The Centers for Disease Control and Prevention (CDC) is considering recommending that clinicians advise teenage boys, men and parents of newborn boys that circumcision lowers the risk of female-to-male HIV transmission, The New York Times reports. Issued December 2, the recommendation draft has a 45-day peer review period, during which it is subject to public comments.
Three randomized controlled studies have shown that circumcised men have about a 60 percent reduced risk of acquiring HIV from vaginal sex. However, these studies were all conducted in sub-Saharan Africa, where heterosexual transmission is very common. In the United States, an estimated 63 percent of 50,000 new HIV cases each year are among men who have sex with men (MSM), while heterosexual transmission accounts for just 25 percent. As Andrew Sullivan points out in his blog, The Dish, only an estimated 4,000 men contract HIV from vaginal sex year in the United States.
There is no evidence that circumcision lowers a man’s risk of contracting HIV through sex with another man. Part of the reason may be that, among MSM, the virus is primarily transmitted through receptive anal intercourse. A circumcision would only protect the insertive partner (the top). Additionally, research suggests that men who are exclusively the insertive partner in sex with other men represent a relatively small fraction of all MSM.
Jonathan Mermin, MD, MPH, director of the National Center for HIV/AIDS at the CDC, told The Times that male circumcision is also linked to reduced sexually transmitted infections, including herpes, bacterial vaginosis and human papilloma virus (HPV).
The proposed recommendations state that teenage boys should receive counseling along with their parents about the various health benefits of circumcision and should have a say in the decision over whether to remove their foreskins.
To read a POZ feature about circumcision as HIV prevention, click here.
To read the New York Times story, click here.
To read the CDC proposal, click here.
To read the Andrew Sullivan blog, click here.
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