Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis
Identifieur interne : 001F67 ( Ncbi/Merge ); précédent : 001F66; suivant : 001F68Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis
Auteurs : Robert S. Van Howe [États-Unis]Source :
- ISRN Urology [ 2090-5807 ] ; 2013.
Abstract
The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.
Url:
DOI: 10.1155/2013/109846
PubMed: 23710368
PubMed Central: 3654279
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis</title><author><name sortKey="Van Howe, Robert S" sort="Van Howe, Robert S" uniqKey="Van Howe R" first="Robert S." last="Van Howe">Robert S. Van Howe</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, 413 E. Ohio Street, Marquette, MI 49855, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, 413 E. Ohio Street, Marquette, MI 49855</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23710368</idno><idno type="pmc">3654279</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654279</idno><idno type="RBID">PMC:3654279</idno><idno type="doi">10.1155/2013/109846</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002494</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002494</idno><idno type="wicri:Area/Pmc/Curation">002493</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002493</idno><idno type="wicri:Area/Pmc/Checkpoint">001706</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001706</idno><idno type="wicri:Area/Ncbi/Merge">001F67</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis</title><author><name sortKey="Van Howe, Robert S" sort="Van Howe, Robert S" uniqKey="Van Howe R" first="Robert S." last="Van Howe">Robert S. Van Howe</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, 413 E. Ohio Street, Marquette, MI 49855, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, 413 E. Ohio Street, Marquette, MI 49855</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author></analytic><series><title level="j">ISRN Urology</title><idno type="ISSN">2090-5807</idno><idno type="eISSN">2090-5815</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hutchinson, J" uniqKey="Hutchinson J">J Hutchinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wiswell, Te" uniqKey="Wiswell T">TE Wiswell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moses, S" uniqKey="Moses S">S Moses</name></author><author><name sortKey="Bailey, Rc" uniqKey="Bailey R">RC Bailey</name></author><author><name sortKey="Ronald, Ar" uniqKey="Ronald A">AR Ronald</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schoen, Ej" uniqKey="Schoen E">EJ 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<front><journal-meta><journal-id journal-id-type="nlm-ta">ISRN Urol</journal-id><journal-id journal-id-type="iso-abbrev">ISRN Urol</journal-id><journal-id journal-id-type="publisher-id">ISRN.UROLOGY</journal-id><journal-title-group><journal-title>ISRN Urology</journal-title></journal-title-group><issn pub-type="ppub">2090-5807</issn><issn pub-type="epub">2090-5815</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23710368</article-id><article-id pub-id-type="pmc">3654279</article-id><article-id pub-id-type="doi">10.1155/2013/109846</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Van Howe</surname><given-names>Robert S.</given-names></name><xref ref-type="aff" rid="I1"></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib></contrib-group><aff id="I1">Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, 413 E. Ohio Street, Marquette, MI 49855, USA</aff><author-notes><corresp id="cor1">*Robert S. Van Howe: <email>rsvanhowe@att.net</email></corresp><fn fn-type="other"><p>Academic Editors: A. M. El-Assmy and A. Natali</p></fn></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>16</day><month>4</month><year>2013</year></pub-date><volume>2013</volume><elocation-id>109846</elocation-id><history><date date-type="received"><day>12</day><month>12</month><year>2012</year></date><date date-type="accepted"><day>22</day><month>1</month><year>2013</year></date></history><permissions><copyright-statement>Copyright © 2013 Robert S. Van Howe.</copyright-statement><copyright-year>2013</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Natural logarithm of odds ratio as a function of the prevalence of circumcision in the population when estimating the prevalence of genital discharge syndrome by circumcision status in adult men. Solid triangles represent individual populations. Circles represent estimates and 95% confidence intervals using meta-regression.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Natural logarithm of odds ratio as a function of the prevalence of circumcision in the population when estimating the prevalence of gonorrhea by circumcision status in adult men. Solid triangles represent individual populations. Circles represent estimates and 95% confidence intervals using meta-regression.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Natural logarithm of odds ratio as a function of the prevalence of circumcision in the population when estimating the prevalence of genital ulcerative disease by circumcision status in adult men. Solid triangles represent individual populations. Circles represent estimates and 95% confidence intervals using meta-regression.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>Natural logarithm of odds ratio as a function of the prevalence of circumcision in the population when estimating the prevalence of syphilis by circumcision status in adult men. Solid triangles represent individual populations. Circles represent estimates and 95% confidence intervals using meta-regression.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Natural logarithm of odds ratio as a function of the prevalence of circumcision in the population when estimating the prevalence of genital warts by circumcision status in adult men. Solid triangles represent individual populations. Circles represent estimates and 95% confidence intervals using meta-regression.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital discharge syndrome by circumcision status in adult men. Empty triangles represent published studies.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.006"></graphic></fig><fig id="fig7" orientation="portrait" position="float"><label>Figure 7</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of nonspecific (nongonococcal) urethritis by circumcision status in adult men. Empty triangles represent published studies.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.007"></graphic></fig><fig id="fig8" orientation="portrait" position="float"><label>Figure 8</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital infections with <italic>Chlamydia trachomatis</italic> by circumcision status in adult men. Solid squares represent likely unpublished studies using the “trim and fill” method.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.008"></graphic></fig><fig id="fig9" orientation="portrait" position="float"><label>Figure 9</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of gonorrhea by circumcision status in adult men. Empty triangles represent published studies.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.009"></graphic></fig><fig id="fig10" orientation="portrait" position="float"><label>Figure 10</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital ulcerative disease by circumcision status in adult men. Empty triangles represent published studies. Solid squares represent likely unpublished studies using the “trim and fill” method.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.010"></graphic></fig><fig id="fig11" orientation="portrait" position="float"><label>Figure 11</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of syphilis by circumcision status in adult men. Empty triangles represent published studies.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.011"></graphic></fig><fig id="fig12" orientation="portrait" position="float"><label>Figure 12</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital herpes/herpes simplex virus type 2 by circumcision status in adult men. Empty triangles represent published studies.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.012"></graphic></fig><fig id="fig13" orientation="portrait" position="float"><label>Figure 13</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital warts by circumcision status in adult men. Empty triangles represent published studies. Solid squares represent likely unpublished studies using the “trim and fill” method.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.013"></graphic></fig><fig id="fig14" orientation="portrait" position="float"><label>Figure 14</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital human papillomavirus of any type by circumcision status in adult men. Empty triangles represent published studies in which the entire penis was sampled and circumcision status was determined by physical examination. Shaded triangles represent published studies in which only the glans was sampled and circumcision status was determined by physical examination. Inverted shaded triangles represent published studies in which entire penis was sampled and circumcision status was determined by patient report. Shaded circles represent published studies in which only the glans was sampled and circumcision status was determined by patient report. Solid squares represent likely unpublished studies using the “trim and fill” method.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.014"></graphic></fig><fig id="fig15" orientation="portrait" position="float"><label>Figure 15</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of genital human papillomavirus of focussing on those at high-risk oncogenic potential by circumcision status in adult men. Empty triangles represent published studies in which the entire penis was sampled and circumcision status was determined by physical examination. Shaded triangles represent published studies in which only the glans was sampled and circumcision status was determined by physical examination. Inverted shaded triangles represent published studies in which entire penis was sampled and circumcision status was determined by patient report. Shaded circles represent published studies in which only the glans was sampled and circumcision status was determined by patient report. Solid squares represent likely unpublished studies using the “trim and fill” method.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.015"></graphic></fig><fig id="fig16" orientation="portrait" position="float"><label>Figure 16</label><caption><p>Funnel graph of precision (1/variance) by the natural logarithm of the odds ratio of studies estimating the prevalence of any sexually transmitted infection versus no sexually transmitted infection by circumcision status in adult men. Empty triangles represent published studies. An outlier study [<xref rid="B88" ref-type="bibr">85</xref>] is identified by an open square.</p></caption><graphic xlink:href="ISRN.UROLOGY2013-109846.016"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Attributes of studies meeting the inclusion criteria.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study STI studied</th><th align="left" rowspan="1" colspan="1">Location</th><th align="left" rowspan="1" colspan="1">When</th><th align="left" rowspan="1" colspan="1">Population</th><th align="left" rowspan="1" colspan="1">Type of study</th><th align="left" rowspan="1" colspan="1">Circumcision status</th><th align="left" rowspan="1" colspan="1">Method of diagnosis</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Agot [<xref rid="B1" ref-type="bibr">152</xref>];<break></break>GDS and GUD</td><td align="left" rowspan="1" colspan="1">Kenya</td><td align="left" rowspan="1" colspan="1">From October 1999 to May 2000</td><td align="left" rowspan="1" colspan="1">18–49 y/o sexually active males unaware of HIV status in circumcising and noncircumcising denominations in Luo ethnic community</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Auvert et al. [<xref rid="B5" ref-type="bibr">153</xref>];<break></break>GC, CT, <break></break>and any</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya</td><td align="left" rowspan="1" colspan="1">From June 1997 to March 1998</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Cluster design to randomly select households</td><td align="left" rowspan="1" colspan="1">Physical exam and self-report</td><td align="left" rowspan="1" colspan="1">Serology (HSV and syphilis). Urine DNA (GC and CT)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Auvert et al. [<xref rid="B7" ref-type="bibr">105</xref>]; <break></break>HPV and GC</td><td align="left" rowspan="1" colspan="1">Orange Farm, South Africa</td><td align="left" rowspan="1" colspan="1">2002–2006</td><td align="left" rowspan="1" colspan="1">Men interested in a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized clinical trial</td><td align="left" rowspan="1" colspan="1">Intention to treat</td><td align="left" rowspan="1" colspan="1">Urethral swabs (HPV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Aynaud et al. [<xref rid="B9" ref-type="bibr">33</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Paris, France</td><td align="left" rowspan="1" colspan="1">From March 1991 to September 1992</td><td align="left" rowspan="1" colspan="1">Men whose female partners had genital condylomata or intraepithelial neoplasia</td><td align="left" rowspan="1" colspan="1">Cross-sectional study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Colposcopy, viral culture, and biopsy</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Aynaud et al. [<xref rid="B10" ref-type="bibr">34</xref>];<break></break>NSU, CT, GC, HPV, and any</td><td align="left" rowspan="1" colspan="1">Paris, France</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Heterosexual HIV-negative men whose female partner has HPV<break></break></td><td align="left" rowspan="1" colspan="1">Cross-sectional study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Chlamydia by PCR, cultures (GC), and HPV by biopsy and penoscopy</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Bailey [<xref rid="B12" ref-type="bibr">114</xref>];<break></break>GDS, GC, and syphilis</td><td align="left" rowspan="1" colspan="1">Mbale, Uganda</td><td align="left" rowspan="1" colspan="1">From April to May 1997</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Single stage cluster sampling cross section</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Baldwin [<xref rid="B14" ref-type="bibr">154</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Tucson, Arizona</td><td align="left" rowspan="1" colspan="1">From July 2000 to January 2001</td><td align="left" rowspan="1" colspan="1">High risk men attending a public STD clinic</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Swab of glans and sulcus (HPV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Barile [<xref rid="B15" ref-type="bibr">59</xref>];<break></break>GUD</td><td align="left" rowspan="1" colspan="1">Japan</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">US military personnel in Japan<break></break></td><td align="left" rowspan="1" colspan="1">Case control</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Bassett [<xref rid="B16" ref-type="bibr">155</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Sydney, Australia</td><td align="left" rowspan="1" colspan="1">From December 1990 to May 1991</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample of heterosexual men</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">HSV2 by serology</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Bleeker [<xref rid="B18" ref-type="bibr">156</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Amsterdam</td><td align="left" rowspan="1" colspan="1">From April 2002 to November 2002</td><td align="left" rowspan="1" colspan="1">18–75 years old. Group A with female partner without CIN. Group B female partner with CIN. Non-STD hospital population</td><td align="left" rowspan="1" colspan="1">Consecutive sample of male partners of <break></break></td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Swab of glans, sulcus, corona, and frenulum (HPV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Burundi [<xref rid="B79" ref-type="bibr">72</xref>];<break></break>GDS, GUD, <break></break>and any</td><td align="left" rowspan="1" colspan="1">Burundi</td><td align="left" rowspan="1" colspan="1">2010</td><td align="left" rowspan="1" colspan="1">General population from 15 to 49 years old</td><td align="left" rowspan="1" colspan="1">National representative population survey</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Buvé [<xref rid="B22" ref-type="bibr">61</xref>];<break></break>syphilis and HSV</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya; Ndola, Zambia; Cotonou, Benin; Yaoundé, Cameroon</td><td align="left" rowspan="1" colspan="1">From June 1997 to March 1998</td><td align="left" rowspan="1" colspan="1">General population from 15 to 49 years old</td><td align="left" rowspan="1" colspan="1">Cluster design to randomly select households</td><td align="left" rowspan="1" colspan="1">Physical exam and self-report</td><td align="left" rowspan="1" colspan="1">Serology (HSV and Lues)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Bwayo [<xref rid="B23" ref-type="bibr">36</xref>];<break></break>GDS, GUD, <break></break>and syphilis</td><td align="left" rowspan="1" colspan="1">25 miles from Nairobi</td><td align="left" rowspan="1" colspan="1">From June 1989 to February 1992</td><td align="left" rowspan="1" colspan="1">Truck drivers enrolled at roadside research clinic</td><td align="left" rowspan="1" colspan="1">Self-selected convenience sample</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Report (GDS and GUD) and serology (Lues)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Cameron [<xref rid="B24" ref-type="bibr">97</xref>];<break></break>GUD versus GDS</td><td align="left" rowspan="1" colspan="1">Nairobi, Kenya</td><td align="left" rowspan="1" colspan="1">From March 1986 to December 1987. Followup to March 1988</td><td align="left" rowspan="1" colspan="1">STD clinic and men who got STD from a prostitute</td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Not documented</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Castellsagué [<xref rid="B25" ref-type="bibr">99</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Brazil, Thailand, Philippines, Spain, Columbia</td><td align="left" rowspan="1" colspan="1">1985–1993</td><td align="left" rowspan="1" colspan="1">Husband or stable partner of woman with cervical cancer or a control woman</td><td align="left" rowspan="1" colspan="1">Seven separate case-control studies</td><td align="left" rowspan="1" colspan="1">Physical exam in Brazil, Thailand, and Philippines. Report in Spain and Columbia</td><td align="left" rowspan="1" colspan="1">PCR for HPV from urethra and glans swabs</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Cook [<xref rid="B30" ref-type="bibr">30</xref>];<break></break>NSU, CT, GC, syphilis, HSV, HPV (warts), and any</td><td align="left" rowspan="1" colspan="1">Seattle, Washington</td><td align="left" rowspan="1" colspan="1">From January to December 1988</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Chart review of heterosexual men</td><td align="left" rowspan="1" colspan="1">Chart review (14.3% missing)</td><td align="left" rowspan="1" colspan="1">Urethral swabs, syphilis by serology, warts, and HSV clinically and warts clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Dave [<xref rid="B31" ref-type="bibr">133</xref>];<break></break>NSU, CT, GC, syphilis, HSV, HPV (warts), and any</td><td align="left" rowspan="1" colspan="1">Great Britain</td><td align="left" rowspan="1" colspan="1">2000</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Large-scale, stratified, probability sample survey<break></break></td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Dickson et al. [<xref rid="B34" ref-type="bibr">157</xref>];<break></break>HSV and any</td><td align="left" rowspan="1" colspan="1">Dunedin, New Zealand</td><td align="left" rowspan="1" colspan="1">1999</td><td align="left" rowspan="1" colspan="1">Birth cohort from 1972 to 1973</td><td align="left" rowspan="1" colspan="1">Prospective cohort repeatedly studied from birth<break></break></td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Dickson et al. [<xref rid="B35" ref-type="bibr">51</xref>];<break></break>any</td><td align="left" rowspan="1" colspan="1">Dunedin, New Zealand</td><td align="left" rowspan="1" colspan="1">From 2004 to 2005</td><td align="left" rowspan="1" colspan="1">Birth cohort from 1972 to 1973</td><td align="left" rowspan="1" colspan="1">Prospective cohort repeatedly studied from birth</td><td align="left" rowspan="1" colspan="1">Life-time medical records</td><td align="left" rowspan="1" colspan="1">Life-time medical records</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Dickson et al. [<xref rid="B36" ref-type="bibr">158</xref>]; HPV</td><td align="left" rowspan="1" colspan="1">Dunedin, New Zealand</td><td align="left" rowspan="1" colspan="1">From 2004 to 2005</td><td align="left" rowspan="1" colspan="1">Birth cohort from 1972 to 1973</td><td align="left" rowspan="1" colspan="1">Prospective cohort repeatedly studied from birth</td><td align="left" rowspan="1" colspan="1">Life-time medical records</td><td align="left" rowspan="1" colspan="1">Serology for 6, 11, 16, and 18</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Dinh [<xref rid="B37" ref-type="bibr">71</xref>];<break></break>HPV (warts)</td><td align="left" rowspan="1" colspan="1">United States</td><td align="left" rowspan="1" colspan="1">From 1999 to 2004</td><td align="left" rowspan="1" colspan="1">Random sample of general population aged from 18 to 59</td><td align="left" rowspan="1" colspan="1">National survey NHANES</td><td align="left" rowspan="1" colspan="1">Patient report using visual aids</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Diseker [<xref rid="B40" ref-type="bibr">159</xref>];<break></break>CT, GC, syphilis, <break></break>and any</td><td align="left" rowspan="1" colspan="1">Baltimore, Denver, Long Beach, San Francisco</td><td align="left" rowspan="1" colspan="1">From July 1993 to September 1996</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Part of RCT, baseline analysis, and cohort analysis<break></break></td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">GC by culture, chlamydia by urine PCR, and syphilis by serology</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Donovan [<xref rid="B43" ref-type="bibr">160</xref>];<break></break>NSU, GC, syphilis, HSV, and HPV (warts)</td><td align="left" rowspan="1" colspan="1">Sydney, Australia</td><td align="left" rowspan="1" colspan="1">From December 1990 to May 1991</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample of heterosexual men<break></break></td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">NGU by clinical picture and microscopy, TPHA for syphilis, HSV by cell culture or clinical criteria, and warts clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Fergusson [<xref rid="B47" ref-type="bibr">138</xref>];<break></break>CT, and any</td><td align="left" rowspan="1" colspan="1">Christchurch, New Zealand</td><td align="left" rowspan="1" colspan="1">From 1998 and 2002</td><td align="left" rowspan="1" colspan="1">Birth cohort from 1977</td><td align="left" rowspan="1" colspan="1">Prospective cohort repeatedly studied from birth<break></break></td><td align="left" rowspan="1" colspan="1">Report and medical records</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris [<xref rid="B48" ref-type="bibr">161</xref>];<break></break>any, warts, CT, HSV, GC, and NSU</td><td align="left" rowspan="1" colspan="1">Australia</td><td align="left" rowspan="1" colspan="1">2005</td><td align="left" rowspan="1" colspan="1">16–64 years old</td><td align="left" rowspan="1" colspan="1">Representative national sample</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Gebremedhin [<xref rid="B51" ref-type="bibr">52</xref>, <xref rid="B50" ref-type="bibr">162</xref>]; any</td><td align="left" rowspan="1" colspan="1">Africa</td><td align="left" rowspan="1" colspan="1">2003–2007</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">18 national demographic health surveys</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Giuliano et al. [<xref rid="B61" ref-type="bibr">102</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Sao Paulo, <break></break>Brazil; Morelos, Mexico, Central Florida</td><td align="left" rowspan="1" colspan="1">2005 and 2006</td><td align="left" rowspan="1" colspan="1">18–70 years old, no previous warts, and no STD or HIV<break></break></td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Glans, sulcus, shaft, and scrotum</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Gottlieb [<xref rid="B64" ref-type="bibr">62</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Baltimore, Denver, Long Beach, San Francisco</td><td align="left" rowspan="1" colspan="1">From July 1993 to September 1996</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Part of RCT cohort analysis</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B65" ref-type="bibr">44</xref>, <xref rid="B66" ref-type="bibr">163</xref>], <break></break>GDS, CT, GC, Lues, HSV, and GUD</td><td align="left" rowspan="1" colspan="1">Rakai, Uganda</td><td align="left" rowspan="1" colspan="1">From November 1994 to October 1998</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Randomized cluster of general population</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Urine PCR (GC and CT), serology (HSV and syphilis), and clinically (GUD) </td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B68" ref-type="bibr">53</xref>];<break></break>GUD</td><td align="left" rowspan="1" colspan="1">Rakai, Uganda</td><td align="left" rowspan="1" colspan="1">Completed December 2006</td><td align="left" rowspan="1" colspan="1">Men 15–45 who wanted a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized controlled trial</td><td align="left" rowspan="1" colspan="1">Intention to treat</td><td align="left" rowspan="1" colspan="1">GUD on physical examination</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Hand [<xref rid="B70" ref-type="bibr">25</xref>];<break></break>GC, syphilis, and chancroid</td><td align="left" rowspan="1" colspan="1">US Naval Hospital St. Albans, NY</td><td align="left" rowspan="1" colspan="1">1945</td><td align="left" rowspan="1" colspan="1">Sailors</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Not documented</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Harbertson [<xref rid="B71" ref-type="bibr">164</xref>];<break></break>any STI</td><td align="left" rowspan="1" colspan="1">Rwanda</td><td align="left" rowspan="1" colspan="1">From October 2008 to November 2010</td><td align="left" rowspan="1" colspan="1">Active duty soldiers ≥21 years old in Rwanda Defense Forces from 46 military sites</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Hart [<xref rid="B72" ref-type="bibr">69</xref>];<break></break>chancroid</td><td align="left" rowspan="1" colspan="1">Australia</td><td align="left" rowspan="1" colspan="1">1970</td><td align="left" rowspan="1" colspan="1">Soldiers, STD clinic</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Clinical diagnosis</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Hart [<xref rid="B73" ref-type="bibr">165</xref>];<break></break>CT and GC</td><td align="left" rowspan="1" colspan="1">South Australia</td><td align="left" rowspan="1" colspan="1">From 1988 to 1990</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Chlamydia by enzyme immunoassay and GC by smear and culture</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Hernandez [<xref rid="B75" ref-type="bibr">35</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Hawaii</td><td align="left" rowspan="1" colspan="1">From July 2004 to December 2006</td><td align="left" rowspan="1" colspan="1">University students ≥18 years old<break></break></td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">HPV swabbed glans, sulcus, shaft, scrotum, and inner foreskin</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Hutchinson [<xref rid="B78" ref-type="bibr">1</xref>];<break></break>GUD versus GDS</td><td align="left" rowspan="1" colspan="1">Metropolitan Free Hospital, London<break></break></td><td align="left" rowspan="1" colspan="1">Past year's experience</td><td align="left" rowspan="1" colspan="1">Men with an STD</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Jew versus Gentile</td><td align="left" rowspan="1" colspan="1">Clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Kapiga [<xref rid="B199" ref-type="bibr">166</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Moshi, Tanzania</td><td align="left" rowspan="1" colspan="1">From June to October 2000</td><td align="left" rowspan="1" colspan="1">Hotel and bar workers</td><td align="left" rowspan="1" colspan="1">Randomized sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Klavs [<xref rid="B85" ref-type="bibr">167</xref>];<break></break>any</td><td align="left" rowspan="1" colspan="1">Slovenia</td><td align="left" rowspan="1" colspan="1">1999–2001</td><td align="left" rowspan="1" colspan="1">Men 18–49 years old</td><td align="left" rowspan="1" colspan="1">National probability sample</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Lajous [<xref rid="B87" ref-type="bibr">100</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Mexico</td><td align="left" rowspan="1" colspan="1">From July 2000 to July 2003</td><td align="left" rowspan="1" colspan="1">Healthy military men</td><td align="left" rowspan="1" colspan="1">Cross-sectional study</td><td align="left" rowspan="1" colspan="1">Physical exam performed but analysis based on report</td><td align="left" rowspan="1" colspan="1">HPV DNA</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Langeni [<xref rid="B88" ref-type="bibr">85</xref>];<break></break>any</td><td align="left" rowspan="1" colspan="1">Botswana</td><td align="left" rowspan="1" colspan="1">2001</td><td align="left" rowspan="1" colspan="1">Men 15–64 who had intercourse</td><td align="left" rowspan="1" colspan="1">National represented sample</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">GDS or GDS by report in the past 12 months</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann [<xref rid="B91" ref-type="bibr">89</xref>];<break></break>NSU, CT, GC, syphilis, HSV, and any</td><td align="left" rowspan="1" colspan="1">United States</td><td align="left" rowspan="1" colspan="1">1992</td><td align="left" rowspan="1" colspan="1">Men 18–59 years old</td><td align="left" rowspan="1" colspan="1">National probability sample</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys [<xref rid="B93" ref-type="bibr">168</xref>];<break></break>GDS, syphilis, HSV, HPV (warts), GUD, and chancroid</td><td align="left" rowspan="1" colspan="1">Kenya</td><td align="left" rowspan="1" colspan="1">From March 1993 to June 1997</td><td align="left" rowspan="1" colspan="1">HIV negative-truck drivers</td><td align="left" rowspan="1" colspan="1">Prospective cohort study and convenience sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Chlamydia by serology assay, TPHA & RPR (syphilis), HSV by serology assay, warts clinically, and chancroid by serology assay</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Lloyd [<xref rid="B95" ref-type="bibr">57</xref>];<break></break>GC, Syphilis, and chancroid</td><td align="left" rowspan="1" colspan="1">Guy's Hospital, London</td><td align="left" rowspan="1" colspan="1">From January to June 1932</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Clinically and soft chancre clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Lu [<xref rid="B96" ref-type="bibr">84</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Tucscon, Arizona; Tampa, Florida</td><td align="left" rowspan="1" colspan="1">From September 2003 to December 2005</td><td align="left" rowspan="1" colspan="1">18–40 year old sexually active males with no previous genital warts or penile cancer or current STD</td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Glans, shaft, and scrotum</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mallon [<xref rid="B98" ref-type="bibr">24</xref>];<break></break>HSV and HPV (warts)</td><td align="left" rowspan="1" colspan="1">Chelsea and Westminster Hospital, London</td><td align="left" rowspan="1" colspan="1">1994–1997</td><td align="left" rowspan="1" colspan="1">Patients referred to a dermatology specialty clinic<break></break></td><td align="left" rowspan="1" colspan="1">Retrospective case control</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Not documented</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mandal [<xref rid="B200" ref-type="bibr">169</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">United Kingdom</td><td align="left" rowspan="1" colspan="1"> </td><td align="left" rowspan="1" colspan="1">STD clinic and men with no evidence of clinical anogenital warts</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Cytology of swabs from urethra, glans, shaft, and anorectal</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mattson [<xref rid="B99" ref-type="bibr">170</xref>];<break></break>any</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya</td><td align="left" rowspan="1" colspan="1">2002–2006</td><td align="left" rowspan="1" colspan="1">18–24 year olds who wanted a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized clinical trial</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">PCR for GC and CT and culture for <italic>T. vaginalis </italic></td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mehta et al. [<xref rid="B100" ref-type="bibr">171</xref>]; <break></break>GC chlamydia</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya</td><td align="left" rowspan="1" colspan="1">2002–2006</td><td align="left" rowspan="1" colspan="1">Men interested in a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized clinical trial</td><td align="left" rowspan="1" colspan="1">Intention to treat</td><td align="left" rowspan="1" colspan="1">Urine for GC and chlamydia</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mehta et al. [<xref rid="B102" ref-type="bibr">172</xref>];<break></break>HSV, Lues, and GUD</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya</td><td align="left" rowspan="1" colspan="1">2002–2006</td><td align="left" rowspan="1" colspan="1">18–24 year old men who wanted a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized clinical trial</td><td align="left" rowspan="1" colspan="1">Intention to treat</td><td align="left" rowspan="1" colspan="1">Serology (Lues and HSV) and Clinically identified (GUD)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mor [<xref rid="B105" ref-type="bibr">173</xref>];<break></break>syphilis</td><td align="left" rowspan="1" colspan="1">San Francisco</td><td align="left" rowspan="1" colspan="1">From January 1996 to December 2005</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Not documented</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mujugira [<xref rid="B113" ref-type="bibr">174</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda, Zambia</td><td align="left" rowspan="1" colspan="1">From November 2004 and April 2007</td><td align="left" rowspan="1" colspan="1">HIV-negative partners of women who are HIV and HSV positive<break></break></td><td align="left" rowspan="1" colspan="1">Discordant couples</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Müller [<xref rid="B201" ref-type="bibr">175</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Alexandra, Johannesburg, South Africa</td><td align="left" rowspan="1" colspan="1">From December 2006 to July 2008</td><td align="left" rowspan="1" colspan="1">18+ sexually active attending HIV testing clinic</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Glans, sulcus, and shaft</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Mwandi [<xref rid="B114" ref-type="bibr">88</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Kenya</td><td align="left" rowspan="1" colspan="1">From August to December 2007</td><td align="left" rowspan="1" colspan="1">General population from 15 to 64 years old</td><td align="left" rowspan="1" colspan="1">Representative samples of households</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Nasio [<xref rid="B116" ref-type="bibr">98</xref>];<break></break>GUD versus GDS</td><td align="left" rowspan="1" colspan="1">Nairobi</td><td align="left" rowspan="1" colspan="1">From January to September 1993</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Newell [<xref rid="B117" ref-type="bibr">176</xref>];<break></break>GDS, syphilis, and GUD</td><td align="left" rowspan="1" colspan="1">Mwanza Region, Tanzania</td><td align="left" rowspan="1" colspan="1">From 1990 to 1991</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Random cluster sample survey<break></break></td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Report (GDS and GUD) and serology (syphilis) </td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Ng'ayo [<xref rid="B118" ref-type="bibr">177</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Fishermen along Lake Victoria ≥18 years of age</td><td align="left" rowspan="1" colspan="1">Random cluster sample cross-sectional survey</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Ng'ayo [<xref rid="B119" ref-type="bibr">178</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Fishermen along Lake Victoria ≥18 years of age</td><td align="left" rowspan="1" colspan="1">Random cluster sample cross-sectional survey</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Swab of glans, corona, shaft, scrotum, and perianal</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Nielson [<xref rid="B121" ref-type="bibr">179</xref>]; HPV</td><td align="left" rowspan="1" colspan="1">Tucscon, Arizona; Tampa, Florida</td><td align="left" rowspan="1" colspan="1">2002–2005</td><td align="left" rowspan="1" colspan="1">18–40 year old sexually active males with no previous genital warts or penile cancer or current STD</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Swab of glans, sulcus, shaft, scrotum, perianal area, and urethra (optional) </td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Obasi [<xref rid="B123" ref-type="bibr">63</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Rural Mwanza Region, Tanzania</td><td align="left" rowspan="1" colspan="1">May and June 1993</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Nested case-control study within an RCT</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Type specific ELISA for HSV2</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Oglivie [<xref rid="B124" ref-type="bibr">180</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">British Columbia, Canada</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">STD clinic never MSM</td><td align="left" rowspan="1" colspan="1">Cross-sectional study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Glans, foreskin, shaft, and scrotum</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Oriel [<xref rid="B125" ref-type="bibr">29</xref>];<break></break>HPV (warts)</td><td align="left" rowspan="1" colspan="1">St. Thomas Hospital, London</td><td align="left" rowspan="1" colspan="1">From October 1967 to January 1979</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Not documented</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Otieno-Nyunya [<xref rid="B126" ref-type="bibr">181</xref>]; Lues</td><td align="left" rowspan="1" colspan="1">Kenya</td><td align="left" rowspan="1" colspan="1">2007</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Nationally representative population-based serosurvey</td><td align="left" rowspan="1" colspan="1">Find article</td><td align="left" rowspan="1" colspan="1">Serology</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Parker [<xref rid="B127" ref-type="bibr">140</xref>];<break></break>NSU, CT, GC, syphilis, HSV, HPV (warts), and any</td><td align="left" rowspan="1" colspan="1">Perth, Australia</td><td align="left" rowspan="1" colspan="1">From May to September 1981<break></break></td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Report and physical exam</td><td align="left" rowspan="1" colspan="1">Cultures and microscopy (NSU, CT, and GC), serology (syphilis) culture (HSV) and warts clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Partridge [<xref rid="B128" ref-type="bibr">182</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Seattle, Washington</td><td align="left" rowspan="1" colspan="1">From June 2003 to March 2006 recruitment</td><td align="left" rowspan="1" colspan="1">University of Washington students 18–20 years old history of vaginal intercourse</td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">HPV swabs of penile shaft, glans, foreskin, scrotum, and urine.</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Rakwar [<xref rid="B130" ref-type="bibr">70</xref>];<break></break>chancroid</td><td align="left" rowspan="1" colspan="1">Mombasa, Kenya</td><td align="left" rowspan="1" colspan="1">Beginning of March 1993</td><td align="left" rowspan="1" colspan="1">Long-distance truckers</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Serology and culture of genital ulcers</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Reynolds [<xref rid="B132" ref-type="bibr">183</xref>];<break></break>GC, syphilis, and HSV</td><td align="left" rowspan="1" colspan="1">Pune, India</td><td align="left" rowspan="1" colspan="1">1993–2000</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Positive gram stain of urethral discharge (GC), RPR, or darkfield (syphilis). Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Richters [<xref rid="B133" ref-type="bibr">184</xref>];<break></break>GC, HSV, <break></break>NSU, and any</td><td align="left" rowspan="1" colspan="1">Australia</td><td align="left" rowspan="1" colspan="1">From May 2001 to June 2002</td><td align="left" rowspan="1" colspan="1">Males 16–59</td><td align="left" rowspan="1" colspan="1">National probability sample</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz [<xref rid="B134" ref-type="bibr">185</xref>];<break></break>any, GC, syphilis, HSV, warts, and CT</td><td align="left" rowspan="1" colspan="1">San Juan, Puerto Rico</td><td align="left" rowspan="1" colspan="1">From October 2009 to December 2011</td><td align="left" rowspan="1" colspan="1">STD clinic and Males from 16 to 83 years old</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Rombaldi [<xref rid="B135" ref-type="bibr">186</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Caxias do Sul, Brazil</td><td align="left" rowspan="1" colspan="1">From February 2003 to July 2004</td><td align="left" rowspan="1" colspan="1">Sexual partners of women with CIN</td><td align="left" rowspan="1" colspan="1">Prospective, prevalence study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Penoscopy and sampling of urethra, glans, preputial mucosa, and shaft</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Schneider [<xref rid="B202" ref-type="bibr">187</xref>];<break></break>HSV and syphilis</td><td align="left" rowspan="1" colspan="1">Guntur district of Andhra Pradesh, India<break></break></td><td align="left" rowspan="1" colspan="1">From September 2004 to September 2005</td><td align="left" rowspan="1" colspan="1">15–49 year olds general populations</td><td align="left" rowspan="1" colspan="1">Random clusters<break></break></td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Serology</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek [<xref rid="B139" ref-type="bibr">58</xref>];<break></break>GC, syphilis <break></break>and any</td><td align="left" rowspan="1" colspan="1">Hines Veteran Hospital, Illinois</td><td align="left" rowspan="1" colspan="1">1931–1944</td><td align="left" rowspan="1" colspan="1">World War I veterans</td><td align="left" rowspan="1" colspan="1">Cross-sectional study<break></break></td><td align="left" rowspan="1" colspan="1">Age at circumcision by report</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Seed [<xref rid="B141" ref-type="bibr">188</xref>];<break></break>GDS, syphilis, GUD and any</td><td align="left" rowspan="1" colspan="1">Rwanda</td><td align="left" rowspan="1" colspan="1">From March to October 1991</td><td align="left" rowspan="1" colspan="1">Steady sexual partner of women enrolled in Project San Francisco</td><td align="left" rowspan="1" colspan="1">Cross-sectional study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Report (GDS and GUD) and RPR (syphilis) </td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Shin [<xref rid="B143" ref-type="bibr">189</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Busan, South Korea</td><td align="left" rowspan="1" colspan="1">From August 29 to September 30, 2002</td><td align="left" rowspan="1" colspan="1">University students</td><td align="left" rowspan="1" colspan="1">Cross section</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Continuous swab for HPV DNA from scrotum to top of glans</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Simonsen [<xref rid="B144" ref-type="bibr">190</xref>];<break></break>GUD</td><td align="left" rowspan="1" colspan="1">Nairobi</td><td align="left" rowspan="1" colspan="1">From March to December 1986</td><td align="left" rowspan="1" colspan="1">STD clinic and men with an STD from a prostitute</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Chancroid by culture</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Smith [<xref rid="B145" ref-type="bibr">191</xref>];<break></break>NSU and GC</td><td align="left" rowspan="1" colspan="1">US military post</td><td align="left" rowspan="1" colspan="1">From January 1983 to September 1984</td><td align="left" rowspan="1" colspan="1">US Army personnel</td><td align="left" rowspan="1" colspan="1">Cross section</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">CDC criteria and culture</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Sobngwi-Tambekou [<xref rid="B147" ref-type="bibr">192</xref>];<break></break>GC, CT and HSV</td><td align="left" rowspan="1" colspan="1">Orange Farm, South Africa</td><td align="left" rowspan="1" colspan="1">2005</td><td align="left" rowspan="1" colspan="1">Males interest in a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized clinical trial</td><td align="left" rowspan="1" colspan="1">Intention to treat</td><td align="left" rowspan="1" colspan="1">Urine samples for GC and CT and serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Suligoi [<xref rid="B151" ref-type="bibr">64</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Garoua, northern Cameroon</td><td align="left" rowspan="1" colspan="1">From December 1997 to January 1998</td><td align="left" rowspan="1" colspan="1">General medical outpatients without complaints of STD or HIV</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">HSV by ELISA</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Svare [<xref rid="B152" ref-type="bibr">193</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Copenhagen, Denmark</td><td align="left" rowspan="1" colspan="1">From March to December 1993</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Report</td><td align="left" rowspan="1" colspan="1">Penile swab for PCR</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Talukdar [<xref rid="B153" ref-type="bibr">194</xref>];<break></break>GC and <break></break>syphilis</td><td align="left" rowspan="1" colspan="1">Kolkata, India</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Homeless men 18–49 years old</td><td align="left" rowspan="1" colspan="1">Cluster design among homeless men</td><td align="left" rowspan="1" colspan="1">Religion</td><td align="left" rowspan="1" colspan="1">Urine PCR (GC) TPHA (syphilis)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor [<xref rid="B155" ref-type="bibr">195</xref>];<break></break>NSU, GC, <break></break>HSV, and any</td><td align="left" rowspan="1" colspan="1">Whitechapel Clinic, The London Hospital</td><td align="left" rowspan="1" colspan="1">From June 1970 to August 1973</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample with randomly selected controls</td><td align="left" rowspan="1" colspan="1">Chart review (10.9% missing)</td><td align="left" rowspan="1" colspan="1">Clinical diagnosis and HSV2 by culture</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Telzak [<xref rid="B157" ref-type="bibr">60</xref>];<break></break>GUD</td><td align="left" rowspan="1" colspan="1">New York City</td><td align="left" rowspan="1" colspan="1">1988–1991</td><td align="left" rowspan="1" colspan="1">STD clinic</td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Dark field, RPR, culture, Tzanck smear, and clinical diagnosis</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Thomas [<xref rid="B158" ref-type="bibr">68</xref>];<break></break>any</td><td align="left" rowspan="1" colspan="1">United States Military</td><td align="left" rowspan="1" colspan="1">From February 1997 to June 2001</td><td align="left" rowspan="1" colspan="1">HIV-positive cases and HIV negative controls</td><td align="left" rowspan="1" colspan="1">Case control</td><td align="left" rowspan="1" colspan="1">Medical records/patient report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Tobian et al. [<xref rid="B159" ref-type="bibr">82</xref>];<break></break>HPV, HSV, syphilis, GDS, and GUD</td><td align="left" rowspan="1" colspan="1">Rakai, Uganda</td><td align="left" rowspan="1" colspan="1">Ended December 2006</td><td align="left" rowspan="1" colspan="1">Men 15–45 who wanted a free circumcision</td><td align="left" rowspan="1" colspan="1">Randomized clinical trial</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Swab of glans and sulcus (HPV) and serology (HSV and syphilis) </td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Todd [<xref rid="B164" ref-type="bibr">145</xref>];<break></break>syphilis</td><td align="left" rowspan="1" colspan="1">Mwanza, Tanzania</td><td align="left" rowspan="1" colspan="1">From 1991 to 1994</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Community randomized trial nested case control</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">RPR and VDRL</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Tseng [<xref rid="B166" ref-type="bibr">66</xref>];<break></break>HPV (warts)</td><td align="left" rowspan="1" colspan="1">Los Angeles, California</td><td align="left" rowspan="1" colspan="1">From May 1975 to October 1985</td><td align="left" rowspan="1" colspan="1">Cases of penile cancer and matched controls and mean age 55.9 and 56.2, respectively</td><td align="left" rowspan="1" colspan="1">Case control</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Patient report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Tyndall [<xref rid="B167" ref-type="bibr">137</xref>];<break></break>GDS and GUD</td><td align="left" rowspan="1" colspan="1">Nairobi</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">STD clinic and men with genital ulcers</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Report</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Uganda [<xref rid="B103" ref-type="bibr">73</xref>];<break></break>syphilis</td><td align="left" rowspan="1" colspan="1">Uganda</td><td align="left" rowspan="1" colspan="1">From February to September 2011</td><td align="left" rowspan="1" colspan="1">Adults from 15 to 59</td><td align="left" rowspan="1" colspan="1">National representative population-based survey</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Serology</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa [<xref rid="B168" ref-type="bibr">79</xref>];<break></break>syphilis <break></break>and any</td><td align="left" rowspan="1" colspan="1">Mwanza Region, Tanzania</td><td align="left" rowspan="1" colspan="1">Study 1: 1990-1991. <break></break>Study 2: 1994-1995. <break></break>Study 3: 1994. <break></break>Study 4: 1991–1993.<break></break>Study 5: 1992.</td><td align="left" rowspan="1" colspan="1">Study 1: GP*<sub>.</sub>
