar
  18. 18.
    Van de Perre P, Clumeck N, Steens M, Zissis G, Carael M, Lagasse R, De Wit S, Lafontaine T, De Mol P, Butzler JP. Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection. Eur J Epidemiol 1987;3:14–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Mbugua GG, Muthami LN, Mutura CW, Oogo SA, Waiyaki PG, Lindan CP, Hearst N. Epidemiology of HIV infection among long distance truck drivers in Kenya. East Afr Med J 1995;72:515–8.PubMedGoogle Scholar
  20. 20.
    Plummer FA, Simonsen JN, Cameron DW, Ndinya-Achola JO, Kreiss JK, Gakinya MN, Waiyaki P, Cheang M, Piot P, Ronald AR, Ngugi EN. Cofactors in male-female sexual transmission of human immunodeficiency virus type 1. J Infect Dis 1991;163:233–9.PubMedGoogle Scholar
  21. 21.
    Diallo MO, Ackah AN, Lafontaine MF, Doorly R, Roux R, Kanga JM, Heroin P, De Cock KM. HIV-1 and HIV-2 infections in men attending sexually transmitted disease clinics in Abidjan, Côte d’Ivoire. AIDS 1992;6:581–5.PubMedCrossRefGoogle Scholar
  22. 22.
    Cameron DW, Simonsen JN, D’Costa LJ, Ronald AR, Maitha GM, Gakinya MN, Cheang M, Ndinya Achola JO, Piot P, Brunham RC, Plummer FA. Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Lancet 1989;2:403–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Greenblatt RM, Lukehart SA, Plummer FA, Quinn TC, Critchlow CW, Ashley RL, D’Costa LJ, Ndinya Achola JO, Corey L, Ronald AR, Holmes KK. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS 1988;2:47–50.PubMedCrossRefGoogle Scholar
  24. 24.
    Simonsen JN, Cameron DW, Gakinya MN, Ndinya Achola JO, D’Costa LJ, Karasira P, Cheang M, Ronald AR, Piot P, Plummer FA. Human immunodeficiency virus infection among men with sexually transmitted diseases Experience from a center in Africa. N Engl J Med 1988;319:274–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Pépin J, Quigley M, Todd J, Gaye I, Janneh M, Van Dyck E, Piot P, Whittle H. Association between HIV-2 infection and genital ulcer diseases among male sexually transmitted disease patients in The Gambia. AIDS 1992;6:489–93.PubMedCrossRefGoogle Scholar
  26. 26.
    Hira SK, Kamanga J, Macuacua R, Mwansa N, Cruess DF, Perine PL. Genital ulcers and male circumcision as risk factors for acquiring HIV-1 in Zambia. J Infect Dis 1990;161:584–5.PubMedGoogle Scholar
  27. 27.
    Nasio JM, Nagelkerke NJD, Mwatha A, Moses S, Ndinya-Achola JO, Plummer FA. Genital ulcer disease among STD clinic attenders in Nairobi: association with HIV-l and circumcision status. Int J STD AIDS 1996;7:410–4.PubMedCrossRefGoogle Scholar
  28. 28.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  29. 29.
    Van de Pene P, Clumeck N, Steens M, Zissis G, Carael M, Lagasse R, De Wit S, Lafontaine T, De Mol P, Butzler JP. Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-I11 infection. Eur J Epidemiol1987;3:14–8.CrossRefGoogle Scholar
  30. 30.
    Newell J, Senkoro K, Mosha F, Grosskurth H, Nicoll A, Barongo L, Borgdoff M, Klokke A, Changalucha J, Killewo J, Velema J, Muller AS, Rugemalila J, Mabey D, Hayes R. A population based study of syphilis and sexually tranmitted disease syndromes in north-westem Tanzania. 2. Risk factors and health seeking behaviour. Genitourin Med 1993;69:421–6.PubMedGoogle Scholar
  31. 31.
    Diallo MO, Ackah AN, Lafontaine MF, Doorly R, Roux R, Kanga JM, Heroin P, De Cock KM. HIV-1 and HIV-2 infections in men attending sexually transmitted disease clinics in Abidjan, Côte d’Ivoire. AIDS 1992;6:581–5.PubMedCrossRefGoogle Scholar
  32. 32.
    Cameron DW, Simonsen JN, D’Costa W, Ronald AR, Maitha GM, Gakinya MN, Cheang M, Ndinya Achola JO, Piot P, Brunham RC, Plummer FA. Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Lancet 1989;2:403–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Roddy RE, Feldblum PJ. Analytical methodology in a cohort study of cofactors for sexual transmission of human immunodeficiency virus [letter]. J Infect Dis 1991;164:1236–7.PubMedGoogle Scholar
  34. 34.
    Bulterys M, Chao A, Bugingo G, Dushimimana A, Duerr A. Female-to-male transmission of HIV-l [letter]. Lancet 1989;2:977–8.PubMedCrossRefGoogle Scholar
  35. 35.
    de Vincenzi I, Mertens T. Male circumcision: a role in HIV prevention? AIDS 1994;8:153–60.PubMedCrossRefGoogle Scholar
  36. 36.
    Greenblatt RM, Lukehart SA, Plummer FA, Quinn TC, Critchlow CW, AshIey RL, D’Costa W, Ndinya Achola JO, Corey L, Ronald AR, Holmes KK. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS 1988;2:47–50.PubMedCrossRefGoogle Scholar
  37. 37.
