CDC Officials Consider Promoting Circumcision to Prevent HIV's Spread

By Allison Bond | August 24, 2009 6:18 pm

circumcision toolsIn an effort to stop the spread of HIV, public health officials are considering initiating a program that would encourage circumcision for all newborn boys in the United States.

Studies have shown that heterosexual adult men reduce their risk of HIV by 50 percent by being circumcised. “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” [The New York Times], says CDC epidemiologist Peter Kilmarx.

On the other hand, circumcision has not been shown to reduce HIV risk among men who have sex with men–the U.S. demographic with the highest risk of contracting the virus. And the American Academy of Pediatrics does not currently endorse routine circumcision, as it doesn’t consider the procedure essential to a baby’s well-being. Finally, nearly four-fifths of American men are circumcised, so it’s not clear whether a policy recommending circumcision would have much impact.

Related Content:
80beats: Study: Circumcision of HIV-Positive Men Doesn’t Protect Women
80beats: Male Circumcision Cuts Risk of HIV, Herpes, and HPV Transmission
DISCOVER: Male Circumcision: A New Defense Against HIV
DISCOVER: Finally! A Nearly Foolproof Circumcision

Image: flickr/ Topdog1

CATEGORIZED UNDER: Health & Medicine
  • Shawn

    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.

  • bud smith

    You have got to be kidding. This is he final blow against the legistamecy of this government agency.

  • foo

    Circumcision does not prevent HIV spread. Condoms do.

    We may as well ablate the labia of all girls to prevent HIV and other STDs as well as uro-genital infections.

    Also, preemptively extirpate the appendix, the spleen and the tonsils, just to be safe.

  • Christina Viering

    The CDC is not forcing circumcision on the public, they are encouraging it.

  • Ian

    Okay here we go again. First point, if the CDC is merely ‘encouraging’ circumcision, then how do they hope to reduce the spread of HIV?

    The second point is that this does not tackle the root cause – there needs to be change in culture and approach to sexual intercourse. Why does the world continue to ignore the success of Uganda’s faith based programme of ABC?

  • Jessica O.

    Please tell me how they think circumcision prevents anything?? Education and proper hygiene make a difference. God forbid people teach their children about sex these days though…..

  • John Kuehne

    This article repeats the 50% myth. Get this straight: it’s 50% in a two year period according the “African” studies. That means that half the circumcised men spared HIV infection in the first two period will become infected in the second tw0-year period. Do that math: if you are having risky sex, circumcision will at best only delay your infection.

    The CDC has no standing left in this matter. When the AIDS epidemic began, they haughtily announced they would have a vaccine in a few years. Now more than 20 years later they have been ineffective at stopping the disease. Amputating sexual tissue from non-consenting minors – who by the way are not having risky sex – is basically voodoo and witchcraft. It’s a desperate attempt to look like they’re in control.

    Why does Europe, where circumcision is rare, have lower rates of HIV infection than the U.S., where 80% of men are already circumcised? Why do so many African countries with high rates of circumcision also have high rates of HIV?

  • Restoring Tally

    There is too much junk science out there and too many people with an agenda (anyone ever notice that some of the pro-circ sites are really circumcision fetish sites?). The three Africa trials appear to have serious flaws in methodology, rendering their conclusions suspect. There are also studies that have conclusions that conflict with the three Africa trials.

    With respect to the CDC upcoming recommendation, first, babies do not have sex. So, RIC is not relevant to reducing HIV. Let the adult man decide if he wishes to have a portion of his sex organ removed by circumcision. If the man is smart, he will wear a condom when having at-risk sex.

    Second, having non-medically required surgery on an infant is a violation of that infant’s human rights and bodily integrity. It is illegal to perform non-medically required genital surgery on infant girls in the US. Why is there a double standard that allows genital surgery on baby boys?

    Many men are finding out that they miss their foreskin. They, like myself, are restoring their foreskin to regain what was taken from us at birth. See to read accounts of men who wish they had never been circumcised and are doing something about it.

  • Dude

    You guys/gals are too funny! Chatting away like experts, expressing religious views, declaring morals to be the solution to all evil. You have to lighten up a bit and take a more scientific point of view, rather than looking up fancy words on Wikipedia and pretending you are smart.

  • Pete

    There have been many good advances in HIV prevention. But I was surprised to see that, based on a few African studies which have internal flaws and are countered by some other studies suggesting the opposite, the US government may, very prematurely, promote circumcision of newborns.