<break></break>Study 2: GP. <break></break>Study 3: fishing villages. <break></break>Study 4: factory workers. <break></break>Study 5: GP*<sub>.</sub></td><td align="left" rowspan="1" colspan="1">Study 1: stratified random cluster sample. <break></break>Study 2: community study.<break></break>Study 3: cluster sample survey.<break></break>Study 4: intake data of cohort study. <break></break>Study 5: baseline round of longitudinal cohort study to assess community level STD control measures impact on HIV.</td><td align="left" rowspan="1" colspan="1">Study 1, 2, 3, and 5: report. <break></break>Study 4: physical exam.</td><td align="left" rowspan="1" colspan="1">RPR for syphilis and patient report for any STI</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Vaccarella [<xref rid="B169" ref-type="bibr">86</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Mexico, 27 public clinics in 14 states</td><td align="left" rowspan="1" colspan="1">From January 2003 to September 2004</td><td align="left" rowspan="1" colspan="1">Men attending vasectomy clinic</td><td align="left" rowspan="1" colspan="1">Consecutive sample<break></break></td><td align="left" rowspan="1" colspan="1">Physical exam in Mexico<break></break></td><td align="left" rowspan="1" colspan="1">Complete swab from scrotum to urethra</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">VanBuskirk [<xref rid="B170" ref-type="bibr">32</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Seattle, Washington</td><td align="left" rowspan="1" colspan="1">From June 2003 to March 2006 recruitment <break></break>data through April 2010</td><td align="left" rowspan="1" colspan="1"> University of Washington students 18–20 years old history of vaginal intercourse</td><td align="left" rowspan="1" colspan="1">Prospective cohort study</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">HPV swabs of penile shaft, glans, foreskin, scrotum, and urine.</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Van Den <break></break>Eeden [<xref rid="B171" ref-type="bibr">67</xref>];<break></break>HPV (warts)</td><td align="left" rowspan="1" colspan="1">Seattle, Washington</td><td align="left" rowspan="1" colspan="1">From April 1987 to September 1991</td><td align="left" rowspan="1" colspan="1">Men ≥ 18 years with condylomata acuminata and matched controls in 4 HMO clinics</td><td align="left" rowspan="1" colspan="1">Case control</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">Clinical exam</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Van Wagoner [<xref rid="B182" ref-type="bibr">196</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Birmingham, Alabama</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">STD clinic and self-identified heterosexual men</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Serology and culture</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Vardas [<xref rid="B183" ref-type="bibr">197</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Not reported</td><td align="left" rowspan="1" colspan="1">18 countries in Africa, Asia-Pacific, Europe, Latin America, and North America</td><td align="left" rowspan="1" colspan="1">Heterosexual men from 16 to 24 years with 1 to 5 lifetime female partners</td><td align="left" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">Serology for 6, 11, 16, and 18; swab of penis, scrotum, perineum, and perianal (HPV) </td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Warner [<xref rid="B186" ref-type="bibr">87</xref>];<break></break>GDS, GUD, <break></break>and GUD <break></break>versus GDS</td><td align="left" rowspan="1" colspan="1">Baltimore, MD</td><td align="left" rowspan="1" colspan="1">From 1993 to 2000</td><td align="left" rowspan="1" colspan="1">Heterosexual African American men undergoing HIV testing at STD clinics</td><td align="left" rowspan="1" colspan="1">Chart review</td><td align="left" rowspan="1" colspan="1">Physical exam documented in medical record</td><td align="left" rowspan="1" colspan="1">Clinical exam</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Vaz [<xref rid="B203" ref-type="bibr">198</xref>];<break></break>syphilis</td><td align="left" rowspan="1" colspan="1">Maputo, Mozambique</td><td align="left" rowspan="1" colspan="1">From 1990 to 1991</td><td align="left" rowspan="1" colspan="1">Prisoners</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Patient report</td><td align="left" rowspan="1" colspan="1">RPR and FTA</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Weaver [<xref rid="B188" ref-type="bibr">31</xref>];<break></break>HPV</td><td align="left" rowspan="1" colspan="1">Seattle, Washington</td><td align="left" rowspan="1" colspan="1">Part 1: from August 1 to October 30, 2000 and<break></break>part 2: May 3, from 2001 to July 9, 2002</td><td align="left" rowspan="1" colspan="1">Part 1: heterosexual men 18–25 years old attending STD clinic. <break></break>Part 2: sexually active undergraduate male students 18–25 years old</td><td align="left" rowspan="1" colspan="1">Consecutive sample</td><td align="left" rowspan="1" colspan="1">Physical exam</td><td align="left" rowspan="1" colspan="1">HPV swabs of penile shaft, glans, foreskin, scrotum, and urine.</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Weiss [<xref rid="B189" ref-type="bibr">65</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">Kisumu, Kenya; Ndola, Zambia; Cotonou, Benin; Yaondé, Cameroon</td><td align="left" rowspan="1" colspan="1">From June 1997 to March 1998</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">Cluster design to randomly select households</td><td align="left" rowspan="1" colspan="1">Physical exam and self-report</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Wilson [<xref rid="B192" ref-type="bibr">23</xref>];<break></break>NSU, GC, <break></break>Lues, and HPV (warts)</td><td align="left" rowspan="1" colspan="1">Canada</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Canadian Army VD treatment center</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Not documented</td><td align="left" rowspan="1" colspan="1">Not documented</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Wolbarst [<xref rid="B195" ref-type="bibr">56</xref>];<break></break>GUD versus GDS</td><td align="left" rowspan="1" colspan="1">New York City</td><td align="left" rowspan="1" colspan="1">Before 1914 to 1926</td><td align="left" rowspan="1" colspan="1">Private patients in urology practice</td><td align="left" rowspan="1" colspan="1">Convenience sample</td><td align="left" rowspan="1" colspan="1">Jew versus Gentile</td><td align="left" rowspan="1" colspan="1">Clinically</td></tr><tr><td align="left" colspan="7" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Xu [<xref rid="B197" ref-type="bibr">199</xref>];<break></break>HSV</td><td align="left" rowspan="1" colspan="1">United States</td><td align="left" rowspan="1" colspan="1">1999–2004</td><td align="left" rowspan="1" colspan="1">General population</td><td align="left" rowspan="1" colspan="1">National health survey</td><td align="left" rowspan="1" colspan="1">Patient report using visual aids</td><td align="left" rowspan="1" colspan="1">Serology (HSV)</td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Meta-analysis of circumcision status of adult males and incidence of sexually transmitted infections using Poisson regression.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact infections/patient years</th><th align="center" rowspan="1" colspan="1">Circumcised infections/patient years</th><th align="center" rowspan="1" colspan="1">Relative risk</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">GDS</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian; unadjusted</td><td align="center" rowspan="1" colspan="1">60/2790</td><td align="center" rowspan="1" colspan="1">53/2740</td><td align="center" rowspan="1" colspan="1">1.1118</td><td align="center" rowspan="1" colspan="1">0.7684–1.6086</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian; 6 weeks*</td><td align="center" rowspan="1" colspan="1">60/2790</td><td align="center" rowspan="1" colspan="1">53/2423.85</td><td align="center" rowspan="1" colspan="1">0.9835</td><td align="center" rowspan="1" colspan="1">0.6797–1.4230</td></tr><tr><td align="left" rowspan="1" colspan="1">Chlamydia</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Diseker</td><td align="center" rowspan="1" colspan="1">36/346</td><td align="center" rowspan="1" colspan="1">88/1109</td><td align="center" rowspan="1" colspan="1">1.3073</td><td align="center" rowspan="1" colspan="1">0.8872–1.9267</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta</td><td align="center" rowspan="1" colspan="1">101/2091</td><td align="center" rowspan="1" colspan="1">88/2027.5</td><td align="center" rowspan="1" colspan="1">1.1128</td><td align="center" rowspan="1" colspan="1">0.8362–1.4810</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta; 6 weeks*</td><td align="center" rowspan="1" colspan="1">101/2091</td><td align="center" rowspan="1" colspan="1">1875.43</td><td align="center" rowspan="1" colspan="1">1.0294</td><td align="center" rowspan="1" colspan="1">0.7735–1.3700</td></tr><tr><td align="left" rowspan="1" colspan="1"> SOB</td><td align="center" rowspan="1" colspan="1">32/1541.75</td><td align="center" rowspan="1" colspan="1">19/1550.5</td><td align="center" rowspan="1" colspan="1">1.6938</td><td align="center" rowspan="1" colspan="1">0.9601–2.9880</td></tr><tr><td align="left" rowspan="1" colspan="1"> SOB; 6 weeks*</td><td align="center" rowspan="1" colspan="1">32/1541.75</td><td align="center" rowspan="1" colspan="1">19/1448.27</td><td align="center" rowspan="1" colspan="1">1.5820</td><td align="center" rowspan="1" colspan="1">0.8968–2.7910</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.2638</bold></td><td align="center" rowspan="1" colspan="1"><bold>1.0194–1.5669</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary; 6 weeks*</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1973</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.9648–1.4859</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Gonorrhea</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Diseker</td><td align="center" rowspan="1" colspan="1">36/346</td><td align="center" rowspan="1" colspan="1">83/1109</td><td align="center" rowspan="1" colspan="1">1.3903</td><td align="center" rowspan="1" colspan="1">0.9402–2.0557</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta</td><td align="center" rowspan="1" colspan="1">74/2102</td><td align="center" rowspan="1" colspan="1">70/2065</td><td align="center" rowspan="1" colspan="1">1.0385</td><td align="center" rowspan="1" colspan="1">0.7490–1.4399</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta; 6 weeks*</td><td align="center" rowspan="1" colspan="1">74/2102</td><td align="center" rowspan="1" colspan="1">70/1912.92</td><td align="center" rowspan="1" colspan="1">0.9620</td><td align="center" rowspan="1" colspan="1">0.6938–1.3339</td></tr><tr><td align="left" rowspan="1" colspan="1"> SOB</td><td align="center" rowspan="1" colspan="1">91/1541.75</td><td align="center" rowspan="1" colspan="1">89/1550.5</td><td align="center" rowspan="1" colspan="1">1.0283</td><td align="center" rowspan="1" colspan="1">0.7677–1.3772</td></tr><tr><td align="left" rowspan="1" colspan="1"> SOB; 6 weeks*</td><td align="center" rowspan="1" colspan="1">91/1541.75</td><td align="center" rowspan="1" colspan="1">89/1448.27</td><td align="center" rowspan="1" colspan="1">0.9605</td><td align="center" rowspan="1" colspan="1">0.7171–1.2864</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1053</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.9116–1.3402</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary; 6 weeks*</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.0448</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.8611–1.2677</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">GUD</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta</td><td align="center" rowspan="1" colspan="1">101/1950</td><td align="center" rowspan="1" colspan="1">51/1912</td><td align="center" rowspan="1" colspan="1">1.9418</td><td align="center" rowspan="1" colspan="1">1.3800–2.7191</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta; 6 weeks*</td><td align="center" rowspan="1" colspan="1">101/1950</td><td align="center" rowspan="1" colspan="1">51/1753.81</td><td align="center" rowspan="1" colspan="1">1.7812</td><td align="center" rowspan="1" colspan="1">1.2720–2.4940</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian</td><td align="center" rowspan="1" colspan="1">75/2790</td><td align="center" rowspan="1" colspan="1">48/2740</td><td align="center" rowspan="1" colspan="1">1.5349</td><td align="center" rowspan="1" colspan="1">1.0681–2.2045</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian; 6 weeks*</td><td align="center" rowspan="1" colspan="1">75/2790</td><td align="center" rowspan="1" colspan="1">48/2581.92</td><td align="center" rowspan="1" colspan="1">1.4460</td><td align="center" rowspan="1" colspan="1">1.0065–2.0774</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.7444</bold></td><td align="center" rowspan="1" colspan="1"><bold>1.3637–2.2313</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary; 6 weeks*</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.6195</bold></td><td align="center" rowspan="1" colspan="1"><bold>1.2660–2.0716</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Syphilis</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Diseker</td><td align="center" rowspan="1" colspan="1">4/347</td><td align="center" rowspan="1" colspan="1">6/1109</td><td align="center" rowspan="1" colspan="1">2.1306</td><td align="center" rowspan="1" colspan="1">0.5560–7.5504</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta</td><td align="center" rowspan="1" colspan="1">6/1976</td><td align="center" rowspan="1" colspan="1">7/1897.5</td><td align="center" rowspan="1" colspan="1">0.8230</td><td align="center" rowspan="1" colspan="1">0.2766–2.4490</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta; 6 weeks*</td><td align="center" rowspan="1" colspan="1">6/1976</td><td align="center" rowspan="1" colspan="1">7/1741.73</td><td align="center" rowspan="1" colspan="1">0.7558</td><td align="center" rowspan="1" colspan="1">0.2539–2.2481</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian</td><td align="center" rowspan="1" colspan="1">45/4286</td><td align="center" rowspan="1" colspan="1">50/4166</td><td align="center" rowspan="1" colspan="1">0.8748</td><td align="center" rowspan="1" colspan="1">0.5848–1.3087</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian; 6 weeks*</td><td align="center" rowspan="1" colspan="1">45/4286</td><td align="center" rowspan="1" colspan="1">50/3925.65</td><td align="center" rowspan="1" colspan="1">0.8243</td><td align="center" rowspan="1" colspan="1">0.5511–1.2334</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.9267</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.6429–1.3359</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary; 6 weeks*</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.8738</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.6059–1.2600</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">HSV</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Dickson</td><td align="center" rowspan="1" colspan="1">19/2235</td><td align="center" rowspan="1" colspan="1">13/1512</td><td align="center" rowspan="1" colspan="1">0.9888</td><td align="center" rowspan="1" colspan="1">0.4883–2.0019</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta</td><td align="center" rowspan="1" colspan="1">100/1628.5</td><td align="center" rowspan="1" colspan="1">86/1493.5</td><td align="center" rowspan="1" colspan="1">1.0664</td><td align="center" rowspan="1" colspan="1">0.7993–1.4226</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mehta; 6 weeks*</td><td align="center" rowspan="1" colspan="1">100/1628.5</td><td align="center" rowspan="1" colspan="1">86/1379.73</td><td align="center" rowspan="1" colspan="1">0.9852</td><td align="center" rowspan="1" colspan="1">0.7384–1.3145</td></tr><tr><td align="left" rowspan="1" colspan="1"> SOB</td><td align="center" rowspan="1" colspan="1">35/1003</td><td align="center" rowspan="1" colspan="1">23/995</td><td align="center" rowspan="1" colspan="1">1.5095</td><td align="center" rowspan="1" colspan="1">0.8921–2.5546</td></tr><tr><td align="left" rowspan="1" colspan="1"> SOB; 6 weeks*</td><td align="center" rowspan="1" colspan="1">35/1003</td><td align="center" rowspan="1" colspan="1">23/929.39</td><td align="center" rowspan="1" colspan="1">1.4100</td><td align="center" rowspan="1" colspan="1">0.8332–2.3862</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian</td><td align="center" rowspan="1" colspan="1">153/2906.5</td><td align="center" rowspan="1" colspan="1">114/2888.5</td><td align="center" rowspan="1" colspan="1">1.3338</td><td align="center" rowspan="1" colspan="1">1.0466–1.6998</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian; 6 weeks*</td><td align="center" rowspan="1" colspan="1">153/2906.5</td><td align="center" rowspan="1" colspan="1">114/2704.81</td><td align="center" rowspan="1" colspan="1">1.2489</td><td align="center" rowspan="1" colspan="1">0.9800–1.5917</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.2302</bold></td><td align="center" rowspan="1" colspan="1"><bold>1.0381–1.4581</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary; 6 weeks*</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1506</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.9709–1.3636</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">HPV</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Auvert</td><td align="center" rowspan="1" colspan="1">144/1086.25</td><td align="center" rowspan="1" colspan="1">90/1125.25</td><td align="center" rowspan="1" colspan="1">1.5132</td><td align="center" rowspan="1" colspan="1">1.1651–1.9650</td></tr><tr><td align="left" rowspan="1" colspan="1"> Auvert; 6 weeks*</td><td align="center" rowspan="1" colspan="1">144/1086.25</td><td align="center" rowspan="1" colspan="1">90/1051.06</td><td align="center" rowspan="1" colspan="1">1.4134</td><td align="center" rowspan="1" colspan="1">1.0883–1.8355</td></tr><tr><td align="left" rowspan="1" colspan="1"> Auvert ADJ<sup>†</sup></td><td align="center" rowspan="1" colspan="1">217.50/1086.25</td><td align="center" rowspan="1" colspan="1">193.03/1125.25</td><td align="center" rowspan="1" colspan="1">1.0657</td><td align="center" rowspan="1" colspan="1">0.8786–1.2924</td></tr><tr><td align="left" rowspan="1" colspan="1"> Auvert ADJ; 6 weeks<sup>∗†</sup></td><td align="center" rowspan="1" colspan="1">217.50/1086.25</td><td align="center" rowspan="1" colspan="1">193.03/1051.06</td><td align="center" rowspan="1" colspan="1">0.9953</td><td align="center" rowspan="1" colspan="1">0.8207–1.2072</td></tr><tr><td align="left" rowspan="1" colspan="1"> Dickson</td><td align="center" rowspan="1" colspan="1">54/7830</td><td align="center" rowspan="1" colspan="1">41/5220</td><td align="center" rowspan="1" colspan="1">0.8780</td><td align="center" rowspan="1" colspan="1">0.5851–1.3177</td></tr><tr><td align="left" rowspan="1" colspan="1"> Lajous</td><td align="center" rowspan="1" colspan="1">37/174</td><td align="center" rowspan="1" colspan="1">8/36</td><td align="center" rowspan="1" colspan="1">1.0451</td><td align="center" rowspan="1" colspan="1">0.4867–2.2441</td></tr><tr><td align="left" rowspan="1" colspan="1"> Lu</td><td align="center" rowspan="1" colspan="1">7/25.4</td><td align="center" rowspan="1" colspan="1">56/243.3</td><td align="center" rowspan="1" colspan="1">1.1967</td><td align="center" rowspan="1" colspan="1">0.5454–2.6256</td></tr><tr><td align="left" rowspan="1" colspan="1"> Partridge</td><td align="center" rowspan="1" colspan="1">32/2486</td><td align="center" rowspan="1" colspan="1">132/7840</td><td align="center" rowspan="1" colspan="1">0.7645</td><td align="center" rowspan="1" colspan="1">0.5196–1.1249</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian</td><td align="center" rowspan="1" colspan="1">80/574</td><td align="center" rowspan="1" colspan="1">42/466</td><td align="center" rowspan="1" colspan="1">1.5464</td><td align="center" rowspan="1" colspan="1">1.0644–2.2466</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian; 6 weeks*</td><td align="center" rowspan="1" colspan="1">80/574</td><td align="center" rowspan="1" colspan="1">42/412.23</td><td align="center" rowspan="1" colspan="1">1.3679</td><td align="center" rowspan="1" colspan="1">0.9416–1.9873</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian ADJ<sup>†</sup></td><td align="center" rowspan="1" colspan="1">120.83/574</td><td align="center" rowspan="1" colspan="1">90.08/466</td><td align="center" rowspan="1" colspan="1">1.0889</td><td align="center" rowspan="1" colspan="1">0.8289–1.4306</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tobian ADJ; 6 weeks<sup>∗†</sup></td><td align="center" rowspan="1" colspan="1">120.83/574</td><td align="center" rowspan="1" colspan="1">90.08/412.23</td><td align="center" rowspan="1" colspan="1">0.9633</td><td align="center" rowspan="1" colspan="1">0.7333–1.2655</td></tr><tr><td align="left" rowspan="1" colspan="1"> VanBuskirk</td><td align="center" rowspan="1" colspan="1">45/124</td><td align="center" rowspan="1" colspan="1">142/412</td><td align="center" rowspan="1" colspan="1">1.0530</td><td align="center" rowspan="1" colspan="1">0.7530–1.4724</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1640</bold></td><td align="center" rowspan="1" colspan="1"><bold>1.0097–1.3421</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary; 6 weeks*</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1184</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.9696–1.2902</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary ADJ<sup>†</sup></td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.0113</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.8941–1.1439</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Summary ADJ; 6 weeks<sup>∗†</sup></td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.9591</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.8475–1.0852</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Any STI</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Dickson</td><td align="center" rowspan="1" colspan="1">70/2991</td><td align="center" rowspan="1" colspan="1">47/1296</td><td align="center" rowspan="1" colspan="1">0.9591</td><td align="center" rowspan="1" colspan="1">0.6627–1.3879</td></tr><tr><td align="left" rowspan="1" colspan="1"> Diseker</td><td align="center" rowspan="1" colspan="1">135/356</td><td align="center" rowspan="1" colspan="1">475/1109</td><td align="center" rowspan="1" colspan="1">0.8853</td><td align="center" rowspan="1" colspan="1">0.7313–1.0718</td></tr><tr><td align="left" rowspan="1" colspan="1"> Fergusson</td><td align="center" rowspan="1" colspan="1">37/2848</td><td align="center" rowspan="1" colspan="1">7/1232</td><td align="center" rowspan="1" colspan="1">2.2864</td><td align="center" rowspan="1" colspan="1">1.0194–5.1289</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mattson</td><td align="center" rowspan="1" colspan="1">17/265.5</td><td align="center" rowspan="1" colspan="1">27/235</td><td align="center" rowspan="1" colspan="1">0.5583</td><td align="center" rowspan="1" colspan="1">0.3043–1.0244</td></tr><tr><td align="left" rowspan="1" colspan="1">Summary</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.9127</bold></td><td align="center" rowspan="1" colspan="1"><bold>0.7801–1.0679</bold></td></tr></tbody></table><table-wrap-foot><fn><p>*Adjusted for a 6-week lead time bias.</p></fn><fn><p><sup>†</sup>Adjusted for sampling bias using data from VanBuskirk et al. [<xref rid="B170" ref-type="bibr">32</xref>].</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label><caption><p>Studies of the association between circumcision status and the prevalence of genital ulcerative disease versus genital discharge syndrome. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact 95% <break></break>confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Cameron </td><td align="center" rowspan="1" colspan="1">56/23</td><td align="center" rowspan="1" colspan="1">94/120</td><td align="center" rowspan="1" colspan="1">3.11</td><td align="center" rowspan="1" colspan="1">1.78–2.63</td><td align="center" rowspan="1" colspan="1">3.0961</td><td align="center" rowspan="1" colspan="1">1.7301–5.6797</td></tr><tr><td align="left" rowspan="1" colspan="1">Hutchinson </td><td align="center" rowspan="1" colspan="1">165/107</td><td align="center" rowspan="1" colspan="1">11/47</td><td align="center" rowspan="1" colspan="1">6.59</td><td align="center" rowspan="1" colspan="1">3.27–13.27</td><td align="center" rowspan="1" colspan="1">6.5517</td><td align="center" rowspan="1" colspan="1">3.1747–14.6549</td></tr><tr><td align="left" rowspan="1" colspan="1">Nasio </td><td align="center" rowspan="1" colspan="1">58/20</td><td align="center" rowspan="1" colspan="1">373/207</td><td align="center" rowspan="1" colspan="1">1.61</td><td align="center" rowspan="1" colspan="1">0.94–2.75</td><td align="center" rowspan="1" colspan="1">1.6083</td><td align="center" rowspan="1" colspan="1">0.9226–2.9055</td></tr><tr><td align="left" rowspan="1" colspan="1">Warner</td><td align="center" rowspan="1" colspan="1">492/2316</td><td align="center" rowspan="1" colspan="1">1836/14352</td><td align="center" rowspan="1" colspan="1">1.66</td><td align="center" rowspan="1" colspan="1">1.49–1.85</td><td align="center" rowspan="1" colspan="1">1.6606</td><td align="center" rowspan="1" colspan="1">1.4863–1.8531</td></tr><tr><td align="left" rowspan="1" colspan="1">Wolbarst </td><td align="center" rowspan="1" colspan="1">330/420</td><td align="center" rowspan="1" colspan="1">203/547</td><td align="center" rowspan="1" colspan="1">2.12</td><td align="center" rowspan="1" colspan="1">1.71–2.63</td><td align="center" rowspan="1" colspan="1">2.1161</td><td align="center" rowspan="1" colspan="1">1.6959–2.6444</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">2.2368</td><td align="center" rowspan="1" colspan="1">1.63–2.24</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 5) was 17.94 (<italic>P</italic> = .0030).</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab4" orientation="portrait" position="float"><label>Table 4</label><caption><p>Studies of the association between circumcision status and the prevalence of genital discharge syndrome.