    Simonsen JN, Cameron DW, Gakinya MN, Ndinya Achola JO, D’Costa W, Karasira P, Cheang M, Ronald AR, Piot P, Plummer FA. Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. N Engl J Med 1988;319:274–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Tyndall M, Odhiambo P, Ronald AR, et al. The increasing seroprevalence of HIV-l in males with other STD in Nairobi, Kenya. VI1 International Conference on AIDS. Florence, June 1991 [abstract MC31171.Google Scholar
  39. 39.
    Hellmann NS, Desmond-Hellmann S, Nsubuga PSJ, et al. Genital trauma during sex is a risk factor for HIV infection in Uganda. VII International Conference on AIDS. Florence, June 1991 [abstract MC3079].Google Scholar
  40. 40.
    Pépin J, Quigley M, Todd J, Gaye I, Janneh M, Van Dyck E, Piot P, Whittle H. Association between HIV-2 infection and genital ulcer diseases among male sexually transmitted disease patients in The Gambia. AIDS 1992;6:489–93.PubMedCrossRefGoogle Scholar
  41. 41.
    Hira SK, Kamanga J, Macuacua R, Mwansa N, Cruess DF, Perine PL. Genital ulcers and male circumcision as risk factors for acquiring HIV-1 in Zambia. J Infect Dis 1990;161:584–5.PubMedGoogle Scholar
  42. 42.
    Nasio JM, Nagelkerke NJD, Mwatha A, Moses S, Ndinya-Achola JO, Plummer FA. Genital ulcer disease among STD clinic attenders in Nairobi: association with HIV-l and circumcision status. Int J STD AIDS 1996;7:410–4.PubMedCrossRefGoogle Scholar
  43. 43.
    Simonsen JN, Cameron DW, Gakinya MN, Ndinya Achola JO, D’Costa W, Karasira P, Cheang M, Ronald AR, Piot P, Plummer FA. Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. N Engl J Med 1988;319:274–8.PubMedCrossRefGoogle Scholar
  44. 44.
    Cameron DW, Simonsen JN, D’Costa LJ, Ronald AR, Maitha GM, Gakinya MN, Cheang M, Ndinya Achola JO, Piot P, Brunham RC, Plummer FA. Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men. Lancet 1989;2:403–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  46. 46.
    Greenblatt RM, Lukehart SA, Plummer FA, Quinn TC, Critchlow CW, Ashley RL, D’Costa LJ, Ndinya Achola JO, Corey L, Ronald AR, Holmes KK. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS 1988;2:47–50.PubMedCrossRefGoogle Scholar
  47. 47.
    Simonsen JN, Cameron DW, Gakinya MN, Ndinya Achola JO, D’Costa LJ, Karasira P, Cheang M, Ronald AR, Piot P, Plummer FA. Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. N Engl J Med 1988;319:274–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Mehendale SM, Shepherd ME, Divekar AD, Gangakhedkar RR, Kamble SS, Menon PA, Yadav R, Risbud AR, Paranjape RS, Gadkari DA, Quinn TC, Bollinger RC, Rodrigues JJ. Evidence for high prevalence & rapid transmission of HIV among individuals attending STD clinics in Pune, India. Indian J Med Res 1996;104:327–35.PubMedGoogle Scholar
  49. 49.
    Bollinger RC, Brookmeyer RS, Mehendale SM, Paranjape RS, Shepherd ME, Gadkari DA, Quinn TC. Risk factors and clinical presentation of acute primary HIV infection in India. JAMA 1997;278:2085–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Ulhas K, Dattatray S. Circumcision in males and HIV transmission. XI International Conference on AIDS. Vancouver, July 1996 [abstract TUC2686].Google Scholar
  51. 51.
    Whittington WL, Jacobs B, Lewis J, et al. HIV-l in patients with genital lesions attending a North American STD clinic. V International Conference on AIDS. Montreal, June 1989 [abstract TAP118].Google Scholar
  52. 52.
    Surick I, McLaughlin M, Chiasson M, et al. HIV infection and circumcision status. V International Conference on AIDS. Montreal, June 1989 [abstract TAP89].Google Scholar
  53. 53.
    Chiasson MA, Stonebumer RL, Hildebrandt DS, Ewing WE, Telzak EE, Jaffe HW. Heterosexual transmission of HIV-l associated with the use of smokable freebase cocaine (crack). AIDS 1991;5:1121–6.PubMedCrossRefGoogle Scholar
  54. 54.
    Kreiss JK, Hopkins SG. The association between circumcision status and human immunodeficiency virus infection among homosexual men. J Infect Dis 1993;168:1404–8.PubMedGoogle Scholar
  55. 55.
    Parker SW, Stewart AJ, Wren MN, Gollow MM, Straton JA. Circumcision and sexually transmissible disease. Med J Aust 1983;2:288–90.PubMedGoogle Scholar
  56. 56.
    Wynder EL, Licklider SD. The question of circumcision. Cancer 1960;13:442–5.PubMedCrossRefGoogle Scholar
  57. 57.
    Stem E, Lachenbruch PA. Circumcision information in a cancer detection center population. J Chron Dis 1968;21:117–24.CrossRefGoogle Scholar
  58. 58.
    Schlossberger NM, Turner RA, Irwin CE Jr. Early adolescent knowledge and attitudes about circumcision: methods and implications for research. J Adolesc Health 1991;12:293–7.Google Scholar
  59. 59.
