CDC Considers “Universal Circumcision” to Fight HIV Cases
This week at the CDC’s National HIV Prevention Conference in Atlanta, the government agency will discuss whether to recommend routine circumcision for all baby boys to protect them from the disease.
Research is split on whether routinely cutting boys at birth will protect them from sexually transmitted diseases, including AIDs and HIV. Most research points to a decrease in diseases only in high-risk populations where such diseases are prevalent.
One of the groups lobbying against such a blanket recommendation is Intact America, a newly-formed group in the U.S. with the aim of lowering the circumcision rate.
But those who state simply that “circumcision prevents STDs” may need to get their facts straight.
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In a recent comprehensive study, circumcision indeed appeared to lower the risk for those repeatedly exposed to HIV.
Possible induced mucosal immunity following repeated subinfectious HIV antigen stimulation of urethral mucosa
The same research also points out that such research can be difficult to control for, because circumcision can be tied to religion, or are often “highly selected”.
Religion (Islam, Judaism):
- May be correlated with lower risk behaviors, less alcohol use, genital hygiene, etc.
- Mainly neonatal
Traditional / tribal
- Behavioral differences
- Younger age (puberty rituals)
Medical indications (phimosis, GUD)
- correlated with higher risk behaviors
In other words, we can’t force the social structure under which babies and men are circumcised, and other factors may play as large a part in exposure to STDs as their behavior. Also, a study cited in this research suggests that it is the number of sex workers in a population that better determines the number of males infected with HIV.
And lets focus on that: males. Male circumcision does not lower the risk to women. While that may not factor into your family’s decision, let’s look at it from a community perspective, which is how the CDC should view it.
A Ugandan study performed by Johns Hopkins School of Public Health found that circumcised men were a bit more likely to transmit HIV to their partners. This study involved 922 HIV-infected men randomly chosen to be circumcised. Researchers provided the couples with HIV information and condoms. The partners in this study were previously free of HIV.
After two years, 18 percent of the women in the circumcised group had become infected with HIV, compared with 12 percent in the uncircumcised group. Cumulative probability of HIV infection at 24 months was 22 percent among women in the circumcised group and 13 percent among those in the uncircumcised group.
Overall, these are studies–including those the CDC is aware of and cites–that play to both sides of the debate. Only one study that the CDC cites claims that the HIV risk is lower for circumcised men. The CDC points out that all the studies are performed in Africa, most in high-risk populations.
Currently, they are operating under the theory that the foreskin holds and breeds diseases. And this is only for female to male infection. HIV rates for homosexuals is not decreased dependent on circumcision.
For its part, the American Academy of Pediatrics (AAP) says that although there may be “potential” medical benefits,
data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child.
So let me ask: Is it in the “best interest” of your son to remove his foreskin, a part of his body?
And if these studies are as of yet “inconclusive,” might we hold off on the recommendation that all boys be snipped at birth?
Image: Ted Drake on Flickr under a Creative Commons License.
The CDC is blindly and ignorantly considering recommending circumcision, based on inconclusive studies not done in the US, even the American Association of Pediatrics, who has never recommended circumcision in its 70 year history is against them, this is bs, circumcision does not prevent HIV, I am circumcised and very unhappy about it, I am restoring my foreskin, and I will never circumcise my son, don’t you think if circumcision prevented anything, 80% of the world would not be uncircumcised.
If parents are allowed to order another person to cut off a part of a boy’s penis, then they should also be allowed to tattoo an ejaculating dragon on to his back.
Are people retarded? It is the boy’s body. He and only he should make the call about what parts will be cut off, if any.
The CDC already recommends routine vaccination against Hepatitis B and HPV, even though those shots are generally only needed for those engaged in risky behavior (healthcare workers notwithstanding).
Abstinence before marriage, fidelity within marriage, and not using IV drugs are what’s really needed to avoid infection with those diseases. But since we as a society seem to have such a hard time with those things, that’s why the CDC makes its recommendations.
how about the CDC makes its case to men already at the age of consent? If they can convince grown men to chop off healthy, functioning parts of the penis in the name of hygiene, then no harm done. Subjecting infants to this procedure is disgusting in the face of above mentioned dubious science that does not apply to the US. I’d like to see the CDeffingC mention Scandinavia and explain how that highly UNCUT population has the lowest incidence of HIV in the world.
If circumcision were effective in preventing the spread of HIV/AIDS, the US would have fewer AIDS cases than Europe, Canada, Australia, etc. Instead, we have more AIDS. Circumcision is a cure in constant search of a disease. The reasons used for continuing the practice would never be sufficient to begin such a practice - on baby girls, for instance. Alas, “custom will reconcile people to any atrocity” - George Bernard Shaw.
It wasn’t that long ago that routine circumcision was recommended, so it won’t surprise me if it is again.
And if Obama’s health plan comes to fruition, I doubt we will have control over medical decisions… if the CDC says do it, betcha it’ll become mandatory under a public healthcare program.
My husband and boy children were circ’d as will be any future male children we have, but I don’t believe in blanket requirements… I believe in smaller government and more individual choice. We are seeing that stripped away more each day.
The CDC would have to be biased and ignorant to recommend universal infant circumcision. Any true cost benefit analysis weighs the harms and losses of circumcision which can only lead to the conclusion that an informed consent decision by adult to surgically remove the most errogenous and funmctional tissue of his genitals is the only ethical thing to do.
Why not simply neuter those who propose/seem to have a need for this “treatment” or, even better, just castrate them?
I can’t express how horrified I am. Even *if* & it’s a huge if, based on all available data, circumcision reduced the chances of getting HIV, babies aren’t having sex AND condoms work much, much better and need to be used even if the boy is circumcised. So the point to this would be…making money, I guess, there certainly isn’t any medical reason.
Sheer insanity.
The WHO already withdrew their circ campaign in Africa because they found it was not effective in hiv prevention afterall. Can we just use our common sense,please? Let’s encourage condom use…not snipping of genitals.