News

CDC May Recommend Infant Circumcisions to Combat HIV

by Kilian Melloy
Monday Aug 24, 2009

The Centers for Disease Control and Prevention (CDC) is weighing a recommendation that all newborn males be circumcised in an effort to curb HIV infections.

An Aug. 23 article at The New York Times noted that the CDC's recommendation is expected to be released in draft form by year's end, but that the issue of circumcision as a means to help prevent HIV transmission has already proved controversial--in part because of the varying results indicated by different studies.

Research indicates that circumcised men are less likely to be infected with HIV as a consequence of sex with HIV+ female partners. But men who sex with men (MSMs) have not been shown to have different rates of infection depending on whether or not they are circumcised, the article said.

An Oct. 8, 2008 Associated Press article also reported that no protective result had been found for circumcision among MSMs.

Because the recommendation would involve subjecting newborns to circumcision, opponents charge that it's tantamount to imposing a surgical procedure.

Despite objections, and despite a lack of evidence pointing to a comprehensive reduction in HIV transmission, some health authorities see circumcision as necessary in the fight against HIV and the disease that the virus leads to, AIDS.

The article quoted the CDC's Dr. Peter Kilmarx, in charge of epidemiology for the CDC's HIV/AIDS prevention department, who defended the recommendation, saying, "We have a significant H.I.V. epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic.

"What we've heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks," added Dr. Kilmarx.

But the benefits in the United States might not be as dramatic as those observed in African countries where research into the issue has taken place.

The New York Times noted that the incidence of HIV transmission to heterosexual circumcised men in several African nations--Kenya, South Africa, and Uganda--was reduced by up to 60%, compared to uncircumcised men.

In Africa, the spread of HIV is much more prevalent in the heterosexual population.

Critics note that because circumcision has not been shown to reduce HIV transmission between MSMs in the United States, the recommendation may not be of any practical value. Moreover, the article said, more than three-quarters of American men are circumcised.

However, in a few decades, that proportion will shift, because circumcision for newborns is not as prevalent as it once was. Moreover, the article said, more Hispanics and African Americans are choosing not to have their make babies circumcised; those populations are harder hit by HIV and AIDS than are Caucasians.

The article noted that the trend may be about to reverse regardless of whether circumcision helps prevent HIV transmission: circumcision can also help prevent other health issues, the article cited American Academy of Pediatrics consultant Dr. Michael Brady as noting.

"We do have evidence to suggest there are health benefits, and families should be given an opportunity to know what they are," the article quoted Dr. Brady as saying.

Moreover, there are indications that circumcised men may have lower rates of other diseases as well, such as syphilis and herpes, the article said.

Another study found that syphilis rates were not affected by circumcision, but that transmission of human papillomavirus (HPV), which can cause cervical cancer in women, was less likely to be passed on to a female sex partner by a circumcised man than by an uncircumcised man, a March 26 AP story reported.

That article noted that only about 30% of the world's male population is circumcised.

When it comes to circumcision and HIV, however, "Our biggest struggle is trying to figure out how to understand the true value for Americans," Dr. Brady said.

An anti-circumcision group, Intact America, is taking its message to Atlanta, where the CDC's National H.I.V. Prevention Conference convenes this week. The article said that Intact America has arranged for mobile billboards to circulate around the city with ads that say HIV rates will not be lowered through the circumcision of infants.

The head of Intact America, Georganne Chapin, was quoted in the article as noting that even heterosexual men gain some benefit in terms of HIV risk, circumcision in itself does not constitute safer sex.

Said Chapin, "Men still need to use condoms."

The article noted that the studies were ambiguous about whether sex with circumcised men was safer for women.

Though experts may be uncertain as yet how much good circumcision would actually do for Americans, in Botswana a program to circumcise up to half a million men by 2012 is already underway, according to a May 30 Associated Press article.

Kilian Melloy serves as EDGE Media Network's Assistant Arts Editor. He also reviews theater for WBUR. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.


Comments

  • , 2009-08-24 15:30:59

    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.