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact 95% <break></break>confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Agot </td><td align="center" rowspan="1" colspan="1">207/237</td><td align="center" rowspan="1" colspan="1">184/210</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="center" rowspan="1" colspan="1">0.76–1.31</td><td align="center" rowspan="1" colspan="1">0.9968</td><td align="center" rowspan="1" colspan="1">0.7525–1.3206</td></tr><tr><td align="left" rowspan="1" colspan="1">Bailey </td><td align="center" rowspan="1" colspan="1">58/118</td><td align="center" rowspan="1" colspan="1">65/79</td><td align="center" rowspan="1" colspan="1">0.60</td><td align="center" rowspan="1" colspan="1">0.38–0.94</td><td align="center" rowspan="1" colspan="1">0.5984</td><td align="center" rowspan="1" colspan="1">0.3657–0.9654</td></tr><tr><td align="left" rowspan="1" colspan="1">Burundi</td><td align="center" rowspan="1" colspan="1">48/1612</td><td align="center" rowspan="1" colspan="1">22/864</td><td align="center" rowspan="1" colspan="1">1.17</td><td align="center" rowspan="1" colspan="1">0.70–1.95</td><td align="center" rowspan="1" colspan="1">1.1693</td><td align="center" rowspan="1" colspan="1">0.6870–2.0486</td></tr><tr><td align="left" rowspan="1" colspan="1">Bwayo </td><td align="center" rowspan="1" colspan="1">88/88</td><td align="center" rowspan="1" colspan="1">376/383</td><td align="center" rowspan="1" colspan="1">1.02</td><td align="center" rowspan="1" colspan="1">0.73–1.41</td><td align="center" rowspan="1" colspan="1">1.0186</td><td align="center" rowspan="1" colspan="1">0.7238–1.4336</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B65" ref-type="bibr">44</xref>]*</td><td align="center" rowspan="1" colspan="1">156/4443</td><td align="center" rowspan="1" colspan="1">33/875</td><td align="center" rowspan="1" colspan="1">0.92</td><td align="center" rowspan="1" colspan="1">0.64–1.36</td><td align="center" rowspan="1" colspan="1">0.9310</td><td align="center" rowspan="1" colspan="1">0.6312–1.4097</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B66" ref-type="bibr">163</xref>]*</td><td align="center" rowspan="1" colspan="1">503/3967</td><td align="center" rowspan="1" colspan="1">97/728</td><td align="center" rowspan="1" colspan="1">0.93</td><td align="center" rowspan="1" colspan="1">0.64–1.36</td><td align="center" rowspan="1" colspan="1">0.9516</td><td align="center" rowspan="1" colspan="1">0.7528–1.2123</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">47/48</td><td align="center" rowspan="1" colspan="1">297/354</td><td align="center" rowspan="1" colspan="1">1.17</td><td align="center" rowspan="1" colspan="1">0.76–1.80</td><td align="center" rowspan="1" colspan="1">1.1668</td><td align="center" rowspan="1" colspan="1">0.7404–1.8383</td></tr><tr><td align="left" rowspan="1" colspan="1">Newell </td><td align="center" rowspan="1" colspan="1">77/1279</td><td align="center" rowspan="1" colspan="1">58/588</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.43–0.87</td><td align="center" rowspan="1" colspan="1">0.6105</td><td align="center" rowspan="1" colspan="1">0.4222–0.8866</td></tr><tr><td align="left" rowspan="1" colspan="1">Seed </td><td align="center" rowspan="1" colspan="1">236/358</td><td align="center" rowspan="1" colspan="1">136/107</td><td align="center" rowspan="1" colspan="1">0.52</td><td align="center" rowspan="1" colspan="1">0.38–0.70</td><td align="center" rowspan="1" colspan="1">0.5159</td><td align="center" rowspan="1" colspan="1">0.3790–0.7095</td></tr><tr><td align="left" rowspan="1" colspan="1">Tyndall </td><td align="center" rowspan="1" colspan="1">86/92</td><td align="center" rowspan="1" colspan="1">311/321</td><td align="center" rowspan="1" colspan="1">0.96</td><td align="center" rowspan="1" colspan="1">0.69–1.35</td><td align="center" rowspan="1" colspan="1">0.9649</td><td align="center" rowspan="1" colspan="1">0.6818–1.3646</td></tr><tr><td align="left" rowspan="1" colspan="1">Warner</td><td align="center" rowspan="1" colspan="1">2316/2849</td><td align="center" rowspan="1" colspan="1">14352/21054</td><td align="center" rowspan="1" colspan="1">1.19</td><td align="center" rowspan="1" colspan="1">1.12–1.26</td><td align="center" rowspan="1" colspan="1">1.1925</td><td align="center" rowspan="1" colspan="1">1.1239–1.2653</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">0.8902</td><td align="center" rowspan="1" colspan="1">0.7277–1.0891</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 9) was 47.36 (<italic>P</italic> < .0001).</p></fn><fn><p>*The Rakai data published in 2004 was used in calculating the summary effect odds ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab5" orientation="portrait" position="float"><label>Table 5</label><caption><p>Studies of the association between circumcision status and the prevalence of nongonococcal urethritis.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Uncircumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Aynaud </td><td align="center" rowspan="1" colspan="1">56/106</td><td align="center" rowspan="1" colspan="1">9/39</td><td align="center" rowspan="1" colspan="1">2.29</td><td align="center" rowspan="1" colspan="1">1.04–5.06</td><td align="center" rowspan="1" colspan="1">2.2811</td><td align="center" rowspan="1" colspan="1">0.9954–5.7489</td></tr><tr><td align="left" rowspan="1" colspan="1">Cook </td><td align="center" rowspan="1" colspan="1">161/379</td><td align="center" rowspan="1" colspan="1">721/1515</td><td align="center" rowspan="1" colspan="1">0.89</td><td align="center" rowspan="1" colspan="1">0.73–1.10</td><td align="center" rowspan="1" colspan="1">0.8927</td><td align="center" rowspan="1" colspan="1">0.7225–1.0996</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">169/4664</td><td align="center" rowspan="1" colspan="1">39/943</td><td align="center" rowspan="1" colspan="1">0.88</td><td align="center" rowspan="1" colspan="1">0.61–1.25</td><td align="center" rowspan="1" colspan="1">0.8762</td><td align="center" rowspan="1" colspan="1">0.6106–1.2843</td></tr><tr><td align="left" rowspan="1" colspan="1">Donovan </td><td align="center" rowspan="1" colspan="1">55/60</td><td align="center" rowspan="1" colspan="1">81/104</td><td align="center" rowspan="1" colspan="1">1.18</td><td align="center" rowspan="1" colspan="1">0.74–1.88</td><td align="center" rowspan="1" colspan="1">1.1763</td><td align="center" rowspan="1" colspan="1">0.7177–1.9282</td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris</td><td align="center" rowspan="1" colspan="1">34/1567</td><td align="center" rowspan="1" colspan="1">136/2209</td><td align="center" rowspan="1" colspan="1">0.35</td><td align="center" rowspan="1" colspan="1">0.24–0.52</td><td align="center" rowspan="1" colspan="1">0.3525</td><td align="center" rowspan="1" colspan="1">0.2333–0.5198</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann </td><td align="center" rowspan="1" colspan="1">21/1097</td><td align="center" rowspan="1" colspan="1">35/1414</td><td align="center" rowspan="1" colspan="1">0.77</td><td align="center" rowspan="1" colspan="1">0.45–1.34</td><td align="center" rowspan="1" colspan="1">0.7735</td><td align="center" rowspan="1" colspan="1">0.4252–1.3751</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">15/80</td><td align="center" rowspan="1" colspan="1">81/570</td><td align="center" rowspan="1" colspan="1">1.32</td><td align="center" rowspan="1" colspan="1">0.73–2.40</td><td align="center" rowspan="1" colspan="1">1.3189</td><td align="center" rowspan="1" colspan="1">0.6724–2.4469</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">138/452</td><td align="center" rowspan="1" colspan="1">236/493</td><td align="center" rowspan="1" colspan="1">0.64</td><td align="center" rowspan="1" colspan="1">0.50–0.82</td><td align="center" rowspan="1" colspan="1">0.6380</td><td align="center" rowspan="1" colspan="1">0.4946–0.8211</td></tr><tr><td align="left" rowspan="1" colspan="1">Richters</td><td align="center" rowspan="1" colspan="1">150/3367</td><td align="center" rowspan="1" colspan="1">369/5092</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.51–0.75</td><td align="center" rowspan="1" colspan="1">0.6148</td><td align="center" rowspan="1" colspan="1">0.5025–0.7492</td></tr><tr><td align="left" rowspan="1" colspan="1">Smith</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.50–0.73</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.50–0.73</td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor </td><td align="center" rowspan="1" colspan="1">100/207</td><td align="center" rowspan="1" colspan="1">42/62</td><td align="center" rowspan="1" colspan="1">0.71</td><td align="center" rowspan="1" colspan="1">0.45–1.13</td><td align="center" rowspan="1" colspan="1">0.7137</td><td align="center" rowspan="1" colspan="1">0.4405–1.1624</td></tr><tr><td align="left" rowspan="1" colspan="1">Wilson </td><td align="center" rowspan="1" colspan="1">140/860</td><td align="center" rowspan="1" colspan="1">45/259</td><td align="center" rowspan="1" colspan="1">0.94</td><td align="center" rowspan="1" colspan="1">0.65–1.35</td><td align="center" rowspan="1" colspan="1">0.9370</td><td align="center" rowspan="1" colspan="1">0.6449–1.3807</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">0.76</td><td align="center" rowspan="1" colspan="1">0.63–0.92</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 11) was 39.78 (<italic>P</italic> < .0001).</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab6" orientation="portrait" position="float"><label>Table 6</label><caption><p>Studies of the association between circumcision status and the prevalence of <italic>Chlamydia trachomatis</italic>.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Auvert</td><td align="center" rowspan="1" colspan="1">9/340</td><td align="center" rowspan="1" colspan="1">3/132</td><td align="center" rowspan="1" colspan="1">1.32</td><td align="center" rowspan="1" colspan="1">0.31–4.37</td><td align="center" rowspan="1" colspan="1">1.1644</td><td align="center" rowspan="1" colspan="1">0.2848–6.7884</td></tr><tr><td align="left" rowspan="1" colspan="1">Aynaud </td><td align="center" rowspan="1" colspan="1">8/154</td><td align="center" rowspan="1" colspan="1">1/47</td><td align="center" rowspan="1" colspan="1">2.44</td><td align="center" rowspan="1" colspan="1">0.30–20.03</td><td align="center" rowspan="1" colspan="1">2.4335</td><td align="center" rowspan="1" colspan="1">0.3125–110.6090</td></tr><tr><td align="left" rowspan="1" colspan="1">Cook </td><td align="center" rowspan="1" colspan="1">34/506</td><td align="center" rowspan="1" colspan="1">147/2089</td><td align="center" rowspan="1" colspan="1">0.95</td><td align="center" rowspan="1" colspan="1">0.65–1.40</td><td align="center" rowspan="1" colspan="1">0.9549</td><td align="center" rowspan="1" colspan="1">0.6293–1.4145</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">72/4761</td><td align="center" rowspan="1" colspan="1">12/970</td><td align="center" rowspan="1" colspan="1">1.22</td><td align="center" rowspan="1" colspan="1">0.66–2.26</td><td align="center" rowspan="1" colspan="1">1.2224</td><td align="center" rowspan="1" colspan="1">0.6554–2.4849</td></tr><tr><td align="left" rowspan="1" colspan="1">Diseker</td><td align="center" rowspan="1" colspan="1">72/212</td><td align="center" rowspan="1" colspan="1">240/622</td><td align="center" rowspan="1" colspan="1">0.88</td><td align="center" rowspan="1" colspan="1">0.65–1.20</td><td align="center" rowspan="1" colspan="1">0.8803</td><td align="center" rowspan="1" colspan="1">0.6382–1.2057</td></tr><tr><td align="left" rowspan="1" colspan="1">Fergusson</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">2.50</td><td align="center" rowspan="1" colspan="1">0.73–8.53</td><td align="center" rowspan="1" colspan="1">2.50</td><td align="center" rowspan="1" colspan="1">0.73–8.53</td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris</td><td align="center" rowspan="1" colspan="1">30/1571</td><td align="center" rowspan="1" colspan="1">59/2294</td><td align="center" rowspan="1" colspan="1">0.74</td><td align="center" rowspan="1" colspan="1">0.48–1.16</td><td align="center" rowspan="1" colspan="1">0.7425</td><td align="center" rowspan="1" colspan="1">0.4596–1.1774</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B65" ref-type="bibr">44</xref>]*</td><td align="center" rowspan="1" colspan="1">71/2131</td><td align="center" rowspan="1" colspan="1">17/421</td><td align="center" rowspan="1" colspan="1">0.83</td><td align="center" rowspan="1" colspan="1">0.48–1.42</td><td align="center" rowspan="1" colspan="1">0.8252</td><td align="center" rowspan="1" colspan="1">0.4751–1.5104</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B66" ref-type="bibr">163</xref>]*</td><td align="center" rowspan="1" colspan="1">53/2589</td><td align="center" rowspan="1" colspan="1">15/462</td><td align="center" rowspan="1" colspan="1">0.63</td><td align="center" rowspan="1" colspan="1">0.35–1.13</td><td align="center" rowspan="1" colspan="1">0.6306</td><td align="center" rowspan="1" colspan="1">0.3466–1.2152</td></tr><tr><td align="left" rowspan="1" colspan="1">Hart</td><td align="center" rowspan="1" colspan="1">251/2725</td><td align="center" rowspan="1" colspan="1">330/4686</td><td align="center" rowspan="1" colspan="1">1.31</td><td align="center" rowspan="1" colspan="1">1.10–1.55</td><td align="center" rowspan="1" colspan="1">1.3079</td><td align="center" rowspan="1" colspan="1">1.0979–1.5567</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann </td><td align="center" rowspan="1" colspan="1">0/1118</td><td align="center" rowspan="1" colspan="1">36/1413</td><td align="center" rowspan="1" colspan="1">0.02</td><td align="center" rowspan="1" colspan="1">0.00–0.28</td><td align="center" rowspan="1" colspan="1">0.0246</td><td align="center" rowspan="1" colspan="1">0–0.1368</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">15/33</td><td align="center" rowspan="1" colspan="1">31/36</td><td align="center" rowspan="1" colspan="1">0.53</td><td align="center" rowspan="1" colspan="1">0.24–1.15</td><td align="center" rowspan="1" colspan="1">0.5308</td><td align="center" rowspan="1" colspan="1">0.2238–1.2241</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">37/553</td><td align="center" rowspan="1" colspan="1">45/684</td><td align="center" rowspan="1" colspan="1">1.02</td><td align="center" rowspan="1" colspan="1">0.65–1.59</td><td align="center" rowspan="1" colspan="1">1.0170</td><td align="center" rowspan="1" colspan="1">0.6303–1.6322</td></tr><tr><td align="left" rowspan="1" colspan="1">Richters</td><td align="center" rowspan="1" colspan="1">74/3392</td><td align="center" rowspan="1" colspan="1">116/5218</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.73–1.32</td><td align="center" rowspan="1" colspan="1">0.9813</td><td align="center" rowspan="1" colspan="1">0.7206–1.3295</td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz</td><td align="center" rowspan="1" colspan="1">41/405</td><td align="center" rowspan="1" colspan="1">20/194</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.56–1.72</td><td align="center" rowspan="1" colspan="1">0.9820</td><td align="center" rowspan="1" colspan="1">0.5452–1.8198</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">0.9099</td><td align="center" rowspan="1" colspan="1">0.72–1.15</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 12) was 35.53 (<italic>P</italic> = .0007).</p></fn><fn><p>*The Rakai data published in 2004 was used in calculating the summary effect odds ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab7" orientation="portrait" position="float"><label>Table 7</label><caption><p>Studies of the association between circumcision status and the prevalence of gonorrhea.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Aynaud </td><td align="center" rowspan="1" colspan="1">1/161</td><td align="center" rowspan="1" colspan="1">0/48</td><td align="center" rowspan="1" colspan="1">0.90</td><td align="center" rowspan="1" colspan="1">0.04–22.47</td><td align="center" rowspan="1" colspan="1">0.2963</td><td align="center" rowspan="1" colspan="1">0.0076–[11.5518]</td></tr><tr><td align="left" rowspan="1" colspan="1">Bailey </td><td align="center" rowspan="1" colspan="1">58/118</td><td align="center" rowspan="1" colspan="1">55/89</td><td align="center" rowspan="1" colspan="1">0.80</td><td align="center" rowspan="1" colspan="1">0.50–1.26</td><td align="center" rowspan="1" colspan="1">0.7959</td><td align="center" rowspan="1" colspan="1">0.4892–1.2944</td></tr><tr><td align="left" rowspan="1" colspan="1">Cook </td><td align="center" rowspan="1" colspan="1">87/453</td><td align="center" rowspan="1" colspan="1">175/2061</td><td align="center" rowspan="1" colspan="1">2.26</td><td align="center" rowspan="1" colspan="1">1.72–2.98</td><td align="center" rowspan="1" colspan="1">2.2616</td><td align="center" rowspan="1" colspan="1">1.6436–3.0031</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">53/4780</td><td align="center" rowspan="1" colspan="1">15/967</td><td align="center" rowspan="1" colspan="1">0.71</td><td align="center" rowspan="1" colspan="1">0.40–1.27</td><td align="center" rowspan="1" colspan="1">0.7148</td><td align="center" rowspan="1" colspan="1">0.3950–1.3714</td></tr><tr><td align="left" rowspan="1" colspan="1">Diseker</td><td align="center" rowspan="1" colspan="1">110/212</td><td align="center" rowspan="1" colspan="1">294/622</td><td align="center" rowspan="1" colspan="1">1.09</td><td align="center" rowspan="1" colspan="1">0.84–1.44</td><td align="center" rowspan="1" colspan="1">1.0977</td><td align="center" rowspan="1" colspan="1">0.8299–1.4474</td></tr><tr><td align="left" rowspan="1" colspan="1">Donovan </td><td align="center" rowspan="1" colspan="1">8/107</td><td align="center" rowspan="1" colspan="1">19/166</td><td align="center" rowspan="1" colspan="1">0.65</td><td align="center" rowspan="1" colspan="1">0.28–1.55</td><td align="center" rowspan="1" colspan="1">0.6541</td><td align="center" rowspan="1" colspan="1">0.2388–1.6331</td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris</td><td align="center" rowspan="1" colspan="1">29/1573</td><td align="center" rowspan="1" colspan="1">52/2302</td><td align="center" rowspan="1" colspan="1">0.82</td><td align="center" rowspan="1" colspan="1">0.52–1.29</td><td align="center" rowspan="1" colspan="1">0.8162</td><td align="center" rowspan="1" colspan="1">0.4972–1.3164</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B65" ref-type="bibr">44</xref>]*</td><td align="center" rowspan="1" colspan="1">25/2177</td><td align="center" rowspan="1" colspan="1">3/435</td><td align="center" rowspan="1" colspan="1">1.67</td><td align="center" rowspan="1" colspan="1">0.50–5.54</td><td align="center" rowspan="1" colspan="1">1.6649</td><td align="center" rowspan="1" colspan="1">0.5046–8.6526</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B66" ref-type="bibr">163</xref>]*</td><td align="center" rowspan="1" colspan="1">29/2613</td><td align="center" rowspan="1" colspan="1">4/473</td><td align="center" rowspan="1" colspan="1">1.31</td><td align="center" rowspan="1" colspan="1">0.46–3.75</td><td align="center" rowspan="1" colspan="1">1.3123</td><td align="center" rowspan="1" colspan="1">0.4578–5.1610</td></tr><tr><td align="left" rowspan="1" colspan="1">Hand (black) </td><td align="center" rowspan="1" colspan="1">473/250</td><td align="center" rowspan="1" colspan="1">71/51</td><td align="center" rowspan="1" colspan="1">1.36</td><td align="center" rowspan="1" colspan="1">0.92–2.01</td><td align="center" rowspan="1" colspan="1">1.3585</td><td align="center" rowspan="1" colspan="1">0.8987–2.0434</td></tr><tr><td align="left" rowspan="1" colspan="1">Hand (white) </td><td align="center" rowspan="1" colspan="1">399/388</td><td align="center" rowspan="1" colspan="1">123/82</td><td align="center" rowspan="1" colspan="1">0.69</td><td align="center" rowspan="1" colspan="1">0.50–0.94</td><td align="center" rowspan="1" colspan="1">0.6858</td><td align="center" rowspan="1" colspan="1">0.4947–0.9474</td></tr><tr><td align="left" rowspan="1" colspan="1">Hart </td><td align="center" rowspan="1" colspan="1">56/2920</td><td align="center" rowspan="1" colspan="1">48/4968</td><td align="center" rowspan="1" colspan="1">1.98</td><td align="center" rowspan="1" colspan="1">1.35–2.93</td><td align="center" rowspan="1" colspan="1">1.9848</td><td align="center" rowspan="1" colspan="1">1.3217–2.9904</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann; 1–4 partners </td><td align="center" rowspan="1" colspan="1">9/440</td><td align="center" rowspan="1" colspan="1">12/542</td><td align="center" rowspan="1" colspan="1">0.92</td><td align="center" rowspan="1" colspan="1">0.39–2.21</td><td align="center" rowspan="1" colspan="1">0.9239</td><td align="center" rowspan="1" colspan="1">0.3405–2.4141</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann; 5–20 partners </td><td align="center" rowspan="1" colspan="1">64/380</td><td align="center" rowspan="1" colspan="1">58/480</td><td align="center" rowspan="1" colspan="1">1.39</td><td align="center" rowspan="1" colspan="1">0.95–2.04</td><td align="center" rowspan="1" colspan="1">1.3934</td><td align="center" rowspan="1" colspan="1">0.9361–2.0775</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann; 21+ partners </td><td align="center" rowspan="1" colspan="1">37/153</td><td align="center" rowspan="1" colspan="1">55/178</td><td align="center" rowspan="1" colspan="1">0.78</td><td align="center" rowspan="1" colspan="1">0.49–1.25</td><td align="center" rowspan="1" colspan="1">0.7831</td><td align="center" rowspan="1" colspan="1">0.4743–1.2826</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavrey </td><td align="center" rowspan="1" colspan="1">14/81</td><td align="center" rowspan="1" colspan="1">88/563</td><td align="center" rowspan="1" colspan="1">1.11</td><td align="center" rowspan="1" colspan="1">0.60–2.04</td><td align="center" rowspan="1" colspan="1">1.1056</td><td align="center" rowspan="1" colspan="1">0.5541–2.0721</td></tr><tr><td align="left" rowspan="1" colspan="1">Lloyd </td><td align="center" rowspan="1" colspan="1">203/178</td><td align="center" rowspan="1" colspan="1">75/43</td><td align="center" rowspan="1" colspan="1">0.65</td><td align="center" rowspan="1" colspan="1">0.43–1.00</td><td align="center" rowspan="1" colspan="1">0.6544</td><td align="center" rowspan="1" colspan="1">0.4161–1.0203</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">54/536</td><td align="center" rowspan="1" colspan="1">43/686</td><td align="center" rowspan="1" colspan="1">1.61</td><td align="center" rowspan="1" colspan="1">1.06–2.44</td><td align="center" rowspan="1" colspan="1">1.6067</td><td align="center" rowspan="1" colspan="1">1.0385–2.4983</td></tr><tr><td align="left" rowspan="1" colspan="1">Reynolds </td><td align="center" rowspan="1" colspan="1">110/1197</td><td align="center" rowspan="1" colspan="1">7/184</td><td align="center" rowspan="1" colspan="1">2.42</td><td align="center" rowspan="1" colspan="1">1.11–5.27</td><td align="center" rowspan="1" colspan="1">2.4145</td><td align="center" rowspan="1" colspan="1">1.1090–6.2430</td></tr><tr><td align="left" rowspan="1" colspan="1">Richters</td><td align="center" rowspan="1" colspan="1">85/3471</td><td align="center" rowspan="1" colspan="1">112/5338</td><td align="center" rowspan="1" colspan="1">1.17</td><td align="center" rowspan="1" colspan="1">0.88–1.55</td><td align="center" rowspan="1" colspan="1">1.1671</td><td align="center" rowspan="1" colspan="1">0.8669–1.5666</td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz</td><td align="center" rowspan="1" colspan="1">59/387</td><td align="center" rowspan="1" colspan="1">28/186</td><td align="center" rowspan="1" colspan="1">1.01</td><td align="center" rowspan="1" colspan="1">0.63–1.64</td><td align="center" rowspan="1" colspan="1">1.0127</td><td align="center" rowspan="1" colspan="1">0.6122–1.7074</td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek (white) </td><td align="center" rowspan="1" colspan="1">22/130</td><td align="center" rowspan="1" colspan="1">10/26</td><td align="center" rowspan="1" colspan="1">0.44</td><td align="center" rowspan="1" colspan="1">0.19–1.04</td><td align="center" rowspan="1" colspan="1">0.4423</td><td align="center" rowspan="1" colspan="1">0.1750–1.1733</td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek (black) </td><td align="center" rowspan="1" colspan="1">50/73</td><td align="center" rowspan="1" colspan="1">19/26</td><td align="center" rowspan="1" colspan="1">0.94</td><td align="center" rowspan="1" colspan="1">0.47–1.87</td><td align="center" rowspan="1" colspan="1">0.9376</td><td align="center" rowspan="1" colspan="1">0.4447–2.0000</td></tr><tr><td align="left" rowspan="1" colspan="1">Smith</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">1.14</td><td align="center" rowspan="1" colspan="1">0.92–1.41</td><td align="center" rowspan="1" colspan="1">1.14</td><td align="center" rowspan="1" colspan="1">0.92–1.41</td></tr><tr><td align="left" rowspan="1" colspan="1">Talukdar</td><td align="center" rowspan="1" colspan="1">19/345</td><td align="center" rowspan="1" colspan="1">10/92</td><td align="center" rowspan="1" colspan="1">0.51</td><td align="center" rowspan="1" colspan="1">0.23–1.13</td><td align="center" rowspan="1" colspan="1">0.5075</td><td align="center" rowspan="1" colspan="1">0.2157–1.2662</td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor </td><td align="center" rowspan="1" colspan="1">72/235</td><td align="center" rowspan="1" colspan="1">21/83</td><td align="center" rowspan="1" colspan="1">1.21</td><td align="center" rowspan="1" colspan="1">0.70–2.09</td><td align="center" rowspan="1" colspan="1">1.2104</td><td align="center" rowspan="1" colspan="1">0.6846–2.2069</td></tr><tr><td align="left" rowspan="1" colspan="1">Wilson </td><td align="center" rowspan="1" colspan="1">640/360</td><td align="center" rowspan="1" colspan="1">229/75</td><td align="center" rowspan="1" colspan="1">0.58</td><td align="center" rowspan="1" colspan="1">0.44–0.78</td><td align="center" rowspan="1" colspan="1">0.5825</td><td align="center" rowspan="1" colspan="1">0.4291–0.7847</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">1.0272</td><td align="center" rowspan="1" colspan="1">0.86–1.23</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 25) was 88.81 (<italic>P</italic> < .0001).