Review Article
Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis
Table 2
Meta-analysis of circumcision status of adult males and incidence of sexually transmitted infections using Poisson regression.
| Study | Intact infections/patient years | Circumcised infections/patient years | Relative risk | 95% confidence interval |
| GDS | | | | | Tobian; unadjusted | 60/2790 | 53/2740 | 1.1118 | 0.7684–1.6086 | Tobian; 6 weeks* | 60/2790 | 53/2423.85 | 0.9835 | 0.6797–1.4230 | Chlamydia | | | | | Diseker | 36/346 | 88/1109 | 1.3073 | 0.8872–1.9267 | Mehta | 101/2091 | 88/2027.5 | 1.1128 | 0.8362–1.4810 | Mehta; 6 weeks* | 101/2091 | 1875.43 | 1.0294 | 0.7735–1.3700 | SOB | 32/1541.75 | 19/1550.5 | 1.6938 | 0.9601–2.9880 | SOB; 6 weeks* | 32/1541.75 | 19/1448.27 | 1.5820 | 0.8968–2.7910 | Summary | | | 1.2638 | 1.0194–1.5669 | Summary; 6 weeks* | | | 1.1973 | 0.9648–1.4859 | Gonorrhea | | | | | Diseker | 36/346 | 83/1109 | 1.3903 | 0.9402–2.0557 | Mehta | 74/2102 | 70/2065 | 1.0385 | 0.7490–1.4399 | Mehta; 6 weeks* | 74/2102 | 70/1912.92 | 0.9620 | 0.6938–1.3339 | SOB | 91/1541.75 | 89/1550.5 | 1.0283 | 0.7677–1.3772 | SOB; 6 weeks* | 91/1541.75 | 89/1448.27 | 0.9605 | 0.7171–1.2864 | Summary | | | 1.1053 | 0.9116–1.3402 | Summary; 6 weeks* | | | 1.0448 | 0.8611–1.2677 | GUD | | | | | Mehta | 101/1950 | 51/1912 | 1.9418 | 1.3800–2.7191 | Mehta; 6 weeks* | 101/1950 | 51/1753.81 | 1.7812 | 1.2720–2.4940 | Tobian | 75/2790 | 48/2740 | 1.5349 | 1.0681–2.2045 | Tobian; 6 weeks* | 75/2790 | 48/2581.92 | 1.4460 | 1.0065–2.0774 | Summary | | | 1.7444 | 1.3637–2.2313 | Summary; 6 weeks* | | | 1.6195 | 1.2660–2.0716 | Syphilis | | | | | Diseker | 4/347 | 6/1109 | 2.1306 | 0.5560–7.5504 | Mehta | 6/1976 | 7/1897.5 | 0.8230 | 0.2766–2.4490 | Mehta; 6 weeks* | 6/1976 | 7/1741.73 | 0.7558 | 0.2539–2.2481 | Tobian | 45/4286 | 50/4166 | 0.8748 | 0.5848–1.3087 | Tobian; 6 weeks* | 45/4286 | 50/3925.65 | 0.8243 | 0.5511–1.2334 | Summary | | | 0.9267 | 0.6429–1.3359 | Summary; 6 weeks* | | | 0.8738 | 0.6059–1.2600 | HSV | | | | | Dickson | 19/2235 | 13/1512 | 0.9888 | 0.4883–2.0019 | Mehta | 100/1628.5 | 86/1493.5 | 1.0664 | 0.7993–1.4226 | Mehta; 6 weeks* | 100/1628.5 | 86/1379.73 | 0.9852 | 0.7384–1.3145 | SOB | 35/1003 | 23/995 | 1.5095 | 0.8921–2.5546 | SOB; 6 weeks* | 35/1003 | 23/929.39 | 1.4100 | 0.8332–2.3862 | Tobian | 153/2906.5 | 114/2888.5 | 1.3338 | 1.0466–1.6998 | Tobian; 6 weeks* | 153/2906.5 | 114/2704.81 | 1.2489 | 0.9800–1.5917 | Summary | | | 1.2302 | 1.0381–1.4581 | Summary; 6 weeks* | | | 1.1506 | 0.9709–1.3636 | HPV | | | | | Auvert | 144/1086.25 | 90/1125.25 | 1.5132 | 1.1651–1.9650 | Auvert; 6 weeks* | 144/1086.25 | 90/1051.06 | 1.4134 | 1.0883–1.8355 | Auvert ADJ† | 217.50/1086.25 | 193.03/1125.25 | 1.0657 | 0.8786–1.2924 | Auvert ADJ; 6 weeks*† | 217.50/1086.25 | 193.03/1051.06 | 0.9953 | 0.8207–1.2072 | Dickson | 54/7830 | 41/5220 | 0.8780 | 0.5851–1.3177 | Lajous | 37/174 | 8/36 | 1.0451 | 0.4867–2.2441 | Lu | 7/25.4 | 56/243.3 | 1.1967 | 0.5454–2.6256 | Partridge | 32/2486 | 132/7840 | 0.7645 | 0.5196–1.1249 | Tobian | 80/574 | 42/466 | 1.5464 | 1.0644–2.2466 | Tobian; 6 weeks* | 80/574 | 42/412.23 | 1.3679 | 0.9416–1.9873 | Tobian ADJ† | 120.83/574 | 90.08/466 | 1.0889 | 0.8289–1.4306 | Tobian ADJ; 6 weeks*† | 120.83/574 | 90.08/412.23 | 0.9633 | 0.7333–1.2655 | VanBuskirk | 45/124 | 142/412 | 1.0530 | 0.7530–1.4724 | Summary | | | 1.1640 | 1.0097–1.3421 | Summary; 6 weeks* | | | 1.1184 | 0.9696–1.2902 | Summary ADJ† | | | 1.0113 | 0.8941–1.1439 | Summary ADJ; 6 weeks*† | | | 0.9591 | 0.8475–1.0852 | Any STI | | | | | Dickson | 70/2991 | 47/1296 | 0.9591 | 0.6627–1.3879 | Diseker | 135/356 | 475/1109 | 0.8853 | 0.7313–1.0718 | Fergusson | 37/2848 | 7/1232 | 2.2864 | 1.0194–5.1289 | Mattson | 17/265.5 | 27/235 | 0.5583 | 0.3043–1.0244 | Summary | | | 0.9127 | 0.7801–1.0679 |
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Adjusted for a 6-week lead time bias. Adjusted for sampling bias using data from VanBuskirk et al. [32].
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