CDC Considers Promoting Routine Circumcision to Reduce HIV Risk
Tuesday, August 25, 2009 9:34In the wake of their analysis of research out of Africa showing that male circumcision may reduce the likelihood of HIV infection in men, the CDC is considering making a recommendation for routine infant circumcision in the US. CDC officials cite the high rate of HIV infection in the US, and a need to do something to control the epidemic.
Opponents to the recommendation point out that the research in Africa focused on men who had sex with women, and did not address the group at highest risk in the US – men who have sex with men. In fact, US research shows that there is probably little to no benefit to circumcision in preventing HIV transmission between men.
Even proponents of the possible recommendation admit that because the US already has a high rate of circumcision (>70% of American adult males are circumcised) AND a high rate of HIV infection as compared to other first world nations, routine infant circumcision is unlikely to have a major impact on HIV infection rates in the United States.
News reports also state that the American Academy of Pediatrics will be changing their official position on circumcision. At this time, the AAP has a neutral position on the benefits versus risks of male circumcision, and as a result, does not recommend circumcision on a routine basis. The new position paper from the AAP will most likely focus more on the potential benefits of circumcision, but will still NOT recommend circumcision as the standard of care for infants in the US.
Circumcision can be an emotionally charged issue, and opinions are often colored by the beliefs of different religious, social and ethnic groups. The decision is complex, and even medical professionals don’t seem to see eye to eye on the issue.
I guess we’ll see what the final recomendations for both organizations look like later this year. Until then, I think it is really important to point out that circumcision is a surgical procedure that carries certain risks. As such, the decision on whether to circumcise should lie with parents. Accurate information about the potential harms and benefits, and how this information actually applies to an infant born in the US, needs to be provided so that parents can make educated decisions.
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Petrina says:
August 26th, 2009 at 2:44 am
“The decision on whether to circumcise should lie with parents.” Actually, the decision on whether to circumcise should lie with the person who owns the penis, the child himself when he becomes an adult.and can make an educated decision for himself. This is also true of females. It should not be the decision of the parents whether to circumcise their daughters, but this is the reality in many African countries. It is not the right of anyone, physician or parent, to be amputating healthy body parts from another individual without their consent because this violates the other person’s bodily integrity. This seems to be a difficult concept for many physicians to grasp, perhaps because they profit financially from doing medically unnecessary surgeries. If they remember the dictum to “First, Do No Harm,” it might become more apparent that they need to start respecting the human rights of children. The medical profession did not do this in the twentieth century to the 70% of circumcised adult males alive today, and they are not doing this now whenever they amputate healthy body parts from defenseless children.
Kristie says:
August 26th, 2009 at 7:57 am
Petrina-
A little emotional here? Female circumcision has absolutely nothing to do with this article. Nether does circumcising anyone in Africa. I mentioned several times that we were talking about recommendations for routine cisumcision in US infant males. I was simply writing to inform parents of these upcoming changes in recommendations, and the fact that the AAP recommendations will most likely NOT coincide with the CDC document.
In an ideal situation, the owner of the body part would decide what to do when they were old enough to consent. However, in the US, it is a parent’s decision whether to do it, or to wait. Who would you rather have decide whether your son was circumcised – YOU or the government??? Personally, I’d rather have it be my decision, so I can say no.
-Kristie
John says:
February 3rd, 2010 at 3:13 pm
Kristie, maybe you would feel more emotional about circumcision if you were on the receiving end of the knife. Maybe one day doctors will find that removing the clitoral hood improves hygiene, eliminates vulvar cancer, and reduces the risk of urinary tract infection. Many men are angry that sexual tissue was amputated (the medical description actually used by the AAP in their description of circumcision) from them without consent. An important point you missed in Petrina’s letter is the definition of “you.” It’s not parents, and it’s not governments.
Kristie says:
February 3rd, 2010 at 5:45 pm
John, it’s quite obvious you don’t have the foggiest idea what my personal opinion about circumcision is. This article wasn’t entitled “Why Kristie Thinks Circumcision is ____”. Parents in the US need to be educated about what choices they will be asked to make in regards to their children, and they should know WHY current recommendations exist. Would you prefer they have no idea, and no education about the matter and just make the decision emotionally? If so, I can tell you from experience most will take the “I want him to look like Daddy” approach, and circumcision rates will not fall.