    Sure, the procedure may be offered to adults. But how could anyone ever ethically justify remove a healthy, functioning structure from an infant? Assuming that he will engage in unsafe sex later, and wishing to *possibly* provide a *partial* reduction of risk of a disease, a disease preventable by other means, years and years down the road?

    The HIV/AIDS fight has many promising battles ahead, but implementing permanent alteration of the bodies of infants is not a victory.

  • Waldo

    Basically everything Restoring Tally said plus the fact that it doesn’t prevent HIV infection if you keep having sex with infected people. Using dodgy studies to support endorsement of a surgical procedure on babies that might prevent a disease few decades later if they happen to have sex with infected person only once or so? Way to go. I am uncircumcized and glad about it and I feel it would be wrong to make that decision for me. I am not engaging in risky sex, nor are most people, so why should that be a reason for circumcision? Quite stupid if you ask me.

  • Adam (and Eve)

    The science is IN !!!!

    NO more highly emotive and alarmist crap from the anticircs

    Millions of people (men and women) will now avoid contracting a wide range of sexually transmitted diseases

    Policies must be formulated urgently

  • Joseph

    Stop and think about this for a minute. Circumcision is something that’s already quite common here in the states, at about 80 of males already circumcised, yet we have a higher HIV rate than countries in Europe where they don’t.

    Keep thinking. There are already studies that say that FGM reduces the risk of HIV. But we would NEVER allow the CDC to even consider this as any kind of tool against HIV.Furthermore. Newborns aren’t having sex. The decision should be HIS to decide when he is a mature adult. HIS body, HIS choice.

    Adam, scaring people with HIV to circumcise their sons IS “alarmist crap.” We’re not the special interest group, pro-circs are. They are interested in “universal circumcision” and could give an actual carp about HIV reduction.

    No, circumcision does not prevent anything. Circumcised men get every STD including AIDs, just like intact men do. It’s no excuse to circumcise a newborn, who doesn’t even have sex yet.

    Let’s talk about the science:

    The CDC is basing its consideration on completely flawed “studies.” Circumcised men were told to abstain from sex for 6 weeks following their operation and were instructed in the use of condoms. Look at the study abstract for more details. Furthermore, the “studies” were ended early, while the numbers were “solid.” Not to mention information from other countries where circumcised men with HIV far outnumbered intact men with HIV were deliberately omitted. One needs to question the validity of “studies” that seek to find a problem for a solution, and not a solution to a problem.

    Hardly scientific at all.

    The best “policy” is to let concenting adults make their OWN choices, not “recommend” the deliberate mutilation and violation of human rights of non-consenting individuals.

  • Cobra71

    The real issue is the dwindling supply of neonatal foreskin tissue available to the medical industry. One small vial of neonatal keratinocytes goes for $300. Neonatal foreskin tissue is processed into cosmetics, skin graft material and various assorted products. As circ rates drop, the medical industry needs to find a new boogeyman to scare parents into mutilating their children. The African AIDS studies this is based on are flawed to the point of laughability. Say NO to these greedy fools! Enough is enough! We have to protect our children from this abuse!

  • Steve

    Circumcised males are missing about 15 square inches of penile skin and many thousands of high pleasure giving erogenous nerve endings. I believe that male circumcisions cut off a lot more nerve endings than female circumcisions do. So in my opinion circumcising baby boys is even worse than circumcising baby girls.

    At the circumstitions/HIV website it lists 20 studies that show circumcisions do not reduce the likelihood of males getting HIV, 4 of those studies show that circumcisions increase the likelihood of males getting HIV. Also at that site it shows that in at least 7 African countries circumcised males have higher AIDS rates than uncircumcised males. A couple years ago the CDC did a study in the U.S. which showed that U.S. men are just as likely to become infected with HIV whether they are circumcised or not. So there are a lot of strong conflicting evidences on whether or not circumcisions reduce the risk of males getting HIV.

  • Steve

    If the CDC does recommend that baby boys be circumcised, they would be the only national medical organization in the world to recommend that baby boys be circumcised. I can’t believe that the CDC really would put themselves in the position of being the only national medical organization in the world to recommend it.

    In much if not in most of Europe it is practically illegal to circumcise baby boys, with an exception for Muslims and Jews to do religious circumcisions. In Canada the main medical organizations recommend against circumcising baby boys. So in my opinion if anything the CDC should be recommending against circumcising baby boys.

  • Someone

    Adam (and Eve) said:

    “The science is IN !!!!

