Declining Rates in Male Circumcision amidst Increasing Evidence of its Public Health Benefit
2007

Declining Rates in Male Circumcision and Its Public Health Benefits

Sample size: 58598 publication 10 minutes Evidence: moderate

Author Information

Author(s): Mor Zohar, Kent Charlotte K., Kohn Robert P., Klausner Jeffrey D.

Primary Institution: San Francisco Department of Public Health

Hypothesis

What are the trends in male circumcision among men attending the San Francisco municipal STD clinic and how do they correlate with HIV and syphilis infection?

Conclusion

Male circumcision rates have declined significantly among men in San Francisco, with variations observed by race/ethnicity and sexual orientation.

Supporting Evidence

  • 55.7% of male patients were circumcised.
  • Circumcision rates varied significantly by race/ethnicity.
  • Declines in circumcision rates were observed among men born after the 1960s.
  • Circumcision may provide modest protection against syphilis in heterosexual men.
  • Most circumcision status was determined by physical examination.

Takeaway

Many men in San Francisco are circumcised, but fewer are getting circumcised now than in the past, and this varies by race and sexual orientation.

Methodology

A cross-sectional study reviewing electronic records of males attending the San Francisco municipal STD clinic from 1996 to 2005.

Potential Biases

Potential for misclassification of circumcision status despite clinical examination.

Limitations

The study design was retrospective and may not generalize to all men outside the clinic.

Participant Demographics

Majority were white (54.1%), born before 1970 (52.3%), and 35.5% identified as gay/bisexual.

Statistical Information

P-Value

0.06

Confidence Interval

95% CI 55.2–56.1

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0000861

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