</p></fn><fn><p>*The Rakai data published in 2004 was used in calculating the summary effect odds ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab8" orientation="portrait" position="float"><label>Table 8</label><caption><p>Studies of the association between circumcision status and the prevalence of genital ulcerative disease.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratios</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Agot </td><td align="center" rowspan="1" colspan="1">133/312</td><td align="center" rowspan="1" colspan="1">93/301</td><td align="center" rowspan="1" colspan="1">1.38</td><td align="center" rowspan="1" colspan="1">1.01–1.88</td><td align="center" rowspan="1" colspan="1">1.3792</td><td align="center" rowspan="1" colspan="1">1.0020–1.9032</td></tr><tr><td align="left" rowspan="1" colspan="1">Barile </td><td align="center" rowspan="1" colspan="1">32/3</td><td align="center" rowspan="1" colspan="1">15/32</td><td align="center" rowspan="1" colspan="1">22.76</td><td align="center" rowspan="1" colspan="1">6.00–86.29</td><td align="center" rowspan="1" colspan="1">21.7418</td><td align="center" rowspan="1" colspan="1">5.5279–128.4283</td></tr><tr><td align="left" rowspan="1" colspan="1">Burundi</td><td align="center" rowspan="1" colspan="1">63/1597</td><td align="center" rowspan="1" colspan="1">17/869</td><td align="center" rowspan="1" colspan="1">2.02</td><td align="center" rowspan="1" colspan="1">1.17–3.47</td><td align="center" rowspan="1" colspan="1">2.0160</td><td align="center" rowspan="1" colspan="1">1.1564–3.6993</td></tr><tr><td align="left" rowspan="1" colspan="1">Bwayo</td><td align="center" rowspan="1" colspan="1">58/118</td><td align="center" rowspan="1" colspan="1">179/583</td><td align="center" rowspan="1" colspan="1">1.60</td><td align="center" rowspan="1" colspan="1">1.12–2.29</td><td align="center" rowspan="1" colspan="1">1.6000</td><td align="center" rowspan="1" colspan="1">1.0988–2.3141</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B65" ref-type="bibr">44</xref>]*</td><td align="center" rowspan="1" colspan="1">297/4302</td><td align="center" rowspan="1" colspan="1">65/843</td><td align="center" rowspan="1" colspan="1">0.90</td><td align="center" rowspan="1" colspan="1">0.68–1.18</td><td align="center" rowspan="1" colspan="1">0.8954</td><td align="center" rowspan="1" colspan="1">0.6751–1.2021</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B66" ref-type="bibr">163</xref>]*</td><td align="center" rowspan="1" colspan="1">383/4087</td><td align="center" rowspan="1" colspan="1">64/761</td><td align="center" rowspan="1" colspan="1">1.11</td><td align="center" rowspan="1" colspan="1">0.85–1.47</td><td align="center" rowspan="1" colspan="1">1.1143</td><td align="center" rowspan="1" colspan="1">0.8428–1.49261</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys</td><td align="center" rowspan="1" colspan="1">13/82</td><td align="center" rowspan="1" colspan="1">46/605</td><td align="center" rowspan="1" colspan="1">2.09</td><td align="center" rowspan="1" colspan="1">1.08–4.02</td><td align="center" rowspan="1" colspan="1">2.0825</td><td align="center" rowspan="1" colspan="1">0.9888–4.1281</td></tr><tr><td align="left" rowspan="1" colspan="1">Newell </td><td align="center" rowspan="1" colspan="1">52/1304</td><td align="center" rowspan="1" colspan="1">18/628</td><td align="center" rowspan="1" colspan="1">1.39</td><td align="center" rowspan="1" colspan="1">0.81–2.40</td><td align="center" rowspan="1" colspan="1">1.3911</td><td align="center" rowspan="1" colspan="1">0.7926–2.5488</td></tr><tr><td align="left" rowspan="1" colspan="1">Seed </td><td align="center" rowspan="1" colspan="1">142/452</td><td align="center" rowspan="1" colspan="1">41/202</td><td align="center" rowspan="1" colspan="1">1.55</td><td align="center" rowspan="1" colspan="1">1.05–2.27</td><td align="center" rowspan="1" colspan="1">1.5470</td><td align="center" rowspan="1" colspan="1">1.0407–2.3358</td></tr><tr><td align="left" rowspan="1" colspan="1">Simonsen</td><td align="center" rowspan="1" colspan="1">23/47</td><td align="center" rowspan="1" colspan="1">35/196</td><td align="center" rowspan="1" colspan="1">2.74</td><td align="center" rowspan="1" colspan="1">1.48–5.07</td><td align="center" rowspan="1" colspan="1">2.7297</td><td align="center" rowspan="1" colspan="1">1.4016–5.2706</td></tr><tr><td align="left" rowspan="1" colspan="1">Telzak</td><td align="center" rowspan="1" colspan="1">239/105</td><td align="center" rowspan="1" colspan="1">211/203</td><td align="center" rowspan="1" colspan="1">2.19</td><td align="center" rowspan="1" colspan="1">1.62–2.96</td><td align="center" rowspan="1" colspan="1">2.1876</td><td align="center" rowspan="1" colspan="1">1.6056–2.9905</td></tr><tr><td align="left" rowspan="1" colspan="1">Tyndall</td><td align="center" rowspan="1" colspan="1">48/130</td><td align="center" rowspan="1" colspan="1">150/482</td><td align="center" rowspan="1" colspan="1">1.19</td><td align="center" rowspan="1" colspan="1">0.81–1.73</td><td align="center" rowspan="1" colspan="1">1.1862</td><td align="center" rowspan="1" colspan="1">0.7937–1.7548</td></tr><tr><td align="left" rowspan="1" colspan="1">Warner</td><td align="center" rowspan="1" colspan="1">492/4673</td><td align="center" rowspan="1" colspan="1">1836/33570</td><td align="center" rowspan="1" colspan="1">1.93</td><td align="center" rowspan="1" colspan="1">1.73–2.14</td><td align="center" rowspan="1" colspan="1">1.9250</td><td align="center" rowspan="1" colspan="1">1.7300–2.1378</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">1.6760</td><td align="center" rowspan="1" colspan="1">1.3926–2.0170</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 11) was 31.09 using MH (<italic>P</italic> = .0011).</p></fn><fn><p>*The Rakai data published in 2004 was used in calculating the summary odds ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab9" orientation="portrait" position="float"><label>Table 9</label><caption><p>Studies of the association between circumcision status and the prevalence of syphilis.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Bailey </td><td align="center" rowspan="1" colspan="1">7/169</td><td align="center" rowspan="1" colspan="1">6/138</td><td align="center" rowspan="1" colspan="1">0.95</td><td align="center" rowspan="1" colspan="1">0.31–2.90</td><td align="center" rowspan="1" colspan="1">0.9528</td><td align="center" rowspan="1" colspan="1">0.2673–3.5173</td></tr><tr><td align="left" rowspan="1" colspan="1">Buvé: Kismu</td><td align="center" rowspan="1" colspan="1">17/393</td><td align="center" rowspan="1" colspan="1">0/156</td><td align="center" rowspan="1" colspan="1">13.92</td><td align="center" rowspan="1" colspan="1">0.83–232.90</td><td align="center" rowspan="1" colspan="1">9.4870</td><td align="center" rowspan="1" colspan="1">1.1611–[55.8609]<sup>†</sup></td></tr><tr><td align="left" rowspan="1" colspan="1">Buvé: Ndola</td><td align="center" rowspan="1" colspan="1">57/480</td><td align="center" rowspan="1" colspan="1">7/48</td><td align="center" rowspan="1" colspan="1">0.81</td><td align="center" rowspan="1" colspan="1">0.35–1.88</td><td align="center" rowspan="1" colspan="1">0.8146</td><td align="center" rowspan="1" colspan="1">0.3442–2.2355</td></tr><tr><td align="left" rowspan="1" colspan="1">Bwayo RPR*</td><td align="center" rowspan="1" colspan="1">14/162</td><td align="center" rowspan="1" colspan="1">42/729</td><td align="center" rowspan="1" colspan="1">1.50</td><td align="center" rowspan="1" colspan="1">0.80–2.81</td><td align="center" rowspan="1" colspan="1">1.4993</td><td align="center" rowspan="1" colspan="1">0.7380–2.8812</td></tr><tr><td align="left" rowspan="1" colspan="1">Bwayo TPHA*</td><td align="center" rowspan="1" colspan="1">38/75</td><td align="center" rowspan="1" colspan="1">106/351</td><td align="center" rowspan="1" colspan="1">1.68</td><td align="center" rowspan="1" colspan="1">1.07–2.62</td><td align="center" rowspan="1" colspan="1">1.6761</td><td align="center" rowspan="1" colspan="1">1.0403–2.6740</td></tr><tr><td align="left" rowspan="1" colspan="1">Cook </td><td align="center" rowspan="1" colspan="1">20/520</td><td align="center" rowspan="1" colspan="1">13/2223</td><td align="center" rowspan="1" colspan="1">6.69</td><td align="center" rowspan="1" colspan="1">3.27–13.70</td><td align="center" rowspan="1" colspan="1">6.5705</td><td align="center" rowspan="1" colspan="1">3.0874–14.4743</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">10/4823</td><td align="center" rowspan="1" colspan="1">3/979</td><td align="center" rowspan="1" colspan="1">0.68</td><td align="center" rowspan="1" colspan="1">0.19–2.46</td><td align="center" rowspan="1" colspan="1">0.6767</td><td align="center" rowspan="1" colspan="1">0.1738–3.8332</td></tr><tr><td align="left" rowspan="1" colspan="1">Diseker</td><td align="center" rowspan="1" colspan="1">10/212</td><td align="center" rowspan="1" colspan="1">18/622</td><td align="center" rowspan="1" colspan="1">1.62</td><td align="center" rowspan="1" colspan="1">0.74–3.69</td><td align="center" rowspan="1" colspan="1">1.6290</td><td align="center" rowspan="1" colspan="1">0.6608–3.7908</td></tr><tr><td align="left" rowspan="1" colspan="1">Donovan </td><td align="center" rowspan="1" colspan="1">1/114</td><td align="center" rowspan="1" colspan="1">2/183</td><td align="center" rowspan="1" colspan="1">0.80</td><td align="center" rowspan="1" colspan="1">0.07–8.95</td><td align="center" rowspan="1" colspan="1">0.8032</td><td align="center" rowspan="1" colspan="1">0.0135–15.5915</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B65" ref-type="bibr">44</xref>]*</td><td align="center" rowspan="1" colspan="1">482/4117</td><td align="center" rowspan="1" colspan="1">93/815</td><td align="center" rowspan="1" colspan="1">1.03</td><td align="center" rowspan="1" colspan="1">0.81–1.30</td><td align="center" rowspan="1" colspan="1">1.0260</td><td align="center" rowspan="1" colspan="1">0.8091–1.3116</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray et al. [<xref rid="B66" ref-type="bibr">163</xref>]*</td><td align="center" rowspan="1" colspan="1">446/3917</td><td align="center" rowspan="1" colspan="1">96/709</td><td align="center" rowspan="1" colspan="1">0.84</td><td align="center" rowspan="1" colspan="1">0.67–1.06</td><td align="center" rowspan="1" colspan="1">0.8410</td><td align="center" rowspan="1" colspan="1">0.6629–1.0750</td></tr><tr><td align="left" rowspan="1" colspan="1">Hand</td><td align="center" rowspan="1" colspan="1">420/1090</td><td align="center" rowspan="1" colspan="1">108/219</td><td align="center" rowspan="1" colspan="1">0.78</td><td align="center" rowspan="1" colspan="1">0.60–1.01</td><td align="center" rowspan="1" colspan="1">0.7815</td><td align="center" rowspan="1" colspan="1">0.6007–1.0204</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann </td><td align="center" rowspan="1" colspan="1">12/1106</td><td align="center" rowspan="1" colspan="1">13/1312</td><td align="center" rowspan="1" colspan="1">1.10</td><td align="center" rowspan="1" colspan="1">0.50–2.41</td><td align="center" rowspan="1" colspan="1">1.0950</td><td align="center" rowspan="1" colspan="1">0.4546–2.6147</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">11/84</td><td align="center" rowspan="1" colspan="1">48/603</td><td align="center" rowspan="1" colspan="1">1.65</td><td align="center" rowspan="1" colspan="1">0.82–3.29</td><td align="center" rowspan="1" colspan="1">1.6438</td><td align="center" rowspan="1" colspan="1">0.7400–3.3705</td></tr><tr><td align="left" rowspan="1" colspan="1">Lloyd </td><td align="center" rowspan="1" colspan="1">81/300</td><td align="center" rowspan="1" colspan="1">25/93</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="center" rowspan="1" colspan="1">0.61–1.66</td><td align="center" rowspan="1" colspan="1">1.0044</td><td align="center" rowspan="1" colspan="1">0.5937–1.7413</td></tr><tr><td align="left" rowspan="1" colspan="1">Mor</td><td align="center" rowspan="1" colspan="1">192/13838</td><td align="center" rowspan="1" colspan="1">384/36290</td><td align="center" rowspan="1" colspan="1">1.31</td><td align="center" rowspan="1" colspan="1">1.10–1.56</td><td align="center" rowspan="1" colspan="1">1.3112</td><td align="center" rowspan="1" colspan="1">1.0956–1.5651</td></tr><tr><td align="left" rowspan="1" colspan="1">Newell </td><td align="center" rowspan="1" colspan="1">125/1229</td><td align="center" rowspan="1" colspan="1">45/597</td><td align="center" rowspan="1" colspan="1">1.35</td><td align="center" rowspan="1" colspan="1">0.95–1.92</td><td align="center" rowspan="1" colspan="1">1.3491</td><td align="center" rowspan="1" colspan="1">0.9379–1.9695</td></tr><tr><td align="left" rowspan="1" colspan="1">Otieno-Nyunya</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">2.2</td><td align="center" rowspan="1" colspan="1">1.3–3.7</td><td align="center" rowspan="1" colspan="1">2.2</td><td align="center" rowspan="1" colspan="1">1.3–3.7</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">9/581</td><td align="center" rowspan="1" colspan="1">3/726</td><td align="center" rowspan="1" colspan="1">3.75</td><td align="center" rowspan="1" colspan="1">1.01–13.91</td><td align="center" rowspan="1" colspan="1">3.7452</td><td align="center" rowspan="1" colspan="1">0.9292–216041</td></tr><tr><td align="left" rowspan="1" colspan="1">Reynolds </td><td align="center" rowspan="1" colspan="1">128/1639</td><td align="center" rowspan="1" colspan="1">9/151</td><td align="center" rowspan="1" colspan="1">1.31</td><td align="center" rowspan="1" colspan="1">0.65–2.63</td><td align="center" rowspan="1" colspan="1">1.3101</td><td align="center" rowspan="1" colspan="1">0.6510–2.9907</td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz</td><td align="center" rowspan="1" colspan="1">68/378</td><td align="center" rowspan="1" colspan="1">37/177</td><td align="center" rowspan="1" colspan="1">0.86</td><td align="center" rowspan="1" colspan="1">0.56–1.33</td><td align="center" rowspan="1" colspan="1">0.8608</td><td align="center" rowspan="1" colspan="1">0.5448–1.3756</td></tr><tr><td align="left" rowspan="1" colspan="1">Schneider</td><td align="center" rowspan="1" colspan="1">107/5049</td><td align="center" rowspan="1" colspan="1">25/986</td><td align="center" rowspan="1" colspan="1">0.84</td><td align="center" rowspan="1" colspan="1">0.54–1.30</td><td align="center" rowspan="1" colspan="1">0.8359</td><td align="center" rowspan="1" colspan="1">0.5335–1.3562</td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek white </td><td align="center" rowspan="1" colspan="1">10/142</td><td align="center" rowspan="1" colspan="1">1/35</td><td align="center" rowspan="1" colspan="1">2.46</td><td align="center" rowspan="1" colspan="1">0.31–19.90</td><td align="center" rowspan="1" colspan="1">2.4557</td><td align="center" rowspan="1" colspan="1">0.3293–109.9779</td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek black </td><td align="center" rowspan="1" colspan="1">19/104</td><td align="center" rowspan="1" colspan="1">6/39</td><td align="center" rowspan="1" colspan="1">1.19</td><td align="center" rowspan="1" colspan="1">0.44–3.19</td><td align="center" rowspan="1" colspan="1">1.1863</td><td align="center" rowspan="1" colspan="1">0.4155–3.9024</td></tr><tr><td align="left" rowspan="1" colspan="1">Seed </td><td align="center" rowspan="1" colspan="1">24/570</td><td align="center" rowspan="1" colspan="1">10/233</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.46–2.08</td><td align="center" rowspan="1" colspan="1">0.9811</td><td align="center" rowspan="1" colspan="1">0.4438–2.3363</td></tr><tr><td align="left" rowspan="1" colspan="1">Talukdar</td><td align="center" rowspan="1" colspan="1">25/339</td><td align="center" rowspan="1" colspan="1">8/94</td><td align="center" rowspan="1" colspan="1">0.87</td><td align="center" rowspan="1" colspan="1">0.38–1.98</td><td align="center" rowspan="1" colspan="1">0.8668</td><td align="center" rowspan="1" colspan="1">0.3640–2.2979</td></tr><tr><td align="left" rowspan="1" colspan="1">Todd </td><td align="center" rowspan="1" colspan="1">187/354</td><td align="center" rowspan="1" colspan="1">39/137</td><td align="center" rowspan="1" colspan="1">1.86</td><td align="center" rowspan="1" colspan="1">1.25–2.76</td><td align="center" rowspan="1" colspan="1">1.8541</td><td align="center" rowspan="1" colspan="1">1.2310–2.8387</td></tr><tr><td align="left" rowspan="1" colspan="1">Uganda</td><td align="center" rowspan="1" colspan="1">149/6643</td><td align="center" rowspan="1" colspan="1">37/2452</td><td align="center" rowspan="1" colspan="1">1.49</td><td align="center" rowspan="1" colspan="1">1.03–2.14</td><td align="center" rowspan="1" colspan="1">1.4864</td><td align="center" rowspan="1" colspan="1">1.0276–2.1990</td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa </td><td align="center" rowspan="1" colspan="1">775/3282</td><td align="center" rowspan="1" colspan="1">155/772</td><td align="center" rowspan="1" colspan="1">1.18</td><td align="center" rowspan="1" colspan="1">0.97–1.42</td><td align="center" rowspan="1" colspan="1">1.1761</td><td align="center" rowspan="1" colspan="1">0.9707–1.4311</td></tr><tr><td align="left" rowspan="1" colspan="1">Vaz</td><td align="center" rowspan="1" colspan="1">74/748</td><td align="center" rowspan="1" colspan="1">29/433</td><td align="center" rowspan="1" colspan="1">1.48</td><td align="center" rowspan="1" colspan="1">0.95–2.31</td><td align="center" rowspan="1" colspan="1">1.4767</td><td align="center" rowspan="1" colspan="1">0.9321–2.3934</td></tr><tr><td align="left" rowspan="1" colspan="1">Wilson </td><td align="center" rowspan="1" colspan="1">90/910</td><td align="center" rowspan="1" colspan="1">10/294</td><td align="center" rowspan="1" colspan="1">2.91</td><td align="center" rowspan="1" colspan="1">1.49–5.66</td><td align="center" rowspan="1" colspan="1">2.9059</td><td align="center" rowspan="1" colspan="1">1.4838–6.3494</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">1.3036</td><td align="center" rowspan="1" colspan="1">1.1103–1.5306</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 28) was 67.70 (<italic>P</italic> < .0001).</p></fn><fn><p>*The RPR data from the Bwayo study and the 2004 Radkai data were used in calculating the summary odds ratios.</p></fn><fn><p><sup>†</sup>Brackets have infinite confidence interval replaced with value equidistant from the odds ratio as the measured confidence interval.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab10" orientation="portrait" position="float"><label>Table 10</label><caption><p>Studies of the association between circumcision status and the prevalence of genital herpes/herpes simplex virus type 2.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Bassett </td><td align="center" rowspan="1" colspan="1">69/36</td><td align="center" rowspan="1" colspan="1">125/70</td><td align="center" rowspan="1" colspan="1">1.07</td><td align="center" rowspan="1" colspan="1">0.65–1.34</td><td align="center" rowspan="1" colspan="1">1.0731</td><td align="center" rowspan="1" colspan="1">0.6348–1.8283</td></tr><tr><td align="left" rowspan="1" colspan="1">Buvé</td><td align="center" rowspan="1" colspan="1">136/199</td><td align="center" rowspan="1" colspan="1">36/96</td><td align="center" rowspan="1" colspan="1">1.82</td><td align="center" rowspan="1" colspan="1">1.17–2.83</td><td align="center" rowspan="1" colspan="1">1.8202</td><td align="center" rowspan="1" colspan="1">1.1512–2.9206</td></tr><tr><td align="left" rowspan="1" colspan="1">Cook </td><td align="center" rowspan="1" colspan="1">49/491</td><td align="center" rowspan="1" colspan="1">205/2031</td><td align="center" rowspan="1" colspan="1">0.99</td><td align="center" rowspan="1" colspan="1">0.70–1.37</td><td align="center" rowspan="1" colspan="1">0.9887</td><td align="center" rowspan="1" colspan="1">0.6977–1.3795</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">48/4785</td><td align="center" rowspan="1" colspan="1">11/971</td><td align="center" rowspan="1" colspan="1">0.89</td><td align="center" rowspan="1" colspan="1">0.46–1.71</td><td align="center" rowspan="1" colspan="1">0.8855</td><td align="center" rowspan="1" colspan="1">0.4514–1.8979</td></tr><tr><td align="left" rowspan="1" colspan="1">Dickson </td><td align="center" rowspan="1" colspan="1">19/241</td><td align="center" rowspan="1" colspan="1">13/162</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.47–2.04</td><td align="center" rowspan="1" colspan="1">0.9825</td><td align="center" rowspan="1" colspan="1">0.4460–2.2295</td></tr><tr><td align="left" rowspan="1" colspan="1">Donovan </td><td align="center" rowspan="1" colspan="1">21/94</td><td align="center" rowspan="1" colspan="1">27/158</td><td align="center" rowspan="1" colspan="1">1.31</td><td align="center" rowspan="1" colspan="1">0.70–2.44</td><td align="center" rowspan="1" colspan="1">1.3061</td><td align="center" rowspan="1" colspan="1">0.6618–2.5514</td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris</td><td align="center" rowspan="1" colspan="1">28/1594</td><td align="center" rowspan="1" colspan="1">55/2317</td><td align="center" rowspan="1" colspan="1">0.74</td><td align="center" rowspan="1" colspan="1">0.47–1.17</td><td align="center" rowspan="1" colspan="1">0.7401</td><td align="center" rowspan="1" colspan="1">0.4499–1.1930</td></tr><tr><td align="left" rowspan="1" colspan="1">Gottlieb </td><td align="center" rowspan="1" colspan="1">27/295</td><td align="center" rowspan="1" colspan="1">74/724</td><td align="center" rowspan="1" colspan="1">0.90</td><td align="center" rowspan="1" colspan="1">0.56–1.42</td><td align="center" rowspan="1" colspan="1">0.8956</td><td align="center" rowspan="1" colspan="1">0.5424–1.4419</td></tr><tr><td align="left" rowspan="1" colspan="1">Gray</td><td align="center" rowspan="1" colspan="1">395/160</td><td align="center" rowspan="1" colspan="1">76/43</td><td align="center" rowspan="1" colspan="1">1.40</td><td align="center" rowspan="1" colspan="1">0.92–2.12</td><td align="center" rowspan="1" colspan="1">1.3961</td><td align="center" rowspan="1" colspan="1">0.8962–2.1560</td></tr><tr><td align="left" rowspan="1" colspan="1">Kapiga</td><td align="center" rowspan="1" colspan="1">3/8</td><td align="center" rowspan="1" colspan="1">57/138</td><td align="center" rowspan="1" colspan="1">1.10</td><td align="center" rowspan="1" colspan="1">0.28–4.30</td><td align="center" rowspan="1" colspan="1">0.9083</td><td align="center" rowspan="1" colspan="1">0.1499–3.9591</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann </td><td align="center" rowspan="1" colspan="1">9/1109</td><td align="center" rowspan="1" colspan="1">22/1427</td><td align="center" rowspan="1" colspan="1">0.53</td><td align="center" rowspan="1" colspan="1">0.24–1.15</td><td align="center" rowspan="1" colspan="1">0.5265</td><td align="center" rowspan="1" colspan="1">0.2125–1.1955</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">20/28</td><td align="center" rowspan="1" colspan="1">32/33</td><td align="center" rowspan="1" colspan="1">0.74</td><td align="center" rowspan="1" colspan="1">0.35–1.56</td><td align="center" rowspan="1" colspan="1">0.7386</td><td align="center" rowspan="1" colspan="1">0.3237–1.6679</td></tr><tr><td align="left" rowspan="1" colspan="1">Mallon </td><td align="center" rowspan="1" colspan="1">8/267</td><td align="center" rowspan="1" colspan="1">0/82</td><td align="center" rowspan="1" colspan="1">5.24</td><td align="center" rowspan="1" colspan="1">0.30–91.81</td><td align="center" rowspan="1" colspan="1">3.3651</td><td align="center" rowspan="1" colspan="1">0.5116–[22.1343]*</td></tr><tr><td align="left" rowspan="1" colspan="1">Mujugira</td><td align="center" rowspan="1" colspan="1">669/358</td><td align="center" rowspan="1" colspan="1">760/483</td><td align="center" rowspan="1" colspan="1">1.19</td><td align="center" rowspan="1" colspan="1">1.00–1.41</td><td align="center" rowspan="1" colspan="1">1.1875</td><td align="center" rowspan="1" colspan="1">0.9966–1.4156</td></tr><tr><td align="left" rowspan="1" colspan="1">Mwandi</td><td align="center" rowspan="1" colspan="1">396/546</td><td align="center" rowspan="1" colspan="1">1320/4355</td><td align="center" rowspan="1" colspan="1">2.39</td><td align="center" rowspan="1" colspan="1">2.07–2.76</td><td align="center" rowspan="1" colspan="1">2.3925</td><td align="center" rowspan="1" colspan="1">2.0671–2.7677</td></tr><tr><td align="left" rowspan="1" colspan="1">Ng'ayo</td><td align="center" rowspan="1" colspan="1">146/86</td><td align="center" rowspan="1" colspan="1">14/4</td><td align="center" rowspan="1" colspan="1">0.49</td><td align="center" rowspan="1" colspan="1">0.15–1.52</td><td align="center" rowspan="1" colspan="1">0.4863</td><td align="center" rowspan="1" colspan="1">0.1129–1.6142</td></tr><tr><td align="left" rowspan="1" colspan="1">Obasi </td><td align="center" rowspan="1" colspan="1">25/77</td><td align="center" rowspan="1" colspan="1">5/25</td><td align="center" rowspan="1" colspan="1">1.62</td><td align="center" rowspan="1" colspan="1">0.56–4.69</td><td align="center" rowspan="1" colspan="1">1.6179</td><td align="center" rowspan="1" colspan="1">0.5292–5.9872</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">60/530</td><td align="center" rowspan="1" colspan="1">44/685</td><td align="center" rowspan="1" colspan="1">1.76</td><td align="center" rowspan="1" colspan="1">1.18–2.64</td><td align="center" rowspan="1" colspan="1">1.7617</td><td align="center" rowspan="1" colspan="1">1.1535–2.7079</td></tr><tr><td align="left" rowspan="1" colspan="1">Reynolds </td><td align="center" rowspan="1" colspan="1">178/1096</td><td align="center" rowspan="1" colspan="1">14/111</td><td align="center" rowspan="1" colspan="1">1.29</td><td align="center" rowspan="1" colspan="1">0.72–2.30</td><td align="center" rowspan="1" colspan="1">1.2875</td><td align="center" rowspan="1" colspan="1">0.7157–2.4867</td></tr><tr><td