  • , 2009-08-24 15:51:46

    Has anyone researched other countries who have intact natural foreskins? I heard the UTI, prostate cancer and other Male Diseases are much greater in the U.S. than any other country? The CDC is blind, Ignorant and quite Arrogant. God Gave us a foreskin, why take it away? 75% of all uncut men in the World are doing fine, thank you! This is fear mongering and the Americans are too stupid to search out the truth! Who knows if this stupid & insane idea is a Muslim / Jewish Conspiracy! Hospital Income derived from Circumcision Procedures range from $ 400.00 to $1,500.00 per circumcision! Nice take for Greedy people! We destroy the awesome sexual feeling that our infant boys will experience when they reach puberty. We sacrifice these boys and soon to be young Men in the name of the Almighty Dollar! If you are so afraid of HIV, Wear a Condom. That is the smart thing to do whether you are gay or straight!!


  • , 2009-08-24 18:26:52

    I could not disagree more with the other comments below. I am circumcised, as was my father, as is my son. Sounds like some really angry people commenting below about a personal family decision. By the way, I have some awesome sexual feelings... no problems in that area. So please take you BS elsewhere. Cheers to the CDC!!!


  • , 2009-08-24 18:59:13

    if circumcision really prevents disease, let the CDC present their case to males who are at the age of consent and let them decide whether they want to hack healthy, functioning parts of the penis off. Subjecting infants to this procedure is a human rights violation and always has been..funny, the CDC doesn’t mention Europe, especially Scandinavia because almost all are uncut in that country and they have the lowest disease incidence of anywhere in the world.


  • , 2009-08-24 19:01:57

    In West Africa and North Africa where male circumcision is above 80 percent, HIV/AIDS infection rates are in single digits (1-5 percent). In East and Southern African nations where male circumcision is below 20 percent, HIV-AIDS infection rate is double-digit (20-30 percent infection rate).


  • , 2009-08-24 19:08:39

    My two sons were circumcised by two different doctors. What upset me was that the first one took off more foreskin than the second one. Just a little bit seemed to be much better. Mrs. R. Hopkins


  • , 2009-08-24 19:11:45

    My two sons were circumcised by two different doctors. The second was done much better by removing only a smsll amount of foreskin. R. Hopkins


  • , 2009-08-24 22:48:53

    If men are engaging in risky sexual behavior, circumcision will not prevent contracting disease, it may only delay the inevitable. Do what you want with your own penis, but defenseless childrens bodies should be left alone.


  • , 2009-08-25 11:18:57

    While I can understand why some people object to infant male circumcision, the near-violence of their opinions in the face of any scientific evidence renders their arguments less forceful.


  • , 2009-08-25 16:12:20

    This tragedy of infant circumcision sexual mutilation is far, far darker than the matter of greed keeping it going on in this sick, violent, religion-damaged US. Greed is just a nice side benefit from the really dark and troubling matter of the psychopathology behind the torturing and the sexual mutilation of the helpless healthy, the ones who cannot consent to sexual mutilation nor escape from the sexual mutilator (MDs, Jews, Muslims). The psychopathology is the great fear, envy, and intense hatred of the intact penis and of its owner. Sexually mutilated men are most content when all or nearly all other men around them are also sexually mutilated, and they ensure this by so easily finding more victims in the form of baby boys. Sexual mutilators would never succeed in seizing intact men in the US and sexually mutilating them (even though this has happened in the past elsewhere and continues today at times elsewhere in the world). This is why it’s so difficult to convince young sexually mutilated fathers to keep their sons intact: the father really cannot stand the thought that his son will have a whole, normal, natural penis when he (the father) has a desexualized, scrawny, dried-up, man-made, man-damaged primary sex organ which can only bring a limited, greatly reduced and permanently damaged sexual experience and poor sexual pleasure. The sex partner of a sexually mutilated man is also cheated: he or she cannot witness the thrill of the man who, by birthright, should enjoy the full measure, the full degree of male sexual pleasure. To the young sexually mutilated man who wrote here that he’s thrilled to be sexually mutilated and whose son and father are also sexually mutilated: you foolishly forget that you can only know what’s been left of your penis after the sexual mutilation. You were cheatd at the start of your life and you will forever remain cheated. Your penis was permanently altered at your birth and your penis is forever damaged anatomically, neurologically and physiologically. You (and your son in time) will only ever know a small part of male sexual pleasure and you’ll never know how easy it is for an intact man to control and enjoy the full measure, the full degree of male sexual pleasure. In your son, you brought about another future sexual mutilator.