    NO more highly emotive and alarmist crap from the anticircs

    Millions of people (men and women) will now avoid contracting a wide range of sexually transmitted diseases

    Policies must be formulated urgently”

    Excuse me? I hope you’re not being serious.

    1: Junk science. The African studies have flaws in the methodology. The circumcised group was told to abstain while waiting for their wounds to heal and instructed in condom usage. The uncircumcised group had no such restrictions or counseling. That is a terribly one-sided way to conduct any “scientific” study. How could anyone expect accurate and non-biased results from THAT? Conveniently, (in an odd and suspicious kind of way) another study further down aimed at the pro-circ literature turned out to have unfavorable results where the circumcised were having higher infection rates, and so they canceled it early dismissing the findings as “flawed”. Bias, bias, bias… It’s showing quite well.

    2: Hopefully we won’t be having anymore thoughtless and fraudulent BS from you pro-circs either. When you restrain an infant and rip off a part of his body without his consent based on mere speculation at his future behaviors or partners, you can bet money it’s going to get highly emotional and personal. Especially from those circumcised in infancy who turned out to resent their ill-advised parents decision. I am one such man. It’s only reasonable to be held to account for this kind of thing.

    3: No, they will not. The only thing that is going to happen is the same thing as it has always been thus far. Nothing changes for the better. A circumcised penis is still flesh, it’s still susceptible to infections of any kind regardless of it’s physical state. Circumcision doesn’t have any bearing on risky behavior as well which is the primary risk factor for all STD’s, so a circumcised man can still get infected much the same way as any uncircumcised one can. You seem to be forgetting that the US is already largely circ’d and yet they somehow have higher rates of STD’s by comparison to other developed nations where the circ rates are lower, despite your miracle studies attempting to find something positive out of it. That’s a negative correlation to circ right out there in the open if you care to look for it. Nevermind the fact that Africans have a different circumstance and culture from the Americas… Can you really apply those studies to the US given consideration of that? I don’t think so, I’m sure many others do too.

    4: And you can rest assured that we will be beside and never stop fighting those policies every step and inch of the way. They aren’t logically going to change anything for the better anytime soon, (and even when that happens I doubt it will be from circ) so what’s the rush here?

  • Booloo21

    I was circumcised as an infant , there were no complications (urologists have confirmed that mine was pretty standard), but it caused me long term sexual relationship problems. Thanks mom and dad for ruining my sex life. Needless to say it ruined our relationship as well. Is that a risk worth taking instead of teaching your son safe sex?

  • Steve

    Australia just released a new policy statement on circumcision. In their new policy statement they state that circumcision is not justified medically, even in light of recent HIV findings from Africa. In my opinion the CDC should be saying the same thing as Australia.

  • cobra71

    I hope you creeps who mutilated your kids get what’s coming to you. I hope they grow up and hate you for taking away their choice. I hope they revile you for mutilating their bodies without consent. I hope they dance on your graves after you’re dead for not protecting them from harm. Think about that why don’t you. The tide against circumcision is growing higher and higher, despite the lies that the circumcision fetish crowd keeps spreading. By the time your kids are grown up, it will be seen as a true crime against human rights, and they will never let their resentment of your stupidity and selfishness go.

  • Bill

    This is just the latest myth and exaggeration of the facts used to perpetuate this horrible practice.

    What about the claim that is reduces the chance of developing penile cancer? The truth is that it is an extremely rare cancer limited to older men, and both intact and cut males remain at risk for this 1-in-100,000 disease. Perhaps the CDC will next recommend surgery on baby girls to provide 100% protection against breast cancer. And so what if circumcision lowers risk of UTI’s a bit? Wouldn’t an antibiotic like the ladies use be a better choice than elective surgery?

    This latest claim of reducing the risk of HIV is just more of the same distortion of the facts.
    The claim that is it cuts the risk in half might be true. But if you will simply read the studies, you will learn that over a typical 2 year period, the actual claims are that 1% of the circumcised men group contracted HIV, compared to 2% of those that had remained intact. Do you know anyone who would choose to have surgery on their genitals for prevention if it only lowered their risk 1%, particularly when everyone knows that a condom is really the only way to have protected sex?

    The USA is the only developed country that still routinely circumcises baby boys for non-religious reasons. The history of the practice in our county traces back to the late 1890’s, when doctors believed that masturbation caused illness, and they knew that a denuded penis reduced the pleasure. Since then, this mutilation of males has continued to look for justification. Societies that circumcised females use the same justifications, stating the females are cleaner, more attractive, and less prone to disease. Our nation sees these atrocities for what they are, and outlawed the practice in 1996. But still, we cut away 20,000 nerve endings and 30-50% of the most sensitive skin on a baby boy, and say stupid things like “It looks better” or “he should look like his dad”. One day, the men of this nation are going to learn the truth about what was taken from then and rise up to demand that all children have the right to decide if they what their genitals cut, not their well intentioned, but terribly misguided parents.