align="left" rowspan="1" colspan="1">Richters</td><td align="center" rowspan="1" colspan="1">68/3476</td><td align="center" rowspan="1" colspan="1">138/5347</td><td align="center" rowspan="1" colspan="1">0.76</td><td align="center" rowspan="1" colspan="1">0.57–1.02</td><td align="center" rowspan="1" colspan="1">0.7580</td><td align="center" rowspan="1" colspan="1">0.5566–1.0241</td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz</td><td align="center" rowspan="1" colspan="1">48/398</td><td align="center" rowspan="1" colspan="1">28/186</td><td align="center" rowspan="1" colspan="1">0.80</td><td align="center" rowspan="1" colspan="1">0.49–1.32</td><td align="center" rowspan="1" colspan="1">0.8014</td><td align="center" rowspan="1" colspan="1">0.4755–1.3715</td></tr><tr><td align="left" rowspan="1" colspan="1">Schneider</td><td align="center" rowspan="1" colspan="1">278/4878</td><td align="center" rowspan="1" colspan="1">80/931</td><td align="center" rowspan="1" colspan="1">0.66</td><td align="center" rowspan="1" colspan="1">0.51–0.86</td><td align="center" rowspan="1" colspan="1">0.6633</td><td align="center" rowspan="1" colspan="1">0.5101–0.8702</td></tr><tr><td align="left" rowspan="1" colspan="1">Suligoi </td><td align="center" rowspan="1" colspan="1">2/5</td><td align="center" rowspan="1" colspan="1">18/57</td><td align="center" rowspan="1" colspan="1">1.27</td><td align="center" rowspan="1" colspan="1">0.23–7.10</td><td align="center" rowspan="1" colspan="1">1.2628</td><td align="center" rowspan="1" colspan="1">0.1112–8.5647</td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor: UK </td><td align="center" rowspan="1" colspan="1">102/180</td><td align="center" rowspan="1" colspan="1">20/59</td><td align="center" rowspan="1" colspan="1">1.67</td><td align="center" rowspan="1" colspan="1">0.95–2.93</td><td align="center" rowspan="1" colspan="1">1.6694</td><td align="center" rowspan="1" colspan="1">0.9283–3.1007</td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor: caribbean </td><td align="center" rowspan="1" colspan="1">50/70</td><td align="center" rowspan="1" colspan="1">2/12</td><td align="center" rowspan="1" colspan="1">4.29</td><td align="center" rowspan="1" colspan="1">0.92–20.00</td><td align="center" rowspan="1" colspan="1">4.2480</td><td align="center" rowspan="1" colspan="1">0.8863–40.7423</td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor: other </td><td align="center" rowspan="1" colspan="1">36/56</td><td align="center" rowspan="1" colspan="1">4/33</td><td align="center" rowspan="1" colspan="1">5.30</td><td align="center" rowspan="1" colspan="1">1.73–16.24</td><td align="center" rowspan="1" colspan="1">5.2451</td><td align="center" rowspan="1" colspan="1">1.6604–22.0974</td></tr><tr><td align="left" rowspan="1" colspan="1">Van Wagoner ≤ 25 years old</td><td align="center" rowspan="1" colspan="1">13/31</td><td align="center" rowspan="1" colspan="1">64/130</td><td align="center" rowspan="1" colspan="1">0.85</td><td align="center" rowspan="1" colspan="1">0.42–1.74</td><td align="center" rowspan="1" colspan="1">0.8524</td><td align="center" rowspan="1" colspan="1">0.3820–1.8147</td></tr><tr><td align="left" rowspan="1" colspan="1">Van Wagoner ≥ 26 years old</td><td align="center" rowspan="1" colspan="1">45/8</td><td align="center" rowspan="1" colspan="1">77/55</td><td align="center" rowspan="1" colspan="1">4.02</td><td align="center" rowspan="1" colspan="1">1.76–9.19</td><td align="center" rowspan="1" colspan="1">3.9905</td><td align="center" rowspan="1" colspan="1">1.6878–10.5916</td></tr><tr><td align="left" rowspan="1" colspan="1">Weiss: Cotonou</td><td align="center" rowspan="1" colspan="1">1/9</td><td align="center" rowspan="1" colspan="1">102/751</td><td align="center" rowspan="1" colspan="1">0.81</td><td align="center" rowspan="1" colspan="1">0.10–6.52</td><td align="center" rowspan="1" colspan="1">0.8183</td><td align="center" rowspan="1" colspan="1">0.0185–6.0119</td></tr><tr><td align="left" rowspan="1" colspan="1">Weiss: Yaoundé</td><td align="center" rowspan="1" colspan="1">1/7</td><td align="center" rowspan="1" colspan="1">235/644</td><td align="center" rowspan="1" colspan="1">0.39</td><td align="center" rowspan="1" colspan="1">0.05–3.20</td><td align="center" rowspan="1" colspan="1">0.3918</td><td align="center" rowspan="1" colspan="1">0.0087–3.0759</td></tr><tr><td align="left" rowspan="1" colspan="1">Weiss: Kisumu</td><td align="center" rowspan="1" colspan="1">161/264</td><td align="center" rowspan="1" colspan="1">41/117</td><td align="center" rowspan="1" colspan="1">1.74</td><td align="center" rowspan="1" colspan="1">1.16–2.61</td><td align="center" rowspan="1" colspan="1">1.7387</td><td align="center" rowspan="1" colspan="1">1.1418–2.6833</td></tr><tr><td align="left" rowspan="1" colspan="1">Weiss: Ndola</td><td align="center" rowspan="1" colspan="1">194/359</td><td align="center" rowspan="1" colspan="1">22/32</td><td align="center" rowspan="1" colspan="1">0.79</td><td align="center" rowspan="1" colspan="1">0.44–1.39</td><td align="center" rowspan="1" colspan="1">0.7863</td><td align="center" rowspan="1" colspan="1">0.4294–1.4627</td></tr><tr><td align="left" rowspan="1" colspan="1">Xu</td><td align="center" rowspan="1" colspan="1">146/919</td><td align="center" rowspan="1" colspan="1">323/2462</td><td align="center" rowspan="1" colspan="1">1.21</td><td align="center" rowspan="1" colspan="1">0.98–1.49</td><td align="center" rowspan="1" colspan="1">1.2109</td><td align="center" rowspan="1" colspan="1">0.9747–1.4993</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">1.1522</td><td align="center" rowspan="1" colspan="1">0.95–1.40</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 32) was 152.13 (<italic>P</italic> < .0001).</p></fn><fn><p>*Brackets have infinite confidence interval replaced with value equidistant from the odds ratio as the measured confidence interval.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab11" orientation="portrait" position="float"><label>Table 11</label><caption><p>Studies of the association between circumcision status and the prevalence of chancroid.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Hand; black </td><td align="center" rowspan="1" colspan="1">60/663</td><td align="center" rowspan="1" colspan="1">18/104</td><td align="center" rowspan="1" colspan="1">0.57</td><td align="center" rowspan="1" colspan="1">0.30–0.92</td><td align="center" rowspan="1" colspan="1">0.5234</td><td align="center" rowspan="1" colspan="1">0.2908–0.9807</td></tr><tr><td align="left" rowspan="1" colspan="1">Hand; white </td><td align="center" rowspan="1" colspan="1">55/732</td><td align="center" rowspan="1" colspan="1">5/200</td><td align="center" rowspan="1" colspan="1">3.01</td><td align="center" rowspan="1" colspan="1">1.19–7.61</td><td align="center" rowspan="1" colspan="1">3.0030</td><td align="center" rowspan="1" colspan="1">1.1890–9.7420</td></tr><tr><td align="left" rowspan="1" colspan="1">Hart [<xref rid="B72" ref-type="bibr">69</xref>]</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">4.76</td><td align="center" rowspan="1" colspan="1">3.45–7.14</td><td align="center" rowspan="1" colspan="1">4.76</td><td align="center" rowspan="1" colspan="1">3.44–7.14</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">10/46</td><td align="center" rowspan="1" colspan="1">91/259</td><td align="center" rowspan="1" colspan="1">0.62</td><td align="center" rowspan="1" colspan="1">0.30–1.28</td><td align="center" rowspan="1" colspan="1">0.6194</td><td align="center" rowspan="1" colspan="1">0.2674–1.3100</td></tr><tr><td align="left" rowspan="1" colspan="1">Lloyd </td><td align="center" rowspan="1" colspan="1">9/372</td><td align="center" rowspan="1" colspan="1">1/117</td><td align="center" rowspan="1" colspan="1">2.83</td><td align="center" rowspan="1" colspan="1">0.35–22.58</td><td align="center" rowspan="1" colspan="1">2.8263</td><td align="center" rowspan="1" colspan="1">0.3846–125.1128</td></tr><tr><td align="left" rowspan="1" colspan="1">Rakwar</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">0.82</td><td align="center" rowspan="1" colspan="1">0.50–1.16</td><td align="center" rowspan="1" colspan="1">0.82</td><td align="center" rowspan="1" colspan="1">0.50–1.16</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">1.33</td><td align="center" rowspan="1" colspan="1">0.52–1.33</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 5) was 59.71 (<italic>P</italic> < .0001).</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab12" orientation="portrait" position="float"><label>Table 12</label><caption><p>Studies of the association between circumcision status and the prevalence of genital warts.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Cook </td><td align="center" rowspan="1" colspan="1">51/489</td><td align="center" rowspan="1" colspan="1">412/1824</td><td align="center" rowspan="1" colspan="1">0.46</td><td align="center" rowspan="1" colspan="1">0.34–0.63</td><td align="center" rowspan="1" colspan="1">0.4618</td><td align="center" rowspan="1" colspan="1">0.3326–0.6307</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">175/4659</td><td align="center" rowspan="1" colspan="1">37/945</td><td align="center" rowspan="1" colspan="1">0.95</td><td align="center" rowspan="1" colspan="1">0.66–1.37</td><td align="center" rowspan="1" colspan="1">0.9594</td><td align="center" rowspan="1" colspan="1">0.6646–1.4173</td></tr><tr><td align="left" rowspan="1" colspan="1">Dinh</td><td align="center" rowspan="1" colspan="1">28/1127</td><td align="center" rowspan="1" colspan="1">133/2822</td><td align="center" rowspan="1" colspan="1">0.53</td><td align="center" rowspan="1" colspan="1">0.35–0.80</td><td align="center" rowspan="1" colspan="1">0.5272</td><td align="center" rowspan="1" colspan="1">0.3356–0.8026</td></tr><tr><td align="left" rowspan="1" colspan="1">Donovan </td><td align="center" rowspan="1" colspan="1">20/95</td><td align="center" rowspan="1" colspan="1">30/155</td><td align="center" rowspan="1" colspan="1">1.09</td><td align="center" rowspan="1" colspan="1">0.58–2.02</td><td align="center" rowspan="1" colspan="1">1.0874</td><td align="center" rowspan="1" colspan="1">0.5517–2.1075</td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris</td><td align="center" rowspan="1" colspan="1">45/1578</td><td align="center" rowspan="1" colspan="1">107/2263</td><td align="center" rowspan="1" colspan="1">0.60</td><td align="center" rowspan="1" colspan="1">0.42–0.86</td><td align="center" rowspan="1" colspan="1">0.6032</td><td align="center" rowspan="1" colspan="1">0.4135–0.8677</td></tr><tr><td align="left" rowspan="1" colspan="1">Lavreys </td><td align="center" rowspan="1" colspan="1">3/92</td><td align="center" rowspan="1" colspan="1">16/635</td><td align="center" rowspan="1" colspan="1">1.29</td><td align="center" rowspan="1" colspan="1">0.37–4.53</td><td align="center" rowspan="1" colspan="1">1.2937</td><td align="center" rowspan="1" colspan="1">0.2370–4.6463</td></tr><tr><td align="left" rowspan="1" colspan="1">Mallon </td><td align="center" rowspan="1" colspan="1">29/246</td><td align="center" rowspan="1" colspan="1">7/75</td><td align="center" rowspan="1" colspan="1">1.26</td><td align="center" rowspan="1" colspan="1">0.53–3.00</td><td align="center" rowspan="1" colspan="1">1.2623</td><td align="center" rowspan="1" colspan="1">0.5139–3.5538</td></tr><tr><td align="left" rowspan="1" colspan="1">Mandal</td><td align="center" rowspan="1" colspan="1">22/66</td><td align="center" rowspan="1" colspan="1">6/11</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.20–1.85</td><td align="center" rowspan="1" colspan="1">0.6142</td><td align="center" rowspan="1" colspan="1">0.1815–2.2693</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">45/545</td><td align="center" rowspan="1" colspan="1">52/677</td><td align="center" rowspan="1" colspan="1">1.07</td><td align="center" rowspan="1" colspan="1">0.71–1.63</td><td align="center" rowspan="1" colspan="1">1.0749</td><td align="center" rowspan="1" colspan="1">0.6931–1.6617</td></tr><tr><td align="left" rowspan="1" colspan="1">Richters</td><td align="center" rowspan="1" colspan="1">110/3429</td><td align="center" rowspan="1" colspan="1">194/5297</td><td align="center" rowspan="1" colspan="1">0.88</td><td align="center" rowspan="1" colspan="1">0.69–1.11</td><td align="center" rowspan="1" colspan="1">0.8759</td><td align="center" rowspan="1" colspan="1">0.6840–1.1171</td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz</td><td align="center" rowspan="1" colspan="1">54/392</td><td align="center" rowspan="1" colspan="1">40/174</td><td align="center" rowspan="1" colspan="1">0.60</td><td align="center" rowspan="1" colspan="1">0.38–0.94</td><td align="center" rowspan="1" colspan="1">0.5997</td><td align="center" rowspan="1" colspan="1">0.3753–0.9640</td></tr><tr><td align="left" rowspan="1" colspan="1">Tseng: cases</td><td align="center" rowspan="1" colspan="1">5/56</td><td align="center" rowspan="1" colspan="1">8/31</td><td align="center" rowspan="1" colspan="1">0.35</td><td align="center" rowspan="1" colspan="1">0.35–1.15</td><td align="center" rowspan="1" colspan="1">0.3499</td><td align="center" rowspan="1" colspan="1">0.0825–1.3348</td></tr><tr><td align="left" rowspan="1" colspan="1">Tseng: controls</td><td align="center" rowspan="1" colspan="1">3/46</td><td align="center" rowspan="1" colspan="1">3/48</td><td align="center" rowspan="1" colspan="1">1.04</td><td align="center" rowspan="1" colspan="1">0.20–5.44</td><td align="center" rowspan="1" colspan="1">1.0430</td><td align="center" rowspan="1" colspan="1">0.1328–8.1928</td></tr><tr><td align="left" rowspan="1" colspan="1">Van Den Eeden</td><td align="center" rowspan="1" colspan="1">14/72</td><td align="center" rowspan="1" colspan="1">25/126</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.48–2.00</td><td align="center" rowspan="1" colspan="1">0.9801</td><td align="center" rowspan="1" colspan="1">0.4656–2.1052</td></tr><tr><td align="left" rowspan="1" colspan="1">Wilson </td><td align="center" rowspan="1" colspan="1">18/982</td><td align="center" rowspan="1" colspan="1">0/304</td><td align="center" rowspan="1" colspan="1">11.47</td><td align="center" rowspan="1" colspan="1">0.96–190.85</td><td align="center" rowspan="1" colspan="1">7.8664</td><td align="center" rowspan="1" colspan="1">1.3505–[45.8203]*</td></tr><tr><td align="left" rowspan="1" colspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">0.8225</td><td align="center" rowspan="1" colspan="1">0.65–1.04</td></tr></tbody></table><table-wrap-foot><fn><p>*Brackets have infinite confidence interval replaced with value equidistant from the odds ratio as the measured confidence interval.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab13" orientation="portrait" position="float"><label>Table 13</label><caption><p>Studies of the association between circumcision status and the prevalence of genital human papillomavirus infection.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio<break></break></th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Aynaud et al. [<xref rid="B9" ref-type="bibr">33</xref>] </td><td align="center" rowspan="1" colspan="1">383/354</td><td align="center" rowspan="1" colspan="1">119/144</td><td align="center" rowspan="1" colspan="1">1.31</td><td align="center" rowspan="1" colspan="1">0.99–1.74</td><td align="center" rowspan="1" colspan="1">1.3089</td><td align="center" rowspan="1" colspan="1">0.9773–1.7551</td></tr><tr><td align="left" rowspan="1" colspan="1">Aynaud et al. [<xref rid="B10" ref-type="bibr">34</xref>] </td><td align="center" rowspan="1" colspan="1">93/69</td><td align="center" rowspan="1" colspan="1">20/28</td><td align="center" rowspan="1" colspan="1">1.89</td><td align="center" rowspan="1" colspan="1">0.98–3.62</td><td align="center" rowspan="1" colspan="1">1.8812</td><td align="center" rowspan="1" colspan="1">0.9354–3.8412</td></tr><tr><td align="left" rowspan="1" colspan="1">Baldwin</td><td align="center" rowspan="1" colspan="1">46/112</td><td align="center" rowspan="1" colspan="1">46/186</td><td align="center" rowspan="1" colspan="1">1.66</td><td align="center" rowspan="1" colspan="1">1.04–2.66</td><td align="center" rowspan="1" colspan="1">1.6585</td><td align="center" rowspan="1" colspan="1">1.0074–2.7333</td></tr><tr><td align="left" rowspan="1" colspan="1">Bleeker; group A</td><td align="center" rowspan="1" colspan="1">A: 18/52</td><td align="center" rowspan="1" colspan="1">3/10</td><td align="center" rowspan="1" colspan="1">1.15</td><td align="center" rowspan="1" colspan="1">0.29–4.67 </td><td align="center" rowspan="1" colspan="1">1.1519</td><td align="center" rowspan="1" colspan="1">0.2562–7.2315</td></tr><tr><td align="left" rowspan="1" colspan="1">Bleeker; group B</td><td align="center" rowspan="1" colspan="1">93/67</td><td align="center" rowspan="1" colspan="1">8/2</td><td align="center" rowspan="1" colspan="1">0.35</td><td align="center" rowspan="1" colspan="1">0.07–1.69</td><td align="center" rowspan="1" colspan="1">0.3489</td><td align="center" rowspan="1" colspan="1">0.0350–1.8257</td></tr><tr><td align="left" rowspan="1" colspan="1">Castellsagué; Brazil </td><td align="center" rowspan="1" colspan="1">40/63</td><td align="center" rowspan="1" colspan="1">1/5</td><td align="center" rowspan="1" colspan="1">3.17</td><td align="center" rowspan="1" colspan="1">0.36–28.18</td><td align="center" rowspan="1" colspan="1">3.1470</td><td align="center" rowspan="1" colspan="1">0.3344–153.8345</td></tr><tr><td align="left" rowspan="1" colspan="1">Castellsagué; Columbia </td><td align="center" rowspan="1" colspan="1">52/183</td><td align="center" rowspan="1" colspan="1">0/4</td><td align="center" rowspan="1" colspan="1">2.57</td><td align="center" rowspan="1" colspan="1">0.14–48.60</td><td align="center" rowspan="1" colspan="1">1.4849</td><td align="center" rowspan="1" colspan="1">0.1824–[12.0884]*</td></tr><tr><td align="left" rowspan="1" colspan="1">Castellsagué; Philippines </td><td align="center" rowspan="1" colspan="1">2/20</td><td align="center" rowspan="1" colspan="1">12/221</td><td align="center" rowspan="1" colspan="1">1.84</td><td align="center" rowspan="1" colspan="1">0.38–8.81</td><td align="center" rowspan="1" colspan="1">1.8362</td><td align="center" rowspan="1" colspan="1">0.1870–9.1816</td></tr><tr><td align="left" rowspan="1" colspan="1">Castellsagué; Spain </td><td align="center" rowspan="1" colspan="1">37/278</td><td align="center" rowspan="1" colspan="1">1/36</td><td align="center" rowspan="1" colspan="1">4.79</td><td align="center" rowspan="1" colspan="1">0.64–35.99</td><td align="center" rowspan="1" colspan="1">4.7785</td><td align="center" rowspan="1" colspan="1">0.7551–199.6211</td></tr><tr><td align="left" rowspan="1" colspan="1">Castellsagué; Thailand </td><td align="center" rowspan="1" colspan="1">35/ 136</td><td align="center" rowspan="1" colspan="1">2/35</td><td align="center" rowspan="1" colspan="1">4.50</td><td align="center" rowspan="1" colspan="1">1.03–19.64</td><td align="center" rowspan="1" colspan="1">4.4810</td><td align="center" rowspan="1" colspan="1">1.0600–40.2844</td></tr><tr><td align="left" rowspan="1" colspan="1">Giuliano et al. [<xref rid="B61" ref-type="bibr">102</xref>]; any HPV<sup>†</sup></td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">0.97</td><td align="center" rowspan="1" colspan="1">0.68–1.39</td><td align="center" rowspan="1" colspan="1">0.97</td><td align="center" rowspan="1" colspan="1">0.68–1.39</td></tr><tr><td align="left" rowspan="1" colspan="1">Giuliano et al. [<xref rid="B61" ref-type="bibr">102</xref>]; high risk HPV<sup>#</sup></td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">NA</td><td align="center" rowspan="1" colspan="1">0.93</td><td align="center" rowspan="1" colspan="1">0.63–1.33</td><td align="center" rowspan="1" colspan="1">0.93</td><td align="center" rowspan="1" colspan="1">0.63–1.33</td></tr><tr><td align="left" rowspan="1" colspan="1">Hernandez</td><td align="center" rowspan="1" colspan="1">14/44</td><td align="center" rowspan="1" colspan="1">52/144</td><td align="center" rowspan="1" colspan="1">0.88</td><td align="center" rowspan="1" colspan="1">0.44–1.74</td><td align="center" rowspan="1" colspan="1">0.8816</td><td align="center" rowspan="1" colspan="1">0.4113–1.8042</td></tr><tr><td align="left" rowspan="1" colspan="1">Lajous </td><td align="center" rowspan="1" colspan="1">365/465</td><td align="center" rowspan="1" colspan="1">28/67</td><td align="center" rowspan="1" colspan="1">1.88</td><td align="center" rowspan="1" colspan="1">1.18–2.98</td><td align="center" rowspan="1" colspan="1">1.8770</td><td align="center" rowspan="1" colspan="1">1.1631–3.0978</td></tr><tr><td align="left" rowspan="1" colspan="1">Mandal</td><td align="center" rowspan="1" colspan="1">22/66</td><td align="center" rowspan="1" colspan="1">6/11</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.20–1.85</td><td align="center" rowspan="1" colspan="1">0.6142</td><td align="center" rowspan="1" colspan="1">0.1815–2.2693</td></tr><tr><td align="left" rowspan="1" colspan="1">Müller; any HPV<sup>†</sup></td><td align="center" rowspan="1" colspan="1">125/29</td><td align="center" rowspan="1" colspan="1">35/19</td><td align="center" rowspan="1" colspan="1">2.34</td><td align="center" rowspan="1" colspan="1">1.17–4.66</td><td align="center" rowspan="1" colspan="1">2.3092</td><td align="center" rowspan="1" colspan="1">1.0971–4.8997</td></tr><tr><td align="left" rowspan="1" colspan="1">Müller; high risk<sup>#</sup></td><td align="center" rowspan="1" colspan="1">80/74</td><td align="center" rowspan="1" colspan="1">23/31</td><td align="center" rowspan="1" colspan="1">1.46</td><td align="center" rowspan="1" colspan="1">0.78–2.72</td><td align="center" rowspan="1" colspan="1">1.4545</td><td align="center" rowspan="1" colspan="1">0.7454–2.8691</td></tr><tr><td align="left" rowspan="1" colspan="1">Müller; low risk</td><td align="center" rowspan="1" colspan="1">124/30</td><td align="center" rowspan="1" colspan="1">34/20</td><td align="center" rowspan="1" colspan="1">2.43</td><td align="center" rowspan="1" colspan="1">1.23–4.81</td><td align="center" rowspan="1" colspan="1">2.4198</td><td align="center" rowspan="1" colspan="1">1.1521–5.0476</td></tr><tr><td align="left" rowspan="1" colspan="1">Ng'ayo</td><td align="center" rowspan="1" colspan="1">136/96</td><td align="center" rowspan="1" colspan="1">8/10</td><td align="center" rowspan="1" colspan="1">1.77</td><td align="center" rowspan="1" colspan="1">0.67–4.65</td><td align="center" rowspan="1" colspan="1">1.7667</td><td align="center" rowspan="1" colspan="1">0.6028–5.3567</td></tr><tr><td align="left" rowspan="1" colspan="1">Nielson; any HPV<sup>†</sup></td><td align="center" rowspan="1" colspan="1">38/36</td><td align="center" rowspan="1" colspan="1">199/190</td><td align="center" rowspan="1" colspan="1">1.01</td><td align="center" rowspan="1" colspan="1">0.61–1.66</td><td align="center" rowspan="1" colspan="1">1.0078</td><td align="center" rowspan="1" colspan="1">0.5942–1.7117</td></tr><tr><td align="left" rowspan="1" colspan="1">Nielson; high risk<sup>#</sup></td><td align="center" rowspan="1" colspan="1">23/51</td><td align="center" rowspan="1" colspan="1">112/227</td><td align="center" rowspan="1" colspan="1">0.91</td><td align="center" rowspan="1" colspan="1">0.53–1.57</td><td align="center" rowspan="1" colspan="1">0.9142</td><td align="center" rowspan="1" colspan="1">0.5062–1.6133</td></tr><tr><td align="left" rowspan="1" colspan="1">Oglivie; any HPV<sup>†</sup></td><td align="center" rowspan="1" colspan="1">89/41</td><td align="center" rowspan="1" colspan="1">94/38</td><td align="center" rowspan="1" colspan="1">0.88</td><td align="center" rowspan="1" colspan="1">0.52–1.49</td><td align="center" rowspan="1" colspan="1">0.8780</td><td align="center" rowspan="1" colspan="1">0.4997–1.5397</td></tr><tr><td align="left" rowspan="1" colspan="1">Oglivie; high risk<sup>#</sup></td><td align="center" rowspan="1" colspan="1">25/105</td><td align="center" rowspan="1" colspan="1">38/94</td><td align="center" rowspan="1" colspan="1">0.59</td><td align="center" rowspan="1" colspan="1">0.33–1.05</td><td align="center" rowspan="1" colspan="1">0.5902</td><td align="center" rowspan="1" colspan="1">0.3160–1.0877</td></tr><tr><td align="left" rowspan="1" colspan="1">Oriel </td><td align="center" rowspan="1" colspan="1">151/69</td><td align="center" rowspan="1" colspan="1">40/28</td><td align="center" rowspan="1" colspan="1">1.53</td><td align="center" rowspan="1" colspan="1">0.87–2.68</td><td align="center" rowspan="1" colspan="1">1.5295</td><td align="center" rowspan="1" colspan="1">0.8362–2.7769</td></tr><tr><td align="left" rowspan="1" colspan="1">Rombaldi</td><td align="center" rowspan="1" colspan="1">47/42</td><td align="center" rowspan="1" colspan="1">7/3</td><td align="center" rowspan="1" colspan="1">0.48</td><td align="center" rowspan="1" colspan="1">0.12–1.97</td><td align="center" rowspan="1" colspan="1">0.4830</td><td align="center" rowspan="1" colspan="1">0.0758–2.2850</td></tr><tr><td align="left" rowspan="1" colspan="1">Shin </td><td align="center" rowspan="1" colspan="1">3/40</td><td align="center" rowspan="1" colspan="1">29/296</td><td align="center" rowspan="1" colspan="1">0.77</td><td align="center" rowspan="1" colspan="1">0.22–2.63</td><td align="center" rowspan="1" colspan="1">0.7660</td><td align="center" rowspan="1" colspan="1">0.1429–2.6506</td></tr><tr><td align="left" rowspan="1" colspan="1">Svare </td><td align="center" rowspan="1" colspan="1">84/89</td><td align="center" rowspan="1" colspan="1">4/20</td><td align="center" rowspan="1" colspan="1">4.78</td><td align="center" rowspan="1" colspan="1">1.57–14.55</td><td align="center" rowspan="1" colspan="1">4.6869</td><td align="center" rowspan="1" colspan="1">1.4852–19.6399</td></tr><tr><td align="left" rowspan="1" colspan="1">Vaccarella</td><td align="center" rowspan="1" colspan="1">62/470</td><td align="center" rowspan="1" colspan="1">6/241</td><td align="center" rowspan="1" colspan="1">5.30</td><td align="center" rowspan="1" colspan="1">2.26–12.42</td><td align="center" rowspan="1" colspan="1">5.2905</td><td align="center" rowspan="1" colspan="1">2.2526–15.1850</td></tr><tr><td align="left" rowspan="1" colspan="1">Vardas; any HPV</td><td align="center" rowspan="1" colspan="1">417/1598 </td><td align="center" rowspan="1" colspan="1">247/905</td><td align="center" rowspan="1" colspan="1">0.96</td><td align="center" rowspan="1" colspan="1">0.80–1.14</td><td align="center" rowspan="1" colspan="1">0.9561</td><td align="center" rowspan="1" colspan="1">0.7981–1.1469</td></tr><tr><td align="left" rowspan="1" colspan="1">Vardas; high risk</td><td align="center" rowspan="1" colspan="1">161/1854</td><td align="center" rowspan="1" colspan="1">115/1037</td><td align="center" rowspan="1" colspan="1">0.78</td><td align="center" rowspan="1" colspan="1">0.61–1.01</td><td align="center" rowspan="1" colspan="1">0.7831</td><td align="center" rowspan="1" colspan="1">0.6050–1.0161</td></tr><tr><td align="left" rowspan="1" colspan="1">Weaver STD clinic</td><td align="center" rowspan="1" colspan="1">0/3</td><td align="center" rowspan="1" colspan="1">10/17</td><td align="center" rowspan="1" colspan="1">0.24</td><td align="center" rowspan="1" colspan="1">0.01–5.08</td><td align="center" rowspan="1" colspan="1">0.4826</td><td align="center" rowspan="1" colspan="1">[0.0478]* –4.8700</td></tr><tr><td align="left" rowspan="1" colspan="1">Weaver University students</td><td align="center" rowspan="1" colspan="1">17/42</td><td align="center" rowspan="1" colspan="1">82/176</td><td align="center" rowspan="1" colspan="1">0.87</td><td align="center" rowspan="1" colspan="1">0.47–1.62</td><td align="center" rowspan="1" colspan="1">0.8691</td><td align="center" rowspan="1" colspan="1">0.4365–1.6708</td></tr><tr><td align="left" rowspan="3" colspan="1">Random effects summary effects:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">Any HPV</td><td align="center" rowspan="1" colspan="1">1.2411</td><td align="center" rowspan="1" colspan="1">1.02–1.51</td></tr><tr><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">High-risk HPV</td><td align="center" rowspan="1" colspan="1">1.1661<break></break></td><td align="center" rowspan="1" colspan="1">0.94–1.45<break></break>8</td></tr><tr><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">Selective HPV</td><td align="center" rowspan="1" colspan="1">1.0128</td><td align="center" rowspan="1" colspan="1">0.80–1.2</td></tr></tbody></table><table-wrap-foot><fn><p>*Brackets indicate that an infinite upper confidence interval was replaced with value equidistant from the odds ratio estimate as the lower confidence interval.