  • , 2009-08-25 23:47:41

    Those of you who are using terms like "mutilation" are not being logical: we don’t call tonsilectomy a mutilation; I doubt if anyone calls ear-piercing a mutilation. Circumcision is a medical procedure (or a religious one) and it has benefits. Leaving the penis uncut may or may not have problems - for many sooner or later it does. Circumcision often is the best way to relieve the pressure of a too-tight foreskin. And it does no harm. Whether it causes one’s sexual pleasure to be lessened is at best a debatible topic. There are anecdotal arguments on both sides. What I hate to see is that "one’s own sexual pleasure" is being used as the reason NOT to circumcise. At best, this selfish argument allows the threat of things like cervical cancer to remain threatening to one’s spouse. Is that the right thing to do? Sex is meant to be given; no one has a right to "take it". One last point: there is evidence that the substance which aids coagulation, not present at birth, increases in percentage until it reaches 120% on the 8th day and then levels off at 100% for the rest of life. The 8th day is the safest for the procedure, especially in less hygenic societies.


  • , 2009-08-26 06:45:14

    Mutilation is the best word to describe it. Mutilation is an act that degrades the appearance or function of any living body. Removing 50%-75% of the folded skin of the penile shaft destroys the proper gliding fuction and removes the most sensitive sensory nerve endings. Piercing ears doesn’t and tonsillectomys are now only done in rare cases (for many years they were a money making fraud, along with lobotomies, hysterectomys, clitoridectomys.) There is enough evidence out there that proves this is another medical money making scam that has gone on too long. With every new generation the medical industry touts some new reason to keep this despicable barbaric act going. (It was first done to stop masturbation, then it was to prevent insanity, then polio, then penile cancer, then urinary tract infections, and now HIV.)There is no reason to circumcise, the skin is attached and doesn’t fully retract in most boys until puberty. If it still remains to tight there are simple creams that work instead of cutting. It is strange how over 80% of the world doesn’t have so many foreskin problems that result in removal. Ignorant parents buy into the lies and betray their sons. Ask some questions, why are all of the studies done in Africa and not peer reviewed before being sold to the media? ANSWER- It is eaiser to cook the results, language barrier, men dropping out of the studies, stopping the study after two years, not checking the status of the women the men slept with. As far as justifing cutting a boys genitals to prevent cervical cancer another lame reason. 80% of American men are circumcised and over half of men get HPV at some point. All of the claims of diseases that are eaiser to aquire because of intact foreskin are all based on pseudoscience. There has never been close analysis of viruses being spread because of foreskin, only stats taken from poor impoverished countries by biased researchers eager to get millions in Gates foundation or WHO money. Half of American doctors back the claims because of the huge profit involved, also the cosmetic and research industries use the infant foreskin to make skin creams and grafts. Do some research the sickness goes on and on. Men need to realize what was done to them, and women need to learn to at least give basic human rights to boys (women sure would be upset if their labia was cut without their permission, but have no problem imposing painful surgery on an infant male to satisfy their preference. If this country truly cared about baby boys they wouldn’t risk their health and sometimes their lifes. At over a 2% complication rate over 25 boys a day have a botched circumcision. Up to 30% have a minor one, (excessive bleeding improper healing.) Most won’t have any signs till they get older, skin to tight, scrotum stretched resulting in hair on the shaft, highly visible wide scar. A boys fate is left with how much skin the doctor pulls up, as mentioned in the comment 5 posts up. People that support this cultural disease need to realize they have no right to alter the genitals of a human being. Start really caring about boys and instead worry more about things like the 80% male teen suicide rate,or the high drop out rate and other things the more strongly impact boys, and stop this circumrape.


  • , 2009-08-29 12:32:51

    The studies concentrate on countries where there is poor hygiene. I wonder if the same stats are true in the U.S.,where people regularly clean under the foreskin. If true, this would make infant circumcision something necessary in Third World countries, but less so in the developed world. Just a thought.


  • , 2009-08-29 12:34:13

    There’s also an aesthetic argument. Maybe I’m culturally conditioned, but I’ve often run across foreskins that are, well, gross - covering up the penis so much it really gets in the way during sex and even urination.


  • , 2009-08-31 15:56:52

    The CDC is are doing this entire issue an injustice by combining the possible HIV prevention benefits in adults with the morally questionable practice of elective, irreversible, unnecessary surgery on defenseless infants. We should let the adults look at the data and decide for themselves, and leave the babies as they were born.


  • , 2009-09-02 10:50:35

    Did you know that without your permission a hospital can sell your baby’s foreskin? How can you let your baby boy be mutilated for science against his or your wishes? Give your boy a choice it’s his body. Did you know that comparable surgery is banned for girls? Talk about sexist!


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