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Estimation of country-specific and global prevalence of male circumcision

BACKGROUND: Male circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence. METHODS: MC pre...

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Autores principales: Morris, Brian J, Wamai, Richard G, Henebeng, Esther B, Tobian, Aaron AR, Klausner, Jeffrey D, Banerjee, Joya, Hankins, Catherine A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772313/
https://www.ncbi.nlm.nih.gov/pubmed/26933388
http://dx.doi.org/10.1186/s12963-016-0073-5
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author Morris, Brian J
Wamai, Richard G
Henebeng, Esther B
Tobian, Aaron AR
Klausner, Jeffrey D
Banerjee, Joya
Hankins, Catherine A
author_facet Morris, Brian J
Wamai, Richard G
Henebeng, Esther B
Tobian, Aaron AR
Klausner, Jeffrey D
Banerjee, Joya
Hankins, Catherine A
author_sort Morris, Brian J
collection PubMed
description BACKGROUND: Male circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence. METHODS: MC prevalence data were obtained by searches in PubMed, Demographic and Health Surveys, AIDS Indicator Surveys, and Behavioural Surveillance Surveys. Male age was ≥15 years in most surveys. Where no data were available, the population proportion whose religious faith or culture requires MC was used. The total number of circumcised males in each country and territory was calculated using figures for total males from (i) 2015 US Central Intelligence Agency (CIA) data for sex ratio and total population in all 237 countries and territories globally and (ii) 2015 United Nations (UN) figures for males aged 15–64 years. RESULTS: The estimated percentage of circumcised males in each country and territory varies considerably. Based on (i) and (ii) above, global MC prevalence was 38.7 % (95 % confidence interval [CI]: 33.4, 43.9) and 36.7 % (95 % CI: 31.4, 42.0). Approximately half of circumcisions were for religious and cultural reasons. For countries lacking data we assumed 99.9 % of Muslims and Jews were circumcised. If actual prevalence in religious groups was lower, then MC prevalence in those countries would be lower. On the other hand, we assumed a minimum prevalence of 0.1 % related to MC for medical reasons. This may be too low, thereby underestimating MC prevalence in some countries. CONCLUSIONS: The present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world. We estimate that 37–39 % of men globally are circumcised. Considering the health benefits of MC, these data may help guide efforts aimed at the use of voluntary, safe medical MC in disease prevention programs in various countries. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12963-016-0073-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-47723132016-03-02 Estimation of country-specific and global prevalence of male circumcision Morris, Brian J Wamai, Richard G Henebeng, Esther B Tobian, Aaron AR Klausner, Jeffrey D Banerjee, Joya Hankins, Catherine A Popul Health Metr Review BACKGROUND: Male circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence. METHODS: MC prevalence data were obtained by searches in PubMed, Demographic and Health Surveys, AIDS Indicator Surveys, and Behavioural Surveillance Surveys. Male age was ≥15 years in most surveys. Where no data were available, the population proportion whose religious faith or culture requires MC was used. The total number of circumcised males in each country and territory was calculated using figures for total males from (i) 2015 US Central Intelligence Agency (CIA) data for sex ratio and total population in all 237 countries and territories globally and (ii) 2015 United Nations (UN) figures for males aged 15–64 years. RESULTS: The estimated percentage of circumcised males in each country and territory varies considerably. Based on (i) and (ii) above, global MC prevalence was 38.7 % (95 % confidence interval [CI]: 33.4, 43.9) and 36.7 % (95 % CI: 31.4, 42.0). Approximately half of circumcisions were for religious and cultural reasons. For countries lacking data we assumed 99.9 % of Muslims and Jews were circumcised. If actual prevalence in religious groups was lower, then MC prevalence in those countries would be lower. On the other hand, we assumed a minimum prevalence of 0.1 % related to MC for medical reasons. This may be too low, thereby underestimating MC prevalence in some countries. CONCLUSIONS: The present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world. We estimate that 37–39 % of men globally are circumcised. Considering the health benefits of MC, these data may help guide efforts aimed at the use of voluntary, safe medical MC in disease prevention programs in various countries. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12963-016-0073-5) contains supplementary material, which is available to authorized users. BioMed Central 2016-03-01 /pmc/articles/PMC4772313/ /pubmed/26933388 http://dx.doi.org/10.1186/s12963-016-0073-5 Text en © Morris et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Morris, Brian J
Wamai, Richard G
Henebeng, Esther B
Tobian, Aaron AR
Klausner, Jeffrey D
Banerjee, Joya
Hankins, Catherine A
Estimation of country-specific and global prevalence of male circumcision
title Estimation of country-specific and global prevalence of male circumcision
title_full Estimation of country-specific and global prevalence of male circumcision
title_fullStr Estimation of country-specific and global prevalence of male circumcision
title_full_unstemmed Estimation of country-specific and global prevalence of male circumcision
title_short Estimation of country-specific and global prevalence of male circumcision
title_sort estimation of country-specific and global prevalence of male circumcision
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772313/
https://www.ncbi.nlm.nih.gov/pubmed/26933388
http://dx.doi.org/10.1186/s12963-016-0073-5
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