CDC Considers "Universal Circumcision" to Fight HIV Cases

Worked for Jesus... 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.

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Comments

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Ian Wilkinson says:

    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.

  8. Why not simply neuter those who propose/seem to have a need for this “treatment” or, even better, just castrate them?

  9. 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.

  10. 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.

  11. This type of thing aggravates me to no end! If circumcision is really so effective why not allow men the option to do so when they are sexually ready? Besides the fact that there is so much uncertainty as to if it really is effective. Like that the US has a high rate of circumcision and a high rate of HIV/AIDS. Common sense and condoms should be where our efforts lie, not mutilating little boys.

  12. How about the health benefits of not cutting nerves and blood vessels and getting to have a natural member? 20,000 FINE TOUCH AND STRETCH nerve endings should NOT be amputated from baby boys without asking the owner. This is such crap.

    There is a greater chance of the baby boy getting MRSA staph from this in a US hospital than the same kid getting HIV through his life. This is such a strange idea that one wonders why the US Meds have this obsession. We have higher HIV and very high Circ rate as compared to natural uncut EU and JP. Could it be cut male Drs and female MDs that are from cut tradition are trying to find a way to keep this barbaric practice going in the US? No other developed country is saying this! They think we are obsessed with choping off baby boy genitals.

    The alleged risk change (not seen in non african studies) is from 3.2% risk to about 1.78 % risk. Oh and BTW, circumcision raises (makes transmission more likely) the HIV for women. Look it up the same africa studies found cut transfered HIV at a much higher rate. The individual does not get much from this. One needs to avoid risk and use a condom.

    This is a fraud pushed by people that don’t have it or don’t know the main male pleasure zones are in the parts cut off by circumcision. One thing is certain, no person should have pleasure zones amputated without being asked. Stop doing this to babies.

  13. Routinely Cutting off of parts of boys genitals is unethical, and a case of medical malpractice, its wrong to do it, it fails all medical ethics criteria because its a healthy body part that has nothing wrong with it. HIV Studies cant justify cutting off healthy body parts of children, period. We could produce studies that showed cutting off any body part, including female circumcision, could prevent some disease. Its just not a valid reason to cut off parts of children. We shouldnt cut off a boys ears or circumcise girls nor should we cut off parts of a boys genitals. Cutting off medically normal parts of little boys genitals is totally insane and there is no way that can be justified. Its genital mutilation, it would be illegal if it was done to girls, and boys have the same right to be protected from alterations of their genitals as girls do. Some people think that since its a boy, its okay to carve up his genitals, since thats only wrong to do to girls, which is appalling. FGM laws alreay prohibit alterations to girls genitals that are far less destructive than male circimcision which destroys the major erogenous zones of the male body. Circumcision also reduces male pleasure sensitivity. You cant cut off skin without removing nerve endings since nerve endings are in skin, so cutting off skin, cuts off nerve endings and that means there are fewer nerve endings left, and less sensitivity.

  14. These half-baked studies just add to the exaggerations and myths, perpetuating this horrible practice.

    Most Americans are circumcised, unlike the rest of the world, yet we have one of the highest HIV rates. All men are at risk for penile cancer, but it only affects 1-in-100,000 older men. Should the CDC recommend surgery to protect girls against breast cancer? Wouldn’t antibiotics be a better choice than surgery for a UTI? The 50% reduction in HIV may be true, but the studies really say that 1% of the circumcised men contracted HIV, compared to 2% of those still intact. Would you choose genital surgery to lower your risk 1%, knowing that real protected sex always includes a condom?

    We correctly outlawed the circumcision of girls in 1996 even though the “benefits” are similar. Still we continue to cut away 20,000 nerves and 50% of the most sensitive skin because “It looks better” or “He’ll look like dad”. Boys need equal protection, as promised by our Constitution.

  15. South African Medical Association’s Human Rights, Law & Ethics Committee stated that it was unethical and illegal to perform circumcision on infant boys. The Committee expressed serious concern not enough scientifically-based evidence was available to confirm circumcisions prevented HIV contraction and the public at large was influenced by incorrect and misrepresented information. http://tinyurl.com/3rhhpx8

    But there are serious money making racist wheels moving to keep on cutting up boys that need to be kicked top the curb: AB768 and HR2400 -healthy good for the penis and person my ASS.

  16. A variety of Jewish and Israeli groups are working to abolish circumcision.

    Beyond the Bris: A Jewish Intactivist Blog
    http://www.beyondthebris.com

    Jews Against Circumcision
    http://www.jewsagainstcircumcision.org

    Kahal: Giving Up Brit Milah (in Hebrew)
    http://www.kahal.org

    Gonnen: Protect the Child (in Hebrew)
    http://www.gonnen.org

    Questioning Circumcision: A Jewish Perspective
    http://www.jewishcircumcision.org

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