    Brinton LA, Reeves WC, Brenes MM, Herrero R, Gaitan E, Tenorio F, de Britton RC, Garcia M, Rawls WE. The male factor in the etiology of cervical cancer among sexually monogamous women. Int J Cancer 1989;44:199–203.PubMedCrossRefGoogle Scholar
  60. 60.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HIV infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  61. 61.
    Kreiss JK, Hopkins SG. The association between circumcision status and human immunodeficiency virus infection among homosexual men. J Infect Dis 1993;168:1404–8.PubMedGoogle Scholar
  62. 62.
    Newell J, Senkoro K, Mosha F, Grosskurth H, Nicoll A, Barongo L, Borgdoff M, KIokke A, Changalucha J, Killewo J, Velema J, Muller AS, Rugemalila J, Mabey D, Hayes R. A population based study of syphilis and sexually tranmitted disease syndromes in north-westem Tanzania. 2. Risk factors and health seeking behaviour. Genitourin Med 1993;69:421–6.PubMedGoogle Scholar
  63. 63.
    de Vincenzi I, Mertens T. Male circumcision: a role in HIV prevention? AIDS 1994;8:153–60.PubMedCrossRefGoogle Scholar
  64. 64.
    Bollinger RC, Brookmeyer RS, Mehendale SM, Paranjape RS, Shepherd ME, Gadkari DA, Quinn TC. Risk factors and clinical presentation of acute primary HIV infection in India. JAMA 1997;278:2085–9.PubMedCrossRefGoogle Scholar
  65. 65.
    Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social organization of Sexuality: Sexual Practices in the United States. Chicago, IL: The University of Chicago Press; 1994.Google Scholar
  66. 66.
    Enzenauer RW. Circumcision and heterosexual transmission of HIV infection to men. N Engl J Med 1986;316:1145–6.Google Scholar
  67. 67.
    Sassan-Morokro M, Greenberg AE, Coulibaly I-M, Coulibaly D, Sidibé K, Ackah A, Tossou O, Gnaore E, Wiktor SZ, De Cock KM. High rates of sexual contact with female sex workers, sexually transmitted diseases, and condom neglect among HIV-infected and uninfected men with tuberculosis in Abidjan, Côte d’Ivoire. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1996;11:183–7.PubMedGoogle Scholar
  68. 68.
    Hunter DJ, Maggwa B, Mati JK, Tukei PM, Mbugua S. Sexual behaviour, sexually transmitted diseases, male circumcision and risk of HIV infection among women in Nairobi, Kenya. AIDS 1994;8:93–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Fischl M, Fayne T, Flanagan S, et al. Seroprevalence and risks of HIV infections in spouses of persons infected with HIV. IV International Conference on AIDS. Stockholm, June 1988 [abstract 40601.Google Scholar
  70. 70.
    Hellman NS, Hellman SD, Nsubuga P, Mbidde EK, Gaingi B. Risk factors for HIV infection among Ugandan couples. VII International Conference on AIDS. Florence, June 1991 [abstract MC3080].Google Scholar
  71. 71.
    Moss GB, Clemetson D, D’Costa L, Plummer FA, Ndinya Achola JO, Reilly M, Holmes KK, Piot P, Maitha GM, Hillier SL, Kiviat NC, Cameron CW, Wamola IA, Kreiss JK. Association of cervical ectopy with heterosexual transmission of human immunodeficiency virus: results of a study of couples in Nairobi, Kenya. J Infect Dis 1991;164:588–91.PubMedGoogle Scholar
  72. 72.
    Carael M, Van de Perre PH, Lepage PH, Allen S, Nsengumuremyi F, Van Goethem C, Ntahorutaba M, Nzaramba D, Clumeck N. Human immunodeficiency virus transmission among heterosexual couples in Central Africa. AIDS 1988;2:201–5.PubMedCrossRefGoogle Scholar
  73. 73.
    Chao A, Bulterys M, Musanganire F, Habimana P, Nawrocki P, Taylor E, Dushimimana A, Saah A. Risk factors associated with prevalent HIV-1 infection among pregnant women in Rwanda. National University of Rwanda-Johns Hopkins University AIDS Research Team. Int J Epidemiol 1994; 23:371–80.PubMedCrossRefGoogle Scholar
  74. 74.
    Royce RA, Sena A, Cates W Jr, Cohen MS. Sexual transmission of HIV. N Engl J Med 1997;336:1072–8.PubMedCrossRefGoogle Scholar
  75. 75.
    Seidlin M, Vogler M, Lee E, Lee YS, Dubin N. Heterosexual transmission of HIV in a cohort of couples in New York City. AIDS 1993;7:1247–54.PubMedCrossRefGoogle Scholar
  76. 76.
    Allen S, Lindan C, Serufilira A, Van de Perre P, Rundle AC, Nsengumuremyi F, Carael M, Schwalbe J, Hulley S. Human immunodeficiency virus infection in urban Rwanda. Demographic and behavioural correlates in a representative sample of childbearing women. JAMA 1991;266:1657–63.PubMedCrossRefGoogle Scholar
  77. 77.
    Kapiga SH, Lyamuya EF, Lwihula GK, Hunter DJ. The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania. AIDS 1998;12:75–84.PubMedCrossRefGoogle Scholar
  78. 78.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HIV infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  79. 79.
    Barongo LR, Borgdorff MW, Mosha FF, Nicoll A, Grosskurth H, Senkoro KP, Newell JN, Changalucha J, Klokke AH, Killewo JZ, Velema JP, Hayes RJ, Dunn DT, Muller LAS, Rugemalila JB. The epidemiology of HIV-l infection in urban areas, roadside settlements, and rural villages in Mwanza Region, Tanzania. AIDS 1992;6:1521–8.PubMedCrossRefGoogle Scholar
  80. 80.