</p></fn><fn><p><sup>†</sup>Data used in calculating Any HPV summary effect.</p></fn><fn><p><sup>#</sup>Data used in calculating high risk HPV summary effect.</p></fn><fn><p>Any HPV: Heterogeneity chi-square (df = 24) 39.98 (<italic>P</italic> = .0215).</p></fn><fn><p>High-risk HPV: Heterogeneity chi-square (df = 24) 45.27 (<italic>P</italic> = .0054).</p></fn><fn><p>Selective HPV: Heterogeneity chi-square (df = 15) 28.82 (<italic>P</italic> = .0164).</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab14" orientation="portrait" position="float"><label>Table 14</label><caption><p>Studies of the association between circumcision status and the prevalence of any sexually transmitted infection versus no sexually transmitted infections. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Study</th><th align="center" rowspan="1" colspan="1">Intact +ve/−ve</th><th align="center" rowspan="1" colspan="1">Circumcised +ve/−ve</th><th align="center" rowspan="1" colspan="1">Odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Exact odds ratio</th><th align="center" rowspan="1" colspan="1">Exact confidence interval</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Auvert</td><td align="center" rowspan="1" colspan="1">82/279</td><td align="center" rowspan="1" colspan="1">19/122</td><td align="center" rowspan="1" colspan="1">1.89</td><td align="center" rowspan="1" colspan="1">1.10–3.25</td><td align="center" rowspan="1" colspan="1">1.8850</td><td align="center" rowspan="1" colspan="1">1.0763–3.4396</td></tr><tr><td align="left" rowspan="1" colspan="1">Aynaud </td><td align="center" rowspan="1" colspan="1">30/132</td><td align="center" rowspan="1" colspan="1">7/41</td><td align="center" rowspan="1" colspan="1">1.33</td><td align="center" rowspan="1" colspan="1">0.54–3.26</td><td align="center" rowspan="1" colspan="1">1.3294</td><td align="center" rowspan="1" colspan="1">0.5208–3.8565</td></tr><tr><td align="left" rowspan="1" colspan="1">Burundi</td><td align="center" rowspan="1" colspan="1">101/1559</td><td align="center" rowspan="1" colspan="1">33/853</td><td align="center" rowspan="1" colspan="1">1.67</td><td align="center" rowspan="1" colspan="1">1.12–2.50</td><td align="center" rowspan="1" colspan="1">1.6743</td><td align="center" rowspan="1" colspan="1">1.1091–2.5848</td></tr><tr><td align="left" rowspan="1" colspan="1">Cook</td><td align="center" rowspan="1" colspan="1">342/198</td><td align="center" rowspan="1" colspan="1">1449/787</td><td align="center" rowspan="1" colspan="1">0.94</td><td align="center" rowspan="1" colspan="1">0.77–1.14</td><td align="center" rowspan="1" colspan="1">0.9382</td><td align="center" rowspan="1" colspan="1">0.7685–1.1472</td></tr><tr><td align="left" rowspan="1" colspan="1">Dave </td><td align="center" rowspan="1" colspan="1">522/4311</td><td align="center" rowspan="1" colspan="1">109/873</td><td align="center" rowspan="1" colspan="1">0.97</td><td align="center" rowspan="1" colspan="1">0.78–1.21</td><td align="center" rowspan="1" colspan="1">0.9698</td><td align="center" rowspan="1" colspan="1">0.7769–1.2187</td></tr><tr><td align="left" rowspan="1" colspan="1">Diseker </td><td align="center" rowspan="1" colspan="1">291/212</td><td align="center" rowspan="1" colspan="1">869/622</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.80–1.21</td><td align="center" rowspan="1" colspan="1">0.9825</td><td align="center" rowspan="1" colspan="1">0.7967–1.2128</td></tr><tr><td align="left" rowspan="1" colspan="1">Ferris</td><td align="center" rowspan="1" colspan="1">166/1458</td><td align="center" rowspan="1" colspan="1">409/1965</td><td align="center" rowspan="1" colspan="1">0.55</td><td align="center" rowspan="1" colspan="1">0.45–0.66</td><td align="center" rowspan="1" colspan="1">0.5471</td><td align="center" rowspan="1" colspan="1">0.4483–0.6654</td></tr><tr><td align="left" rowspan="1" colspan="1">Gebremedhin</td><td align="center" rowspan="1" colspan="1">1178/21926</td><td align="center" rowspan="1" colspan="1">2623/43363</td><td align="center" rowspan="1" colspan="1">0.89</td><td align="center" rowspan="1" colspan="1">0.83–0.95</td><td align="center" rowspan="1" colspan="1">0.8882</td><td align="center" rowspan="1" colspan="1">0.8269–0.9536</td></tr><tr><td align="left" rowspan="1" colspan="1">Harbertson</td><td align="center" rowspan="1" colspan="1">185/360</td><td align="center" rowspan="1" colspan="1">371/304</td><td align="center" rowspan="1" colspan="1">0.42</td><td align="center" rowspan="1" colspan="1">0.33–0.53</td><td align="center" rowspan="1" colspan="1">0.4214</td><td align="center" rowspan="1" colspan="1">0.3311–0.5353</td></tr><tr><td align="left" rowspan="1" colspan="1">Klavs</td><td align="center" rowspan="1" colspan="1">38/682</td><td align="center" rowspan="1" colspan="1">2/35</td><td align="center" rowspan="1" colspan="1">0.98</td><td align="center" rowspan="1" colspan="1">0.23–4.21</td><td align="center" rowspan="1" colspan="1">0.09751</td><td align="center" rowspan="1" colspan="1">0.2348–8.6761</td></tr><tr><td align="left" rowspan="1" colspan="1">Langeni</td><td align="center" rowspan="1" colspan="1">6931/173523</td><td align="center" rowspan="1" colspan="1">927/35099</td><td align="center" rowspan="1" colspan="1">1.51</td><td align="center" rowspan="1" colspan="1">1.41–1.62</td><td align="center" rowspan="1" colspan="1">1.5124</td><td align="center" rowspan="1" colspan="1">1.4106–1.6229</td></tr><tr><td align="left" rowspan="1" colspan="1">Laumann 1–4 partners </td><td align="center" rowspan="1" colspan="1">15/434</td><td align="center" rowspan="1" colspan="1">26/528</td><td align="center" rowspan="1" colspan="1">0.70</td><td align="center" rowspan="1" colspan="1">0.37–1.34</td><td align="center" rowspan="1" colspan="1">0.7021</td><td align="center" rowspan="1" colspan="1">0.3411–1.3960</td></tr><tr><td align="left" rowspan="1" colspan="1"> 5–20 partners </td><td align="center" rowspan="1" colspan="1">80/364</td><td align="center" rowspan="1" colspan="1">102/436</td><td align="center" rowspan="1" colspan="1">0.94</td><td align="center" rowspan="1" colspan="1">0.68–1.30</td><td align="center" rowspan="1" colspan="1">0.9395</td><td align="center" rowspan="1" colspan="1">0.6696–1.3152</td></tr><tr><td align="left" rowspan="1" colspan="1">21+ partners </td><td align="center" rowspan="1" colspan="1">61/129</td><td align="center" rowspan="1" colspan="1">95/138</td><td align="center" rowspan="1" colspan="1">0.69</td><td align="center" rowspan="1" colspan="1">0.46–1.03</td><td align="center" rowspan="1" colspan="1">0.6875</td><td align="center" rowspan="1" colspan="1">0.4502–1.0457</td></tr><tr><td align="left" rowspan="1" colspan="1">Parker </td><td align="center" rowspan="1" colspan="1">350/240</td><td align="center" rowspan="1" colspan="1">404/325</td><td align="center" rowspan="1" colspan="1">1.17</td><td align="center" rowspan="1" colspan="1">0.94–1.46</td><td align="center" rowspan="1" colspan="1">1.1730</td><td align="center" rowspan="1" colspan="1">0.9360–1.4707</td></tr><tr><td align="left" rowspan="1" colspan="1">Richters</td><td align="center" rowspan="1" colspan="1">487/3460</td><td align="center" rowspan="1" colspan="1">929/4736</td><td align="center" rowspan="1" colspan="1">0.72</td><td align="center" rowspan="1" colspan="1">0.12–0.81</td><td align="center" rowspan="1" colspan="1">0.7176</td><td align="center" rowspan="1" colspan="1">0.6362–0.8086</td></tr><tr><td align="left" rowspan="1" colspan="1">Rodriguez-Diaz</td><td align="center" rowspan="1" colspan="1">293/153</td><td align="center" rowspan="1" colspan="1">157/57</td><td align="center" rowspan="1" colspan="1">0.70</td><td align="center" rowspan="1" colspan="1">0.48–1.00</td><td align="center" rowspan="1" colspan="1">0.6956</td><td align="center" rowspan="1" colspan="1">0.4752–1.0104</td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek white</td><td align="center" rowspan="1" colspan="1">26/126</td><td align="center" rowspan="1" colspan="1">10/26</td><td align="center" rowspan="1" colspan="1">0.54</td><td align="center" rowspan="1" colspan="1">0.23–1.25</td><td align="center" rowspan="1" colspan="1">0.5385</td><td align="center" rowspan="1" colspan="1">0.2176–1.4070</td></tr><tr><td align="left" rowspan="1" colspan="1">Schrek black </td><td align="center" rowspan="1" colspan="1">58/65</td><td align="center" rowspan="1" colspan="1">22/23</td><td align="center" rowspan="1" colspan="1">0.93</td><td align="center" rowspan="1" colspan="1">0.47–1.85</td><td align="center" rowspan="1" colspan="1">0.9333</td><td align="center" rowspan="1" colspan="1">0.4451–1.9595</td></tr><tr><td align="left" rowspan="1" colspan="1">Seed </td><td align="center" rowspan="1" colspan="1">378/216</td><td align="center" rowspan="1" colspan="1">177/66</td><td align="center" rowspan="1" colspan="1">0.65</td><td align="center" rowspan="1" colspan="1">0.47–0.91</td><td align="center" rowspan="1" colspan="1">0.6529</td><td align="center" rowspan="1" colspan="1">0.4620–0.9159</td></tr><tr><td align="left" rowspan="1" colspan="1">Taylor </td><td align="center" rowspan="1" colspan="1">251/56</td><td align="center" rowspan="1" colspan="1">87/17</td><td align="center" rowspan="1" colspan="1">0.88</td><td align="center" rowspan="1" colspan="1">0.48–1.59</td><td align="center" rowspan="1" colspan="1">0.8761</td><td align="center" rowspan="1" colspan="1">0.4521–1.6293</td></tr><tr><td align="left" rowspan="1" colspan="1">Thomas</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">1.08</td><td align="center" rowspan="1" colspan="1">0.52–2.26</td><td align="center" rowspan="1" colspan="1">1.08</td><td align="center" rowspan="1" colspan="1">0.52–2.26</td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa 1</td><td align="center" rowspan="1" colspan="1">117/1239</td><td align="center" rowspan="1" colspan="1">70/572</td><td align="center" rowspan="1" colspan="1">0.77</td><td align="center" rowspan="1" colspan="1">0.56–1.05</td><td align="center" rowspan="1" colspan="1">0.7717</td><td align="center" rowspan="1" colspan="1">0.5592–1.0711</td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa 2 </td><td align="center" rowspan="1" colspan="1">291/1854</td><td align="center" rowspan="1" colspan="1">84/374</td><td align="center" rowspan="1" colspan="1">0.70</td><td align="center" rowspan="1" colspan="1">0.54–0.91</td><td align="center" rowspan="1" colspan="1">0.6989</td><td align="center" rowspan="1" colspan="1">0.5322–0.9246</td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa 3 </td><td align="center" rowspan="1" colspan="1">85/262</td><td align="center" rowspan="1" colspan="1">58/119</td><td align="center" rowspan="1" colspan="1">0.67</td><td align="center" rowspan="1" colspan="1">0.45–0.99</td><td align="center" rowspan="1" colspan="1">0.6662</td><td align="center" rowspan="1" colspan="1">0.4392–1.0133</td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa 4 </td><td align="center" rowspan="1" colspan="1">29/799</td><td align="center" rowspan="1" colspan="1">23/723</td><td align="center" rowspan="1" colspan="1">1.14</td><td align="center" rowspan="1" colspan="1">0.65–1.99</td><td align="center" rowspan="1" colspan="1">1.1408</td><td align="center" rowspan="1" colspan="1">0.6308–2.0853</td></tr><tr><td align="left" rowspan="1" colspan="1">Urassa 5 </td><td align="center" rowspan="1" colspan="1">355/4409</td><td align="center" rowspan="1" colspan="1">101/987</td><td align="center" rowspan="1" colspan="1">0.79</td><td align="center" rowspan="1" colspan="1">0.62–0.99</td><td align="center" rowspan="1" colspan="1">0.7869</td><td align="center" rowspan="1" colspan="1">0.6220–1.0023</td></tr><tr><td align="left" colspan="2" rowspan="1">Random effects summary effect:</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">0.8627</td><td align="center" rowspan="1" colspan="1">0.7368–1.0102</td></tr><tr><td align="left" colspan="2" rowspan="1">—without Langeni</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">0.8248</td><td align="center" rowspan="1" colspan="1">0.7358–0.9245</td></tr></tbody></table><table-wrap-foot><fn><p>Heterogeneity chi-square (df = 26) was 303.00 (<italic>P</italic> < .0001); without Langeni chi-square (df = 25) was 99.59 (<italic>P</italic> < .0001).</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab15" orientation="portrait" position="float"><label>Table 15</label><caption><p>Impact of removing outlying studies on between-study heterogeneity and summary effects.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Outlier studies</th><th align="center" rowspan="1" colspan="1">Chi-square (<italic>P</italic> value)</th><th align="center" rowspan="1" colspan="1">Adjusted odds ratio <break></break>(95% confidence interval)</th><th align="center" rowspan="1" colspan="1">Heterogeneity chi-square <break></break>(df, <italic>P</italic> value)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">GUD versus GDS</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>2.24 (1.63–2.24)</bold></td><td align="center" rowspan="1" colspan="1"><bold>17.20 (4, .0068)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Warner</td><td align="center" rowspan="1" colspan="1">7.85 (.0051)</td><td align="center" rowspan="1" colspan="1">2.65 (1.67–4.18)</td><td align="center" rowspan="1" colspan="1">9.35 (3, .0250)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hutchinson</td><td align="center" rowspan="1" colspan="1">10.08 (.0015)</td><td align="center" rowspan="1" colspan="1">1.92 (1.53–2.40)</td><td align="center" rowspan="1" colspan="1">7.12 (3, .0681)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hutchinson and Warner</td><td align="center" rowspan="1" colspan="1">14.87 (df = 2) (.0006)</td><td align="center" rowspan="1" colspan="1">2.15 (1.68–2.74)</td><td align="center" rowspan="1" colspan="1">2.33 (2, .3121)</td></tr><tr><td align="left" rowspan="1" colspan="1">GDS</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.8902 (0.73–1.09)</bold></td><td align="center" rowspan="1" colspan="1"><bold>47.36 (9, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Bailey</td><td align="center" rowspan="1" colspan="1">6.223 (.0125)</td><td align="center" rowspan="1" colspan="1">0.9209 (0.75–1.13)</td><td align="center" rowspan="1" colspan="1">41.13 (8, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Newell</td><td align="center" rowspan="1" colspan="1">9.94 (.0016)</td><td align="center" rowspan="1" colspan="1">0.9279 (0.76–1.13)</td><td align="center" rowspan="1" colspan="1">37.42 (8, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Seed</td><td align="center" rowspan="1" colspan="1">23.54 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.9614 (0.81–1.13)</td><td align="center" rowspan="1" colspan="1">23.82 (8, .0025)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Warner</td><td align="center" rowspan="1" colspan="1">26.08 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8482 (0.70–1.03)</td><td align="center" rowspan="1" colspan="1">21.28 (8, .0065)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Warner and Seed</td><td align="center" rowspan="1" colspan="1">37.30 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.91.47 (0.79–1.07)</td><td align="center" rowspan="1" colspan="1">10.06 (7, .1850)</td></tr><tr><td align="left" rowspan="1" colspan="1">NSU</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.76 (0.63–0.92)</bold></td><td align="center" rowspan="1" colspan="1"><bold>39.78 (11, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Lavreys</td><td align="center" rowspan="1" colspan="1">4.02 (.0450)</td><td align="center" rowspan="1" colspan="1">0.74 (0.61–0.89)</td><td align="center" rowspan="1" colspan="1">35.76 (10, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Donovan</td><td align="center" rowspan="1" colspan="1">4.24 (.0394)</td><td align="center" rowspan="1" colspan="1">0.74 (0.61–0.92)</td><td align="center" rowspan="1" colspan="1">35.54 (10, .0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook</td><td align="center" rowspan="1" colspan="1">5.94 (.0148)</td><td align="center" rowspan="1" colspan="1">0.75 (0.61–0.92)</td><td align="center" rowspan="1" colspan="1">33.84 (10, .0002)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Aynaud</td><td align="center" rowspan="1" colspan="1">6.25 (.0124)</td><td align="center" rowspan="1" colspan="1">0.73 (0.61–0.88)</td><td align="center" rowspan="1" colspan="1">33.53 (10, .0002)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Ferris</td><td align="center" rowspan="1" colspan="1">12.92 (.0003)</td><td align="center" rowspan="1" colspan="1">0.80 (0.68–0.95)</td><td align="center" rowspan="1" colspan="1">26.86 (10, .0027)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Ferris and Aynaud</td><td align="center" rowspan="1" colspan="1">18.78 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.77 (0.66–0.91)</td><td align="center" rowspan="1" colspan="1">21.00 (9, .0126)</td></tr><tr><td align="left" rowspan="1" colspan="1">Chlamydia</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.9099 (0.72–1.15)</bold></td><td align="center" rowspan="1" colspan="1"><bold>35.53 (13, .0007)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Hart [<xref rid="B73" ref-type="bibr">165</xref>]</td><td align="center" rowspan="1" colspan="1">10.83 (.0010)</td><td align="center" rowspan="1" colspan="1">0.8605 (0.67–1.10)</td><td align="center" rowspan="1" colspan="1">24.70 (12, .0163)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Laumann</td><td align="center" rowspan="1" colspan="1">18.43 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.9920 (0.85–1.16)</td><td align="center" rowspan="1" colspan="1">17.10 (12, .1460)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Laumann and Hart</td><td align="center" rowspan="1" colspan="1">27.78 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.9362 (0.87–1.00)</td><td align="center" rowspan="1" colspan="1">7.75 (11, .7357)</td></tr><tr><td align="left" rowspan="1" colspan="1">Gonorrhea</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.03 (0.86–1.23)</bold></td><td align="center" rowspan="1" colspan="1"><bold>88.81 (25, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Lloyd</td><td align="center" rowspan="1" colspan="1">5.23 (.0222)</td><td align="center" rowspan="1" colspan="1">1.05 (0.88–1.26)</td><td align="center" rowspan="1" colspan="1">83.58 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hand</td><td align="center" rowspan="1" colspan="1">9.16 (df = 2) (.0102)</td><td align="center" rowspan="1" colspan="1">1.04 (0.86–1.25)</td><td align="center" rowspan="1" colspan="1">79.55 (23, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hart [<xref rid="B73" ref-type="bibr">165</xref>]</td><td align="center" rowspan="1" colspan="1">9.42 (.0021)</td><td align="center" rowspan="1" colspan="1">0.99 (0.83–1.19)</td><td align="center" rowspan="1" colspan="1">79.39 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Wilson</td><td align="center" rowspan="1" colspan="1">18.26 (<.0001)</td><td align="center" rowspan="1" colspan="1">1.07 (0.90–1.26)</td><td align="center" rowspan="1" colspan="1">70.55 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook</td><td align="center" rowspan="1" colspan="1">30.10 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.99 (0.84–1.15)</td><td align="center" rowspan="1" colspan="1">58.71 (24, .0002)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook and Wilson</td><td align="center" rowspan="1" colspan="1">44.32 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">1.03 (0.89–1.19)</td><td align="center" rowspan="1" colspan="1">44.49 (23, .0669)</td></tr><tr><td align="left" rowspan="1" colspan="1">GUD</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.6760 (1.39–2.02)</bold></td><td align="center" rowspan="1" colspan="1"><bold>31.09 (11, .0011)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Tyndall</td><td align="center" rowspan="1" colspan="1">4.21 (.0402)</td><td align="center" rowspan="1" colspan="1">1.7326 (1.43–2.10)</td><td align="center" rowspan="1" colspan="1">26.88 (10, .0027)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Warner</td><td align="center" rowspan="1" colspan="1">6.48 (.0109)</td><td align="center" rowspan="1" colspan="1">1.6492 (1.33–2.05)</td><td align="center" rowspan="1" colspan="1">24.61 (10, .0109)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Barile</td><td align="center" rowspan="1" colspan="1">7.64 (.0057)</td><td align="center" rowspan="1" colspan="1">1.6308 (1.38–1.92)</td><td align="center" rowspan="1" colspan="1">23.45 (10, .0057)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gray</td><td align="center" rowspan="1" colspan="1">10.33 (.0013)</td><td align="center" rowspan="1" colspan="1">1.7581 (1.48–2.09)</td><td align="center" rowspan="1" colspan="1">20.76 (10, .0228)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gray and Warner</td><td align="center" rowspan="1" colspan="1">12.61 (df = 2) (.0018)</td><td align="center" rowspan="1" colspan="1">1.7385 (1.40–2.17)</td><td align="center" rowspan="1" colspan="1">18.48 (9, .0300)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gray and Barile</td><td align="center" rowspan="1" colspan="1">17.73 (df = 2) (.0001)</td><td align="center" rowspan="1" colspan="1">1.7334 (1.51–1.99)</td><td align="center" rowspan="1" colspan="1">13.36 (9, .1470)</td></tr><tr><td align="left" rowspan="1" colspan="1">Syphilis</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.3036 (1.11–1.53)</bold></td><td align="center" rowspan="1" colspan="1"><bold>67.70 (28, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Todd</td><td align="center" rowspan="1" colspan="1">4.18 (.0409)</td><td align="center" rowspan="1" colspan="1">1.2766 (1.08–1.50)</td><td align="center" rowspan="1" colspan="1">63.52 (27, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Wilson</td><td align="center" rowspan="1" colspan="1">4.98 (.0256)</td><td align="center" rowspan="1" colspan="1">1.2704 (1.08–1.49)</td><td align="center" rowspan="1" colspan="1">62.72 (27, .0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Buvé; Kismu</td><td align="center" rowspan="1" colspan="1">5.24 (.0221)</td><td align="center" rowspan="1" colspan="1">1.2804 (1.10–1.50)</td><td align="center" rowspan="1" colspan="1">62.46 (27, .0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Otieno</td><td align="center" rowspan="1" colspan="1">5.37 (.0204)</td><td align="center" rowspan="1" colspan="1">1.2685 (1.08–1.49)</td><td align="center" rowspan="1" colspan="1">62.33 (27, .0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gray</td><td align="center" rowspan="1" colspan="1">9.05 (.0026)</td><td align="center" rowspan="1" colspan="1">1.3439 (1.14–1.58)</td><td align="center" rowspan="1" colspan="1">58.65 (27, .0004)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hand</td><td align="center" rowspan="1" colspan="1">10.95 (.0009)</td><td align="center" rowspan="1" colspan="1">1.3467 (1.15–1.58)</td><td align="center" rowspan="1" colspan="1">56.75 (27, .0007)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook</td><td align="center" rowspan="1" colspan="1">17.52 (<.0001)</td><td align="center" rowspan="1" colspan="1">1.2304 (1.07–1.42)</td><td align="center" rowspan="1" colspan="1">50.18 (27, .0043)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook and Hand</td><td align="center" rowspan="1" colspan="1">27.55 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">1.2704 (1.11–1.45)</td><td align="center" rowspan="1" colspan="1">40.15 (26, .0377)</td></tr><tr><td align="left" rowspan="1" colspan="1">Chancroid</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.3321 (0.52–1.33)</bold></td><td align="center" rowspan="1" colspan="1"><bold>59.71 (5, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Lloyd</td><td