Randomized trials have demonstrated that male circumcision (MC) reduces heterosexual acquisition of HIV, herpes simplex virus type 2, human papillomavirus (HPV), and genital ulcer disease among men, and it reduces HPV, genital ulcer disease, bacterial vaginosis, and trichomoniasis among female partners. The pathophysiology behind these effects is multifactorial, relying on anatomic and cellular changes. MC is cost effective and potentially cost saving in both the United States and Africa. The World Health Organization and Joint United Nations Program on HIV/AIDS proposed reaching 80% MC coverage in HIV endemic countries, but current rates fall far behind targets. Barriers to scale-up include supply-side and demand-side challenges. In the United States, neonatal MC rates are decreasing, but the American Academy of Pediatrics now recognizes the medical benefits of MC and supports insurance coverage. Although MC is a globally valuable tool to prevent HIV and other sexually transmitted infections, it is underutilized. Further research is needed to address barriers to MC uptake.

中文翻译：

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男性包皮环切术：一种全球相关但未充分利用的预防艾滋病毒和其他性传播感染的方法。

随机试验表明，男性包皮环切术 (MC) 减少了男性异性接触 HIV、2 型单纯疱疹病毒、人乳头瘤病毒 (HPV) 和生殖器溃疡病，并减少了男性中的 HPV、生殖器溃疡病、细菌性阴道病和滴虫病。女性伴侣。这些影响背后的病理生理学是多因素的，依赖于解剖和细胞的变化。MC 在美国和非洲都具有成本效益并且可能节省成本。世界卫生组织和联合国艾滋病毒/艾滋病联合计划提议在艾滋病毒流行国家达到 80% 的 MC 覆盖率，但目前的比率远远落后于目标。扩大规模的障碍包括供应方和需求方的挑战。在美国，新生儿 MC 率正在下降，但美国儿科学会现在承认 MC 的医疗福利并支持保险。尽管 MC 是预防 HIV 和其他性传播感染的全球有价值的工具，但它并未得到充分利用。需要进一步的研究来解决 MC 吸收的障碍。