    Grosskurth H, Mosha F, Todd J, Senkoro K, Newell J, Klokke A, Changalucha J, West B, Mayaud P, Gavyole A, Gabone R, Mabey D, Hayes R. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. AIDS 1995;9:927–34.PubMedCrossRefGoogle Scholar
  81. 81.
    Gershy-Damet G-M, Koffi K, Soro B, Coulibaly A, Koffi D, Sangare V, Josseran R, Guelain J, Aoussi E, Odehouri K. Seroepidemiological survey of HIV-l and HIV-2 infections in the five regions of Ivory Coast. AIDS 1991;5:462–3.PubMedCrossRefGoogle Scholar
  82. 82.
    Van de Perre P, Carael M, NzVanaramba D, Zissis G, Kayihigi J, Butzler JP. Risk factors for HIV seropositivity in selected urban-based Rwandese adults. AIDS 1987;1:207–11.PubMedGoogle Scholar
  83. 83.
    Hudson CP, Hennis AJ, Kataaha P, Lloyd G, Moore AT, Sutehall GM, Whetstone R, Wreghitt T, Karpas A. Risk factors for the spread of AIDS in rural Africa: evidence from a comparative seroepidemiological survey of AIDS, hepatitis B and syphilis in southwestern Uganda. AIDS 1988;2:255–60.PubMedGoogle Scholar
  84. 84.
    Guimaraes M, Castilho E, Ramos-Filho C, et al. Heterosexual transmission of HIV-1: a multicenter study in Rio de Janeiro, Brazil. VIZ International Conference on AIDS. Florence, June 1991 [abstract MC3098].Google Scholar
  85. 85.
    Seed J, Allen S, Mertens T, Hudes E, Serufilira A, Carael M, Karita E, Van de Perre P, Nsengumuremyi F. Male circumcision, sexually transmitted disease, and risk of HIV. JAcquired Immune Defciency Syndromes Human Retrovirol1995;883–90.Google Scholar
  86. 86.
    Malamba SS, Wagner HU, Maude G, Okongo M, Nunn AJ, Kengeya Kayondo JF, Mulder DW. Risk factors for HIV-l infection in adults in a rural Ugandan community: a case-control study. AIDS 1994;8:253–7.PubMedCrossRefGoogle Scholar
  87. 87.
    Konde-Lule JK, Berkley SF, Downing R. Knowledge, attitudes and practices concerning AIDS in Ugandans. AIDS 1989;3:513–8.PubMedCrossRefGoogle Scholar
  88. 88.
    Quigley M, Munguti K, Grosskurth H, Todd J, Mosha F, Senkoro K, Newell J, Mayaud P, ka-Gina G, Klokke A, Mabey D, Gavyole A, Hayes R. Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study. AIDS 1997;11:237–48.PubMedCrossRefGoogle Scholar
  89. 89.
    Gomo E, Chibatamoto PP, Chandiwana SK, Sabeta CT. Risk factors for HIV infection in a rural cohort in Zimbabwe: a pilot study. Cent Afr J Med 1997;43:350–4.PubMedGoogle Scholar
  90. 90.
    Malamba SS, Wagner HU, Maude G, Okongo M, Nunn AJ, Kengeya Kayondo JF, Mulder DW. Risk factors for HIV-l infection in adults in a rural Ugandan community: a casecontrol study. AIDS 1994;8:253–7.PubMedCrossRefGoogle Scholar
  91. 91.
    Konde-Lule JK, Berkley SF, Downing R. Knowledge, attitudes, and practices concerning AIDS in Ugandans. AIDS 1989;3:513–8.PubMedCrossRefGoogle Scholar
  92. 92.
    Barongo LR, Borgdorff MW, Mosha FF, Nicoll A, Grosskurth H, Senkoro KP, Newell JN, Changalucha J, Klokke AH, Killewo JZ, Velema JP, Hayes RJ, Dunn DT, Muller LAS, Rugemalila JB. The epidemiology of HIV-1 infection in urban areas, roadside settlements, and rural villages in Mwanza Region, Tanzania. AIDS 1992;6:1521–8.PubMedCrossRefGoogle Scholar
  93. 93.
    Grosskurth H, Mosha F, Todd J, Senkoro K, Newell J, Klokke A, Changalucha J, West B, Mayaud P, Gavyole A, Gabone R, Mabey D, Hayes R. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. AIDS 1995;9:927–34.PubMedCrossRefGoogle Scholar
  94. 94.
    Grosskurth H, Munguti K, Todd J, Balira R, Mayaud P, ka-Gina G, Klokke A, Mosha F, Mabey D, Hayes R. HIV incidence in rural Tanzania: case control study on risk factors. XI International Conference on AIDS. Vancouver, July 1996 [abstract WEC2211.Google Scholar
  95. 95.
    Kiwanuka N, Gray R, Sewankambo NK, Serwadda D, Wawer M, Li C. Religion, behaviours, and circumcision as determinants of HIV dynamics in rural Uganda. XI International Conference on AIDS. Vancouver, July 1996 [abstract PUDD1294].Google Scholar
  96. 96.
    Gershy-Damet G-M, Koffi K, Soro B, Coulibaly A, Koffi D, Sangare V, Josseran R, Guelain J, Aoussi E, Odehouri K. Seroepidemiological survey of HIV-1 and HIV-2 infections in the five regions of Ivory Coast. AIDS 1991;5:462–3.PubMedCrossRefGoogle Scholar
  97. 97.