align="center" rowspan="1" colspan="1">4.83 (.0279)</td><td align="center" rowspan="1" colspan="1">1.5961 (0.5418–4.7022)</td><td align="center" rowspan="1" colspan="1">54.88 (4, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hand</td><td align="center" rowspan="1" colspan="1">11.69 (df = 2) (.0029)</td><td align="center" rowspan="1" colspan="1">1.4490 (0.4186–5.0152)</td><td align="center" rowspan="1" colspan="1">48.02 (3, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Rakwar</td><td align="center" rowspan="1" colspan="1">14.74 (.0001)</td><td align="center" rowspan="1" colspan="1">1.5289 (0.4499–5.1956)</td><td align="center" rowspan="1" colspan="1">44.97 (4, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Hart [<xref rid="B72" ref-type="bibr">69</xref>]</td><td align="center" rowspan="1" colspan="1">52.23 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8177 (0.5092–1.3134)</td><td align="center" rowspan="1" colspan="1">7.48 (4, .1128)</td></tr><tr><td align="left" rowspan="1" colspan="1">Herpes; simplex virus</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1522 (0.95–1.40)</bold></td><td align="center" rowspan="1" colspan="1"><bold>152.13 (32, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Van Wagoner</td><td align="center" rowspan="1" colspan="1">6.24 (df = 2) (.0442)</td><td align="center" rowspan="1" colspan="1">1.1293 (0.93–1.38)</td><td align="center" rowspan="1" colspan="1">145.89 (31, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Laumann</td><td align="center" rowspan="1" colspan="1">4.76 (.0291)</td><td align="center" rowspan="1" colspan="1">1.1771 (0.97–1.43)</td><td align="center" rowspan="1" colspan="1">147.37 (31, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Ferris</td><td align="center" rowspan="1" colspan="1">5.68 (.0172)</td><td align="center" rowspan="1" colspan="1">1.1735 (0.96–1.43)</td><td align="center" rowspan="1" colspan="1">146.45 (31, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Richters</td><td align="center" rowspan="1" colspan="1">13.61 (.0002)</td><td align="center" rowspan="1" colspan="1">1.1761 (0.97–1.27)</td><td align="center" rowspan="1" colspan="1">138.52 (31, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Schneider</td><td align="center" rowspan="1" colspan="1">26.18 (<.0001)</td><td align="center" rowspan="1" colspan="1">1.1851 (0.98–1.43)</td><td align="center" rowspan="1" colspan="1">1.25.95 (31, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mwandi</td><td align="center" rowspan="1" colspan="1">86.28 (<.0001)</td><td align="center" rowspan="1" colspan="1">1.0944 (0.94–1.27)</td><td align="center" rowspan="1" colspan="1">65.85 (31, .0003)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Mwandi and Schneider</td><td align="center" rowspan="1" colspan="1">99.97 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">1.1311 (0.98–1.30)</td><td align="center" rowspan="1" colspan="1">51.16 (30, .0073)</td></tr><tr><td align="left" rowspan="1" colspan="1">Genital Warts</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.8275 (0.65–1.04)</bold></td><td align="center" rowspan="1" colspan="1"><bold>37.07 (14, .0007)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Oriel</td><td align="center" rowspan="1" colspan="1">5.46 (.0194)</td><td align="center" rowspan="1" colspan="1">0.7792 (0.69–0.98)</td><td align="center" rowspan="1" colspan="1">31.61 (13, .0027)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Wilson</td><td align="center" rowspan="1" colspan="1">6.76 (.0093)</td><td align="center" rowspan="1" colspan="1">0.7885 (0.64–0.98)</td><td align="center" rowspan="1" colspan="1">30.31 (13, .0042)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook</td><td align="center" rowspan="1" colspan="1">11.89 (.0006)</td><td align="center" rowspan="1" colspan="1">0.8696 (0.70–1.08)</td><td align="center" rowspan="1" colspan="1">25.18 (13, .0218)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Cook and Wilson</td><td align="center" rowspan="1" colspan="1">18.13 (df = 2) (.0001)</td><td align="center" rowspan="1" colspan="1">0.8365 (0.69–1.01)</td><td align="center" rowspan="1" colspan="1">18.93 (12, .0901)</td></tr><tr><td align="left" rowspan="1" colspan="1">HPV any</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.2411 (1.03–1.51)</bold></td><td align="center" rowspan="1" colspan="1"><bold>39.98 (24, .0215)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Lajous</td><td align="center" rowspan="1" colspan="1">4.09 (.0431)</td><td align="center" rowspan="1" colspan="1">1.1962 (0.98–1.45)</td><td align="center" rowspan="1" colspan="1">35.89 (23, .0424)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Vardas</td><td align="center" rowspan="1" colspan="1">5.56 (.0184)</td><td align="center" rowspan="1" colspan="1">1.2912 (1.05–1.59)</td><td align="center" rowspan="1" colspan="1">34.42 (23, .0593)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Vaccarella</td><td align="center" rowspan="1" colspan="1">8.29 (.0040)</td><td align="center" rowspan="1" colspan="1">1.1806 (0.99–1.40)</td><td align="center" rowspan="1" colspan="1">31.69 (23, .1068)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Vaccarella and Vardas</td><td align="center" rowspan="1" colspan="1">12.77 (df = 2) (.0017)</td><td align="center" rowspan="1" colspan="1">1.2320 (1.02–1.48)</td><td align="center" rowspan="1" colspan="1">27.21 (22, .2033)</td></tr><tr><td align="left" rowspan="1" colspan="1">HPV high risk</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.1611 (0.94–1.45)</bold></td><td align="center" rowspan="1" colspan="1"><bold>45.27 (24, .0054)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Oglivie</td><td align="center" rowspan="1" colspan="1">4.01 (.0451)</td><td align="center" rowspan="1" colspan="1">1.2162 (0.98–1.51)</td><td align="center" rowspan="1" colspan="1">41.26 (23, .0111)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Svare</td><td align="center" rowspan="1" colspan="1">4.02 (.0450)</td><td align="center" rowspan="1" colspan="1">1.1323 (0.92–1.40)</td><td align="center" rowspan="1" colspan="1">41.25 (23, .0111)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Lajous</td><td align="center" rowspan="1" colspan="1">4.86 (.0274)</td><td align="center" rowspan="1" colspan="1">1.1192 (0.90–1.39)</td><td align="center" rowspan="1" colspan="1">40.41 (23, .0138)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Vardas</td><td align="center" rowspan="1" colspan="1">8.04 (.0046)</td><td align="center" rowspan="1" colspan="1">1.2186 (0.98–1.52)</td><td align="center" rowspan="1" colspan="1">37.23 (23, .0307)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Vaccarella</td><td align="center" rowspan="1" colspan="1">8.77 (.0031)</td><td align="center" rowspan="1" colspan="1">1.1049 (0.91–1.35)</td><td align="center" rowspan="1" colspan="1">36.50 (23, .0366)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Vardas and Vaccarella</td><td align="center" rowspan="1" colspan="1">15.74 (df = 2) (.0004)</td><td align="center" rowspan="1" colspan="1">1.1602 (0.95–1.41)</td><td align="center" rowspan="1" colspan="1">29.53 (22, .1303)</td></tr><tr><td align="left" rowspan="1" colspan="1">HPV high risk selective</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>1.0128 (0.80–1.28)</bold></td><td align="center" rowspan="1" colspan="1"><bold>28.82 (15, .0164)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1">Aynaud et al. [<xref rid="B9" ref-type="bibr">33</xref>]</td><td align="center" rowspan="1" colspan="1">4.62 (.0316)</td><td align="center" rowspan="1" colspan="1">0.9727 (0.76–1.25)</td><td align="center" rowspan="1" colspan="1">24.20 (14, .0433)</td></tr><tr><td align="left" rowspan="1" colspan="1">Vardas</td><td align="center" rowspan="1" colspan="1">4.20 (.0404)</td><td align="center" rowspan="1" colspan="1">1.0564 (0.82–1.37)</td><td align="center" rowspan="1" colspan="1">24.62 (14, .0385)</td></tr><tr><td align="left" rowspan="1" colspan="1">Vaccarella</td><td align="center" rowspan="1" colspan="1">9.92 (.0016)</td><td align="center" rowspan="1" colspan="1">0.9553 (0.79–1.15)</td><td align="center" rowspan="1" colspan="1">18.90 (14, .1689)</td></tr><tr><td align="left" rowspan="1" colspan="1">Vaccarella and Aynaud I</td><td align="center" rowspan="1" colspan="1">15.60 (df = 2) (.0004)</td><td align="center" rowspan="1" colspan="1">0.8747 (0.74–1.03)</td><td align="center" rowspan="1" colspan="1">13.22 (13, .4306)</td></tr><tr><td align="left" rowspan="1" colspan="1">Vaccarella and Vardas</td><td align="center" rowspan="1" colspan="1">13.13 (df = 2) (.0014)</td><td align="center" rowspan="1" colspan="1">1.0073 (0.82–1.23)</td><td align="center" rowspan="1" colspan="1">15.69 (13, .2664)</td></tr><tr><td align="left" rowspan="1" colspan="1">Any STI</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.8627 (0.7368–1.0102)</bold></td><td align="center" rowspan="1" colspan="1"><bold>303.00 (26, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Auvert</td><td align="center" rowspan="1" colspan="1">4.55 (.0329)</td><td align="center" rowspan="1" colspan="1">0.8425 (0.7182–0.9884)</td><td align="center" rowspan="1" colspan="1">298.45 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Seed</td><td align="center" rowspan="1" colspan="1">5.63 (.0177)</td><td align="center" rowspan="1" colspan="1">0.8732 (0.7432–1.0266)</td><td align="center" rowspan="1" colspan="1">297.37 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Uganda</td><td align="center" rowspan="1" colspan="1">5.87 (.0154)</td><td align="center" rowspan="1" colspan="1">0.8410 (0.7164–0.9873)</td><td align="center" rowspan="1" colspan="1">297.13 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Urassa</td><td align="center" rowspan="1" colspan="1">15.68 (df = 5) (.0078)</td><td align="center" rowspan="1" colspan="1">0.8846 (0.7379–1.0605)</td><td align="center" rowspan="1" colspan="1">287.32 (21, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gebremedhin</td><td align="center" rowspan="1" colspan="1">10.48 (.0012)</td><td align="center" rowspan="1" colspan="1">0.8638 (0.7186–1.0383)</td><td align="center" rowspan="1" colspan="1">292.52 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Richters</td><td align="center" rowspan="1" colspan="1">29.28 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8713 (0.7394–1.0268)</td><td align="center" rowspan="1" colspan="1">273.72 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Ferris</td><td align="center" rowspan="1" colspan="1">35.50 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8822 (0.7542–1.0319)</td><td align="center" rowspan="1" colspan="1">2267.50 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Harbertson</td><td align="center" rowspan="1" colspan="1">49.14 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8923 (0.7665–1.0389)</td><td align="center" rowspan="1" colspan="1">253.86 (25, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Langeni</td><td align="center" rowspan="1" colspan="1">203.41 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8248 (0.7358–0.9245)</td><td align="center" rowspan="1" colspan="1">99.59 (25, <.0001) </td></tr><tr><td align="left" rowspan="1" colspan="1"> Langeni and Ferris</td><td align="center" rowspan="1" colspan="1">221.08 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8442 (0.7554–0.9434)</td><td align="center" rowspan="1" colspan="1">81.92 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Langeni and Harbertson</td><td align="center" rowspan="1" colspan="1">234.61 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8519 (0.7700–0.9426)</td><td align="center" rowspan="1" colspan="1">68.39 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1">Any STI without Langeni</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><bold>0.8248 (0.74–0.92)</bold></td><td align="center" rowspan="1" colspan="1"><bold>99.59 (25, <.0001)</bold></td></tr><tr><td align="left" rowspan="1" colspan="1"> Richters</td><td align="center" rowspan="1" colspan="1">5.92 (.0150)</td><td align="center" rowspan="1" colspan="1">0.8344 (0.7374–0.9442)</td><td align="center" rowspan="1" colspan="1">93.67 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gebremedhin</td><td align="center" rowspan="1" colspan="1">7.28 (.0070)</td><td align="center" rowspan="1" colspan="1">0.8250 (0.7236–0.9406)</td><td align="center" rowspan="1" colspan="1">92.31 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Auvert</td><td align="center" rowspan="1" colspan="1">7.32 (.0068)</td><td align="center" rowspan="1" colspan="1">0.8078 (0.7219–0.9039)</td><td align="center" rowspan="1" colspan="1">92.27 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Parker</td><td align="center" rowspan="1" colspan="1">9.79 (.0017)</td><td align="center" rowspan="1" colspan="1">0.8071 (0.7195–0.9053)</td><td align="center" rowspan="1" colspan="1">89.80 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Burundi</td><td align="center" rowspan="1" colspan="1">10.37 (.0013)</td><td align="center" rowspan="1" colspan="1">0.8030 (0.7182–0.8978)</td><td align="center" rowspan="1" colspan="1">89.22 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Ferris</td><td align="center" rowspan="1" colspan="1">17.67 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8442 (0.7554–0.9434)</td><td align="center" rowspan="1" colspan="1">81.92 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Harbertson</td><td align="center" rowspan="1" colspan="1">31.20 (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8519 (0.7700–0.9426)</td><td align="center" rowspan="1" colspan="1">68.39 (24, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Harbertson and Burundi</td><td align="center" rowspan="1" colspan="1">40.87 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8317 (0.7544–0.9157)</td><td align="center" rowspan="1" colspan="1">58.72 (23, <.0001)</td></tr><tr><td align="left" rowspan="1" colspan="1"> Harbertson and Ferris</td><td align="center" rowspan="1" colspan="1">51.08 (df = 2) (<.0001)</td><td align="center" rowspan="1" colspan="1">0.8761 (0.794–0.9602)</td><td align="center" rowspan="1" colspan="1">48.51 (23, .0014)</td></tr></tbody></table></table-wrap><table-wrap id="tab16" orientation="portrait" position="float"><label>Table 16</label><caption><p>Sensitivity analysis of high-risk and general populations of studies of the association between circumcision status and various sexually transmitted infections.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th><th align="center" rowspan="1" colspan="1">Random-effects odds ratio</th><th align="center" rowspan="1" colspan="1">95% confidence interval</th><th align="center" rowspan="1" colspan="1">Heterogeneity chi-square (df)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Genital discharge syndrome</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.18</td><td align="center" rowspan="1" colspan="1">1.11–1.25</td><td align="center" rowspan="1" colspan="1">2.14 (3) <italic>P</italic> = .5444</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">0.77</td><td align="center" rowspan="1" colspan="1">0.59–0.99</td><td align="center" rowspan="1" colspan="1">16.78 (5) <italic>P</italic> = .0049</td></tr><tr><td align="left" rowspan="1" colspan="1">NSU</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">0.95</td><td align="center" rowspan="1" colspan="1">0.73–1.55</td><td align="center" rowspan="1" colspan="1">13.90 (6) <italic>P</italic> = .0308</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">0.61</td><td align="center" rowspan="1" colspan="1">0.48–0.76</td><td align="center" rowspan="1" colspan="1">11.76 (4) <italic>P</italic> = .0192</td></tr><tr><td align="left" rowspan="1" colspan="1">Chlamydia</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.02</td><td align="center" rowspan="1" colspan="1">0.83–1.26</td><td align="center" rowspan="1" colspan="1">9.49 (6) <italic>P</italic> = .1478</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">0.77</td><td align="center" rowspan="1" colspan="1">0.46–1.31</td><td align="center" rowspan="1" colspan="1">22.40 (6) <italic>P</italic> = .0010</td></tr><tr><td align="left" rowspan="1" colspan="1">Gonorrhea</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.09</td><td align="center" rowspan="1" colspan="1">0.86–1.40</td><td align="center" rowspan="1" colspan="1">77.07 (15) <italic>P</italic> < .0001</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">1.02</td><td align="center" rowspan="1" colspan="1">0.88–1.18</td><td align="center" rowspan="1" colspan="1">11.12 (10) <italic>P</italic> = .3482</td></tr><tr><td align="left" rowspan="1" colspan="1">GUD</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.91</td><td align="center" rowspan="1" colspan="1">1.50–2.43</td><td align="center" rowspan="1" colspan="1">15.63 (6) <italic>P</italic> = .0159</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">1.34</td><td align="center" rowspan="1" colspan="1">1.13–1.59</td><td align="center" rowspan="1" colspan="1">3.78 (4) <italic>P</italic> = .4371</td></tr><tr><td align="left" rowspan="1" colspan="1">Syphilis</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.40</td><td align="center" rowspan="1" colspan="1">1.06–1.85</td><td align="center" rowspan="1" colspan="1">39.45 (12) <italic>P</italic> < .0001</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">1.22</td><td align="center" rowspan="1" colspan="1">1.00–1.49</td><td align="center" rowspan="1" colspan="1">27.96(15) <italic>P</italic> = .0218</td></tr><tr><td align="left" rowspan="1" colspan="1">Herpes simplex</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.20</td><td align="center" rowspan="1" colspan="1">0.99–1.46</td><td align="center" rowspan="1" colspan="1">23.15 (14) <italic>P</italic> = .0579</td></tr><tr><td align="left" rowspan="1" colspan="1"> General population</td><td align="center" rowspan="1" colspan="1">1.06</td><td align="center" rowspan="1" colspan="1">0.78–1.45</td><td align="center" rowspan="1" colspan="1">124.28 (17) <italic>P</italic> < .0001</td></tr><tr><td align="left" rowspan="1" colspan="1">Genital warts</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">0.91</td><td align="center" rowspan="1" colspan="1">0.58–1.44</td><td align="center" rowspan="1" colspan="1">28.16 (7) <italic>P</italic> = .0002</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">0.78</td><td align="center" rowspan="1" colspan="1">0.63–0.96</td><td align="center" rowspan="1" colspan="1">8.61 (6) <italic>P</italic> = .1969</td></tr><tr><td align="left" rowspan="1" colspan="1">Any HPV</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.24</td><td align="center" rowspan="1" colspan="1">0.85–1.82</td><td align="center" rowspan="1" colspan="1">14.13 (8) <italic>P</italic> = .0786</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">1.23</td><td align="center" rowspan="1" colspan="1">0.97–1.55</td><td align="center" rowspan="1" colspan="1">24.10 (15) <italic>P</italic> = .0634</td></tr><tr><td align="left" rowspan="1" colspan="1">High-risk HPV</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">1.08</td><td align="center" rowspan="1" colspan="1">0.72–1.63</td><td align="center" rowspan="1" colspan="1">15.82 (8) <italic>P</italic> = .0450</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">1.21</td><td align="center" rowspan="1" colspan="1">0.92–1.58</td><td align="center" rowspan="1" colspan="1">28.65 (15) <italic>P</italic> = .0178</td></tr><tr><td align="left" rowspan="1" colspan="1">Any STD</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> High-risk populations</td><td align="center" rowspan="1" colspan="1">0.96</td><td align="center" rowspan="1" colspan="1">0.79–1.17</td><td align="center" rowspan="1" colspan="1">6.29(4) <italic>P</italic> = .1788</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations</td><td align="center" rowspan="1" colspan="1">0.84</td><td align="center" rowspan="1" colspan="1">0.69–1.02</td><td align="center" rowspan="1" colspan="1">296.71 (20) <italic>P</italic> ≤ .0001</td></tr><tr><td align="left" rowspan="1" colspan="1"> General populations; no Langerin</td><td align="center" rowspan="1" colspan="1">0.79</td><td align="center" rowspan="1" colspan="1">0.69–0.90</td><td align="center" rowspan="1" colspan="1">43.59 (19) <italic>P</italic> < .0001</td></tr></tbody></table></table-wrap><table-wrap id="tab17" orientation="portrait" position="float"><label>Table 17</label><caption><p>Evaluation of publication bias in studies evaluating the association between sexually transmitted diseases and circumcision status in adult males using the methods described by Egger et al. [<xref rid="B46" ref-type="bibr">39</xref>], Macaskill et al. [<xref rid="B97" ref-type="bibr">40</xref>], and Begg and Mazumdar [<xref rid="B17" ref-type="bibr">41</xref>].</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th><th align="center" rowspan="1" colspan="1">Begg</th><th align="center" rowspan="1" colspan="1">Begg's alternative</th><th align="center" rowspan="1" colspan="1">Egger</th><th align="center" rowspan="1" colspan="1">Egger's weighted</th><th align="center" rowspan="1" colspan="1">Macaskill</th><th align="center" rowspan="1" colspan="1">Macaskill's pooled variance</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Genital discharge syndrome</td><td align="center" rowspan="1" colspan="1">0.9287</td><td align="center" rowspan="1" colspan="1">0.3252</td><td align="center" rowspan="1" colspan="1">0.0213</td><td align="center" rowspan="1" colspan="1">0.0056</td><td align="center" rowspan="1" colspan="1">0.0127</td><td align="center" rowspan="1" colspan="1">0.0171</td></tr><tr><td align="left" rowspan="1" colspan="1">Nonspecific urethritis</td><td align="center" rowspan="1" colspan="1">0.0549</td><td align="center" rowspan="1" colspan="1">0.0397</td><td align="center" rowspan="1" colspan="1">0.1301</td><td align="center" rowspan="1" colspan="1">0.3893</td><td align="center" rowspan="1" colspan="1">0.1322</td><td align="center" rowspan="1" colspan="1">0.0917</td></tr><tr><td align="left" rowspan="1" colspan="1">Chlamydia</td><td align="center" rowspan="1" colspan="1">0.8695</td><td align="center" rowspan="1" colspan="1">0.9563</td><td align="center" rowspan="1" colspan="1">0.0855</td><td align="center" rowspan="1" colspan="1">0.0003</td><td align="center" rowspan="1" colspan="1">0.1172</td><td align="center" rowspan="1" colspan="1">0.2961</td></tr><tr><td align="left" rowspan="1" colspan="1">Gonorrhea</td><td align="center" rowspan="1" colspan="1">0.2801</td><td align="center" rowspan="1" colspan="1">0.0404</td><td align="center" rowspan="1" colspan="1">0.3403</td><td align="center" rowspan="1" colspan="1">0.5653</td><td align="center" rowspan="1" colspan="1">0.1124</td><td align="center" rowspan="1" colspan="1">0.1764</td></tr><tr><td align="left" rowspan="1" colspan="1">Genital ulcerative disease</td><td align="center" rowspan="1" colspan="1">0.6547</td><td align="center" rowspan="1" colspan="1">0.7884</td><td align="center" rowspan="1" colspan="1">0.3795</td><td align="center" rowspan="1" colspan="1">0.1073</td><td align="center" rowspan="1" colspan="1">0.1804</td><td align="center" rowspan="1" colspan="1">0.3424</td></tr><tr><td align="left" rowspan="1" colspan="1">Syphilis</td><td align="center" rowspan="1" colspan="1">0.7356</td><td align="center" rowspan="1" colspan="1">0.6258</td><td align="center" rowspan="1" colspan="1">0.1429</td><td align="center" rowspan="1" colspan="1">0.8972</td><td align="center" rowspan="1" colspan="1">0.1023</td><td align="center" rowspan="1" colspan="1">0.6316</td></tr><tr><td align="left" rowspan="1" colspan="1">Genital herpes</td><td align="center" rowspan="1" colspan="1">0.2646</td><td align="center" rowspan="1" colspan="1">0.0137</td><td align="center" rowspan="1" colspan="1">0.1627</td><td align="center" rowspan="1" colspan="1">0.0014</td><td align="center" rowspan="1" colspan="1">0.3803</td><td align="center" rowspan="1" colspan="1">0.1324</td></tr><tr><td align="left" rowspan="1" colspan="1">Genital warts</td><td align="center" rowspan="1" colspan="1">0.5862</td><td align="center" rowspan="1" colspan="1">0.6918</td><td align="center" rowspan="1" colspan="1">0.1782</td><td align="center" rowspan="1" colspan="1">0.9378</td><td align="center" rowspan="1" colspan="1">0.5768</td><td align="center" rowspan="1" colspan="1">0.7383</td></tr><tr><td align="left" rowspan="1" colspan="1">Human papillomavirus: any type</td><td align="center" rowspan="1" colspan="1">0.9627</td><td align="center" rowspan="1" colspan="1">0.5592</td><td align="center" rowspan="1" colspan="1">0.1461</td><td align="center" rowspan="1" colspan="1">0.0035</td><td align="center" rowspan="1" colspan="1">0.0639</td><td align="center" rowspan="1" colspan="1">0.0857</td></tr><tr><td align="left" rowspan="1" colspan="1">Human papillomavirus: oncogenic type</td><td align="center" rowspan="1" colspan="1">0.8153</td><td align="center" rowspan="1" colspan="1">0.5911</td><td align="center" rowspan="1" colspan="1">0.2465</td><td align="center" rowspan="1" colspan="1">0.0889</td><td align="center" rowspan="1" colspan="1">0.0531</td><td align="center" rowspan="1" colspan="1">0.0913</td></tr><tr><td align="left" rowspan="1" colspan="1">Any sexually transmitted infection</td><td align="center" rowspan="1" colspan="1">0.0913</td><td align="center" rowspan="1" colspan="1">0.3482</td><td align="center" rowspan="1" colspan="1">0.1286</td><td align="center" rowspan="1" colspan="1">0.0900</td><td align="center" rowspan="1" colspan="1"><0.0001</td><td align="center" rowspan="1" colspan="1"><0.0001</td></tr><tr><td align="left" rowspan="1" colspan="1">Any sexually transmitted infection: without Langeni</td><td align="center" rowspan="1" colspan="1">0.8084</td><td align="center" rowspan="1" colspan="1">0.7079</td><td align="center" rowspan="1" colspan="1">0.9552</td><td align="center" rowspan="1" colspan="1">0.0765</td><td align="center" rowspan="1" colspan="1">0.2035</td><td align="center" rowspan="1" colspan="1">0.3550</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Michigan</li></region></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Van Howe, Robert S" sort="Van Howe, Robert S" uniqKey="Van Howe R" first="Robert S." last="Van Howe">Robert S. 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