Whether male circumcision in infancy or childhood provides protection against the acquisition of human immunodeficiency virus (HIV) or other sexually transmitted infections (STIs) in adulthood remains to be established. In the first national cohort study to address this issue, we identified 810,719 non-Muslim males born in Denmark between 1977 and 2003 and followed them over the age span 0–36 years between 1977 and 2013. We obtained information about cohort members’ non-therapeutic circumcisions, HIV diagnoses and other STI outcomes from national health registers and used Cox proportional hazards regression analyses to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) associated with foreskin status (i.e., circumcised v. genitally intact). During a mean of 22 years of follow-up, amounting to a total observation period of 17.7 million person-years, 3375 cohort members (0.42%) underwent non-therapeutic circumcision, and 8531 (1.05%) received hospital care for HIV or other STIs. Compared with genitally intact males, rates among circumcised males were not statistically significantly reduced for any specific STI. Indeed, circumcised males had a 53% higher rate of STIs overall (HR = 1.53, 95% CI: 1.24–1.89), and rates were statistically significantly increased for anogenital warts (74 cases in circumcised males v. 7151 cases in intact males, HR = 1.51; 95% CI: 1.20–1.90) and syphilis (four cases in circumcised males v. 197 cases in intact males, HR = 3.32; 95% CI: 1.23–8.95). In this national cohort study spanning more than three decades of observation, non-therapeutic circumcision in infancy or childhood did not appear to provide protection against HIV or other STIs in males up to the age of 36 years. Rather, non-therapeutic circumcision was associated with higher STI rates overall, particularly for anogenital warts and syphilis.

婴儿期或儿童期的男性包皮环切术是否能防止成年期感染人类免疫缺陷病毒 (HIV) 或其他性传播感染 (STI)，仍有待确定。在第一个解决这一问题的全国性队列研究中，我们确定了 1977 年至 2003 年间在丹麦出生的 810,719 名非穆斯林男性，并在 1977 年至 2013 年的 0 至 36 岁之间对他们进行了跟踪调查。我们获得了有关队列成员非穆斯林的信息。来自国家健康登记册的治疗性包皮环切术、艾滋病毒诊断和其他性传播感染结果，并使用 Cox 比例风险回归分析来计算与包皮状态相关的 95% 置信区间 (CIs) 的风险比 (HRs)（即，包皮环切术v.生殖器完好）。在平均 22 年的随访中，总计 1770 万人年的总观察期，3375 名队列成员（0.42%）接受了非治疗性包皮环切术，8531 名（1.05%）接受了 HIV 或其他疾病的住院治疗性传播感染。与生殖器完好的男性相比，任何特定性传播感染的割礼男性的发病率均未显着降低。事实上，包皮环切的男性总体性传播感染率高出 53%（HR = 1.53，95% CI：1.24-1.89），肛门生殖器疣的发病率显着增加（包皮环切男性 74 例，完整男性 7151 例， HR = 1.51；95% CI：1.20–1.90）和梅毒（4 例割包皮的男性v. 完整男性 197 例，HR = 3.32；95% CI：1.23–8.95）。在这项跨越 30 多年观察的全国性队列研究中，婴儿期或儿童期的非治疗性包皮环切术似乎无法为 36 岁以下的男性提供预防 HIV 或其他性传播感染的保护。相反，非治疗性包皮环切术与总体上较高的 STI 发病率相关，特别是对于肛门生殖器疣和梅毒。