    Van de Perre P, Carael M, NzVanaramba D, Zissis G, Kayihigi J, Butzler JP. Risk factors for HIV seropositivity in selected urban-based Rwandese adults. AIDS 1987;1:207–11.PubMedGoogle Scholar
  98. 98.
    Hudson CP, Hennis AJ, Kataaha P, Lloyd G, Moore AT, Sutehall GM, Whetstone R, Wreghitt T, Karpas A. Risk factors for the spread of AIDS in rural Africa: evidence from a comparative seroepidemiological survey of AIDS, hepatitis B, and syphilis in southwestern Uganda. AIDS 1988;2:255–60.PubMedGoogle Scholar
  99. 99.
    Guimaraes M, Castilho E, Ramos-Filho C, et al. Heterosexual transmission of HIV-l: a multicenter study in Rio de Janeiro, Brazil. VII International Conference on AIDS. Florence, June 1991 [abstract MC3098].Google Scholar
  100. 100.
    Seed J, Allen S, Mertens T, Hudes E, Serufilira A, Carael M, Karita E, Van de Perre P, Nsengumuremyi F. Male circumcision, sexually transmitted disease, and risk of HIV. J Acquir Immune Defic Syndr Hum Retrovirol 1995;8:83–90.PubMedGoogle Scholar
  101. 101.
    Quigley M, Munguti K, Grosskurth H, Todd J, Mosha F, Senkoro K, Newell J, Mayaud P, ka-Gina G, Klokke A, Mabey D, Gavyole A, Hayes R. Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study. AIDS 1997;11:237–48.PubMedCrossRefGoogle Scholar
  102. 102.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HIV infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  103. 103.
    Gomo E, Chibatamoto PP, Chandiwana SK, Sabeta CT. Risk factors for HIV infection in a rural cohort in Zimbabwe: a pilot study. Cent Afr J Med 1997;43:350–4.PubMedGoogle Scholar
  104. 104.
    Hudson CP, Hennis AJ, Kataaha P, Lloyd G, Moore AT, Sutehall GM, Whetstone R, Wreghitt T, Karpas A. Risk factors for the spread of AIDS in rural Africa: evidence from a comparative seroepidemiological survey of AIDS, hepatitis B, and syphilis in southwestern Uganda. AIDS 1988;2:255–60.PubMedGoogle Scholar
  105. 105.
    Mbugua GG, Muthami LN, Mutura CW, Oogo SA, Waiyaki PG, Lindan CP, Hearst N. Epidemiology of HIV infection among long distance truck drivers in Kenya. East Afr Med J 1995;72:515–4.PubMedGoogle Scholar
  106. 106.
    Malamba SS, Wagner HU, Maude G, Okongo M, Nunn AJ, Kengeya Kayondo JF, Mulder DW. Risk factors for HIV-1 infection in adults in a rural Ugandan community: a casecontrol study. AIDS 1994;8:253–7.PubMedCrossRefGoogle Scholar
  107. 107.
    Konde-Lule JK, Berkley SF, Downing R. Knowledge, attitudes, and practices concerning AIDS in Ugandans. AIDS 1989;3:513–8.PubMedCrossRefGoogle Scholar
  108. 108.
    Bwayo J, Plummer F, Omari M, Mutere A, Moses S, Ndinya Achola J, Velentgas P, Kreiss J. Human immunodeficiency virus infection in long-distance truck drivers in East Africa. Arch Intern Med 1994;154:1391–6.PubMedCrossRefGoogle Scholar
  109. 109.
    Seed J, Allen S, Mertens T, Hudes E, Serufilira A, Carael M, Karita E, Van de Perre P, Nsengumuremyi F. Male circumcision, sexually transmitted disease, and risk of HIV. J Acquired Immune Deficiency Syndromes Human Retrovirol 1995;8:83–90.Google Scholar
  110. 110.
    Pépin J, Quigley M, Todd J, Gaye I, Janneh M, Van Dyck E, Piot P, Whittle H. Association between HIV-2 infection and genital ulcer diseases among male sexually transmitted disease patients in The Gambia. AIDS 1992;6:489–93.PubMedCrossRefGoogle Scholar
  111. 111.
    Hill AB. The environment and disease: association or causation? Proc R Soc Med 1965;58:295–300.PubMedGoogle Scholar
  112. 112.
    Mertens TE, Hayes RJ, Smith PG. Epidemiological methods to study the interaction between HIV infection and other sexually transmitted diseases. A IDS 1990;4:57–65.Google Scholar
  113. 113.
    Mertens TE. Estimating the effects of misclassification. Lancet 1993;342:418–21.PubMedCrossRefGoogle Scholar
  114. 114.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Vis type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  115. 115.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HW infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  116. 116.
    Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052–7.PubMedCrossRefGoogle Scholar
  117. 117.
    Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol 1996;77:291–5.PubMedGoogle Scholar
  118. 118.
    Cold CJ, Taylor JR. The prepuce. Br J Urol. In press.Google Scholar
  119. 119.
    Van Howe RS, Cold CJ. Advantages and disadvantages of neonatal circumcision. JAMA 1997;278:203.PubMedCrossRefGoogle Scholar
  120. 120.
    Hughes GK. Circumcision—another look. Ohio Med 1990;86:92.PubMedGoogle Scholar
  121. 121.