  • Robert Grasse

    [Moderator’s note: this comment has been removed for violating DISCOVER’s standards of civil discussion.]

  • advorak

    When I was born in the 1950s, circumcision was a completely standard procedure in the U.S.; almost no male babies born in U.S. hospitals during that era made it out of the hospital intact. So, I can hardly blame my parents for the fact that I’m circumcised. Today, however, it is far from a given that a baby born in the U.S. will be circumcised. Boys today who are circumcised understand, or will come to understand, that their parents made a deliberate decision to have part of their genitals amputated. If you are a soon-to-be parent of a boy and are considering having him circumcised, you need to think about the fact that if you do have him circ’d, one day he will know that you chose to do this to him, and he may resent you or hate you for it. He might let you know how he feels, or worse, he might be embarrased to bring it up and hate you silently.

  • David Game

    This is so silly. Circumcision can potentially help stop HIV. I am completely happy with my circumsized penis and i am a bisexual male. I have had condoms break on me and i will be very happy to know that i have a second line of defense. You say your child may hate you for getting him cut, thats so silly, what kind of sex crazed child hates their parent for a medical procedure that no one really even notices or discusses except in situations like these. You can choose to possibly lend a helping hand in potentially protecting your child or you can be foolish.

    Now i understand for religious reasons or even for personal choices not doing it for your kid but for all these people to be soo upset about the cdc just suggesting a healthier choice is downright silly. It’s ultimately your choice for your baby but PEOPLE SHOULD STILL BE POINTED IN THE HEALTHY DIRECTION.

  • Medpro82

    Here is some actual science about circumcision preventing HIV…

    “Immunocompetent cells expressing specific HIV receptors are present in all mucosal surfaces of the penis. Once HIV binds to a receptor, the target cell then migrates to the regional lymph node where infection of CD4 T cells is established. To determine where HIV enters the penis we have studied the distribution of target cells in the glans penis, frenulum, foreskin and urethral meatus from 5 fresh, uncircumcised penises obtained at autopsy. We also measured the thickness of the overlying layer of keratin which potentially prevents HIV gaining access to these penile receptors. MethodsLangerhans cells, dendritic cells, macrophages and T-cells were studied using immunohistochemical staining techniques on fresh-frozen penile sections examined by confocal microscopy. Keratin thickness was measured using histochemical staining and light microscopy. ResultsHIV target cells expressing CD4 and CCR5 were found in the inner and outer foreskin, frenulum and glans penis, but at lower levels in the urethral meatus and penile urethra. Dendritic cells, macrophages and T cells expressing these receptors were observed in high densities in the dermis of all regions of the penis except the urethra. HIV susceptible Langerhans cells in the inner foreskin and frenulum were closer to the epithelial surface, but less frequent than in the outer foreskin and glans. There was little if any protective covering of keratin overlying the inner foreskin and frenulum, in contrast to the glans penis and outer foreskin which were heavily keratinized, thus protecting them from viral entry. ConclusionsHIV is most likely to enter the penis of uncircumcised men via superficial Langerhans cells on the inner aspect of the foreskin and frenulum since these sites are not keratinised. The major protective effect of male circumcision can best be explained by the removal of most HIV receptor sites in the foreskin and frenulum.”-McCoombe SG, Cameron PU, Short RV; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
    Int Conf AIDS. 2004 Jul 11-16; 15

    I was circumcised as an adult after I had had several sexual partners. I chose circumcision for religous reasons, but I found an unintended benefit….SEX IS BETTER… WAY BETTER. I had a great sex life before, but it is better now.. I think all the guys who are complaining about not having a foreskin are nuts. If you had a bad sex life before, adding a foreskin is not going to change anything, but good luck with that..

  • Menzo

    Basically everything Restoring Tally said plus the fact that it doesn’t prevent HIV infection if you keep having sex with infected people. Using dodgy studies to support endorsement of a surgical procedure on babies that might prevent a disease few decades later if they happen to have sex with infected person only once or so? Way to go. I am uncircumcized and glad about it and I feel it would be wrong to make that decision for me. I am not engaging in risky sex, nor are most people, so why should that be a reason for circumcision? Quite stupid if you ask me.

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