    Pépin J, Quigley M, Todd J, Gaye I, Janneh M, Van Dyck E, Piot P, Whittle H. Association between HIV-2 infection and genital ulcer diseases among male sexually transmitted disease patients in The Gambia. AIDS 1992;6:489–93.PubMedCrossRefGoogle Scholar
  122. 122.
    Moses S, Plummer FA, Bradley JE, Ndinya-Achola JO, Nagelkerke JD, Ronald AR. The association between lack of male circumcision and risk for HIV infection: a review of the epidemiological data. Sex Transm Dis 1994;21:201–10.PubMedCrossRefGoogle Scholar
  123. 123.
    Bowen JM, Tobin N, Simpson RB, Ley WB, Ansari MM. Effects of washing on the bacterial flora of the stallion’s penis. J Reprod Fert 1982;32:41–5.Google Scholar
  124. 124.
    Prakash S, Rao R, Venkatesan K, Ramakrishnan S. Sub-preputial wetness—its nature. Ann Natl Med Sci (India) 1982;18:109–12.Google Scholar
  125. 125.
    Fleiss PM, Hodges F, Van Howe RS. Immunological functions of the human prepuce: a review. Sex Transm Inf 1998;77:364–7.Google Scholar
  126. 126.
    Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052–7.PubMedCrossRefGoogle Scholar
  127. 127.
    Cook LS. Koutsky LA. Holmes KK. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic. Genitourin Med 1993;69:262–4.PubMedGoogle Scholar
  128. 128.
    Weiss GN, Sanders M, Westbrook KC. The distribution and density of Langerhans cells in the human prepuce: site of a diminished immune response? Isr J Med Sci 1993;29:42–3.PubMedGoogle Scholar
  129. 129.
    Cold CJ, Taylor JR. The prepuce. Br J Urol. In press.Google Scholar
  130. 130.
    Spira IA, Marx PA, Patterson BK, Mahoney J, Koup RA, Wolinsky SM, Ho DD. Cellular targets of infection and route of viral dissemination after intravaginal inoculations of simian immunodeficiency virus into rhesus macaques. J Exp Med 1996;183;215–25.PubMedCrossRefGoogle Scholar
  131. 131.
    Dezzutti CS. Mechanisms of HIV Transmission through Epithelial Cell Barriers. I2 th World AIDS Conference. Geneva, June/July 1998 [abstract 278/32124]. Quotes from Reuters News Service story of July 2,1998.Google Scholar
  132. 132.
    Plummer FA. Heterosexual transmission of human immunodeficiency virus type 1 (HIV): interactions of conventional sexually transmitted diseases, hormonal contraception, and HIV-1. AIDS Res Hum Retroviruses 1998;14(Suppl 1):S5–S10.PubMedGoogle Scholar
  133. 133.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HIV infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  134. 134.
    Seed J, Allen S, Mertens T, Hudes E, Serufilira A, Carael M, Karita E, Van de Perre P, Nsengumuremyi F. Male circumcision, sexually transmitted disease, and risk of HIV. J Acquired Immune Deficiency Syndromes Human Retrovirol 1995;8:83–90.Google Scholar
  135. 135.
    Beaugé M. Traitement Médical du Phimosis Congénital de L’Adolescent [Conservative Treatment of Primary Phimosis in Adolescents]. Saint-Antoine University. Paris VI. 1990–1991.Google Scholar
  136. 136.
    Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052–7.PubMedCrossRefGoogle Scholar
  137. 137.
    Marck J. Aspects of male circumcision in sub-equatorial African culture history. Health Transition Review 1997;7(Suppl):337–59.PubMedGoogle Scholar
  138. 138.
    Krantz I, Ahlberg BM. Circumcision and HIV. Lancet 1995;345:730.PubMedCrossRefGoogle Scholar
  139. 139.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  140. 140.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HIV infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  141. 141.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  142. 142.
    Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social Organization of sexuality: Sexual Practices in the United States. Chicago, IL: The University of Chicago Press; 1994.Google Scholar
  143. 143.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  144. 144.
    Van Howe RS. Does circumcision influence sexually transmitted diseases? a literature review. Br J Urol. In press.Google Scholar
  145. 145.
    Newell J, Senkoro K, Mosha F, Grosskurth H, Nicoll A, Barongo L, Borgdoff M, Klokke A, Changalucha J, Killewo J, Velema J, Muller AS, Rugemalila J, Mabey D, Hayes R. A population based study of syphilis and sexually tranmitted disease syndromes in north-westem Tanzania. 2. Risk factors and health seeking behaviour. Genitourin Med 1993;69:421–6.PubMedGoogle Scholar
  146. 146.
    Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052–7.PubMedCrossRefGoogle Scholar
  147. 147.
    Cook LS, Koutsky LA, Holmes KK. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic. Genitourin Med 1993;69:262–4.PubMedGoogle Scholar
  148. 148.
    Van Howe RS. Does circumcision influence sexually transmitted diseases? a literature review. Br J Urol. In press.Google Scholar
  149. 149.
    Bassett I, Donovan B, Bodsworth NJ, Held PR, Ho DW, Jeansson S, Cunningham AL. Herpes simplex virus type 2 infection of heterosexual men attending a sexual health centre. Med J Aust 1994; 160:697–700.PubMedGoogle Scholar
  150. 150.
    Donovan B, Bassett I, Bodsworth NJ. Male circumcision and common sexually transmissible diseases in a developed nation setting. Genitourin Med 1994;70:317–20.PubMedGoogle Scholar
  151. 151.
    Aynaud O, Ionesco M, Barrasso R. Penile intraepithelial neoplasia. Specific clinical features correlate with histologic and virologic findings. Cancer 1994;74:1762–7.PubMedCrossRefGoogle Scholar
  152. 152.
    Cook LS, Koutsky LA, Holmes KK. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic. Genitourin Med 1993;69:262–4.PubMedGoogle Scholar
  153. 153.
    Kreiss JK, Hopkins SG. The association between circumcision status and human immunodeficiency virus infection among homosexual men. J Infect Dis 1993;168:1404–8.PubMedGoogle Scholar
  154. 154.
    Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052–7.PubMedCrossRefGoogle Scholar
  155. 155.
    Bassett I, Donovan B, Bodsworth NJ, Field PR, Ho DW, Jeansson S, Cunningham AL. Herpes simplex virus type 2 infection of heterosexual men attending a sexual health centre. Med J Aust 1994; 160:697–700.PubMedGoogle Scholar
  156. 156.
    Donovan B, Bassett I, Bodsworth NJ. Male circumcision and common sexually transmissible diseases in a developed nation setting. Genitourin Med 1994;70:317–20.PubMedGoogle Scholar
  157. 157.
    Hand EA. Circumcision and venereal disease. Arch Dermatol Syphilology 1949;60:341–6.Google Scholar
  158. 158.
    Cook LS, Koutsky LA, Holmes KK. Circumcision and sexually transmitted diseases. Am J Public Health 1994;84:197–201.PubMedGoogle Scholar
  159. 159.
    De Man P, Jodal U, Van Kooten C, Svanborg C. Bacterial adherence as a virulence factor in urinary tract infection. APMIS 1990;98:1053–60.PubMedCrossRefGoogle Scholar
  160. 160.
    Roberts JA. Etiology and pathophysiology of pyelonephritis. Am J Kidney Dis 1991;17:1–9.PubMedGoogle Scholar
  161. 161.
    Fink AJ. A possible explanation for heterosexual male infection with AIDS. N Engl J Med 1986;315:1167.PubMedGoogle Scholar
  162. 162.
    United Press International (Release date: October 29,1986). Circumcision cited as possible factor in AIDS. Rocky Mountain News (Thursday, October 30, 1986):66. Cited in: Ritter TJ, Denniston GC. Say No to Circumcision! 40 Compelling Reasons. 2nd ed. Aptos, CA: Hourglass. 1996:33-1.Google Scholar
  163. 163.
    Mitchell C. AIDS clues turn tide: scientists discover circumcision is key. Winipeg Free Press. (July 23, 1995).Google Scholar
  164. 164.
    Zoberman L. Delisting circumcision short sighted? Can Med Assoc J 1995;153:14.Google Scholar
  165. 165.
    Editer. Uncircumcised men may be at greater risk for AIDS. Men’s Confidential 1996 (Sep);12(9):4.Google Scholar
  166. 166.
    Chalmers TC, Frank CS, Reitman D. Minimizing the three stages of publication bias. JAMA 1990;263:1392–5.PubMedCrossRefGoogle Scholar
  167. 167.
    Dickersin K. The existence of publication bias and risk factors for it occurrence. JAMA 1990; 263:1385–9.PubMedCrossRefGoogle Scholar
  168. 168.
    Koren G, Klein N. Bias against negative studies in newspaper reports of medical research. JAMA 1991;266:1824–6.PubMedCrossRefGoogle Scholar
  169. 169.
    de Vincenzi I, Mertens T. Male circumcision: a role in HN prevention? AIDS 1994;8:153–60.PubMedCrossRefGoogle Scholar
  170. 170.
    Bailar JC III. The promise and problems of meta-analysis. N Engl J Med 1997;337:559–61PubMedCrossRefGoogle Scholar
  171. 171.
    Tyndall MW, Ronald AR, Agoki E, Malisa W, Bwayo JJ, Ndinya Achola JO, Moses S, Plummer FA. Increased risk of infection with Human Immunodeficiency Virus type 1 among uncircumcised men presenting with genital ulcer disease in Kenya. Clin Infect Dis 1996;23:449–53.PubMedGoogle Scholar
  172. 172.
    Urassa M, Todd J, Boerma JT, Hayes R, Isingo R. Male circumcision and susceptibility to HN infection among men in Tanzania. AIDS 1997;11:73–80.Google Scholar
  173. 173.
    Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052–7.PubMedCrossRefGoogle Scholar
  174. 174.
    Sow PS, Diop BM, Barry HL, Badiane S, Coll/Seck AM. Tétanus et pratiques traditionnelles á Dakar (á propos de 141 cas). Dakar Med 1993;38:55–9.PubMedGoogle Scholar
  175. 175.
    Hrdy DB. Cultural practices contributing to the transmission of human immunodeficiency virus in Africa. Rev Infect Dis 1987;9:1109–19.PubMedGoogle Scholar
  176. 176.
    Annobil SH, Al-Hilfi A, Kazi T. Primary tuberculosis of the penis in an infant. Tubercle 1990;71:229–30.PubMedCrossRefGoogle Scholar
  177. 177.
    Crowley IP, Kesner KM. Ritual circumcision (umkhwetha) among the Xhosa of the Ciskei. Br J Urol 1990;66:318–21.PubMedGoogle Scholar
  178. 178.
    Phillips K, Ruttman T, Viljoen J. Flying doctors, saving costs. S Afr Med J 1996;86:1557–8.PubMedGoogle Scholar
  179. 179.
    Özdemir E. Significantly increased complication risks with mass circumcisions. Br J Urol 1997;80:136–9.PubMedGoogle Scholar
  180. 180.
    Hrdy DB. Cultural practices contributing to the transmission of human immunodeficiency virus in Africa. Rev Infect Dis 1987;9:1109–19.PubMedGoogle Scholar
  181. 181.
    Seed J, Allen S, Mertens T, Hudes E, Serufilira A, Carael M, Karita E, Van de Perre P, Nsengumuremyi F. Male circumcision, sexually transmitted disease, and risk of HIV. J Acquired Immune Deficiency Syndromes Human Retrovirol 1995;8:83–90.Google Scholar
  182. 182.
    World Health Organization. Global Programme on AIDS: The Current Global Situation of the HIV/AIDS Pandemic. Quarterly Report. July 3, 1995.Google Scholar
  183. 183.
    Van Howe RS. Routine circumcision: cost-utility analysis. Paper presented at Strategies for Intactivists Evanston, Illinois April 12, 1996.Google Scholar
  184. 184.
    Gee WF, Ansell JS. Neonatal circumcision: a ten-year overview: with comparison of the Gomco clamp and the Plastibell device. Pediatrics 1976;58:824–7.PubMedGoogle Scholar
  185. 185.
    Özdemir E. Significantly increased complication risks with mass circumcisions. Br J Urol 1997;80:136–9.PubMedGoogle Scholar
  186. 186.
    Weir SS, Feldblum PJ, Roddy RE, Zekeng L. Gonorrhoea as a risk factor for HIV acquisition. AIDS 1994;8:1605–8.PubMedCrossRefGoogle Scholar
  187. 187.
    Van de Perre P, Clumeck N, Steens M, Zissis G, Carael M, Lagasse R, De Wit S, Lafontaine T, De Mol P, Butzler JP. Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection. Eur J Epidemiol 1987;3:14–8.PubMedCrossRefGoogle Scholar
  188. 188.
    Piot P, Laga M. Genital ulcers, other sexually transmitted diseases, and the sexual transmission of HIV. BMJ 1989;298:623–4.PubMedGoogle Scholar
  189. 189.
    Dezzutti CS. Mechanisms of HIV Transmission through Epithelial Cell Bamers. 12 th World AIDS Conference. Geneva, June/July 1998 [abstract 278/32124]. Quotes from Reuters News Service story of July 2,1998.Google Scholar
  190. 190.
    Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social Organization of Sexuality: Sexual Practices in the United States. Chicago, IL: The University of Chicago Press;1994.Google Scholar
  191. 191.
    Mertens TE, Hayes RJ, Smith PG. Epidemiological methods to study the interaction between HIV infection and other sexually transmitted diseases. AIDS 1990;4:57–65.PubMedCrossRefGoogle Scholar
  192. 192.
    Mertens TE. Estimating the effects of misclassification. Lancet 1993;342:418–21.PubMedCrossRefGoogle Scholar
  193. 193.
    Allen S, Serufilira A, Bogaerts J, Van de Perre P, Nsengumuremyi F, Linden C, Carael M, Wolf W, Coates T, Hulley S. Confidential HIV testing and condom promotion in Africa. Impact on HIV and gonorrhoea rates. JAMA 1992;268:3338–43.PubMedCrossRefGoogle Scholar
  194. 194.
    Allen S, Tice J, Van de Perre P, Serufilira A, Hudes E, Nsengumuremyi F, Bogaerts J, Lindan C, Hulley S. Effect of serotesting with counselling on condom use and seroconversion among HJY discordant couples in Africa. BMJ 1992;304:1605–9.PubMedCrossRefGoogle Scholar
  195. 195.
    Richters J, Gerofi J, Donovan B. Why do condoms break or slip off in use? An exploratory study. Int J STD AIDS 1995;6:11–8.PubMedGoogle Scholar
  196. 196.
    Holmes KK. Human ecology and behaviour and sexually transmitted bacterial infections. Proc Natl Acad Sci USA 1994;91:2448–55.PubMedCrossRefGoogle Scholar
  197. 197.
    Royce RA, Sena A, Cates W Jr, Cohen MS. Sexual transmission of HIV. N Engl J Med 1997;336:1072–8.PubMedCrossRefGoogle Scholar
  198. 198.
    Weiss GN, Weiss EB. A perspective on controversies over neonatal circumcision. Clin Pediatr Phila 1994;33:726–30.PubMedGoogle Scholar
  199. 199.
    Niku SD, Stock JA, Kaplan GW. Neonatal circumcision. Urol Clin North Am 1995;22:57–65.PubMedGoogle Scholar
  200. 200.
    Weiss GN. Prophylactic neonatal surgery and infectious diseases. Pediatr Infect Dis J 1997;16:727–34.PubMedCrossRefGoogle Scholar
  201. 201.
    Schoen EJ. Benefits of newborn circumcision: is Europe ignoring medical evidence? Arch Dis Child 1997;77:258–60.PubMedGoogle Scholar
  202. 202.
    Schlesinger Y, Urbach J. Circumcision and endocarditis prophylaxis. Arch Pediatr Adolesc Med 1998;152:412.PubMedGoogle Scholar
  203. 203.
    Koren G, Klein N. Bias against negative studies in newspaper reports of medical research. JAMA 1991;266:1824–6.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic / Plenum Publishers, New York 1999

Authors and Affiliations

  • Robert S. Van Howe

There are no affiliations available

Personalised recommendations