Thursday, November 19, 2009

Part II: Will a Mandate to Circumcise Newborns Reduce the Spread of HIV in the United States?

I am hoping that you read the last post about the Studies that this possible mandate is based. If not, I encourage you to do so.

I have thought about the statistics all week long. When I hear that circumcision lowers risk for HIV infection by 50-60%, I automatically think in crazy numbers. When worded that way, it leads the reader to think that only 40-50% of the circumcised males may contract the HIV virus. Or that the uncircumcised males have a 50-60% increased risk of contracting HIV.

I'd just like to point out again that this 50-60% rate that keeps getting thrown in our face is based on a HALF PERCENTAGE POINT. There were many factors involved that were not kept track of. The men received extensive counseling on the benefits of using condoms and approximately 98% of the men did not contract the HIV virus.

Circumcising Newborns:
This would be a "preventative" measure that we would not see the effects of for many years. The complication rate ranges from 20%-35% (based on those African studies!), and this must be considered when weighing benefits and risks.

Ironically, we have an HIV epidemic in the US now, and the majority of those males are circumcised. The use of condoms has been shown to reduce the spread of HIV, and there has been no evidence that being circumcised and wearing condoms is any better than just using condoms alone. We have twice as many HIV infected males in the US as does Europe and our circumcision rates are significantly higher. According to many medical organizations, including the American Academy of Pediatrics, in 2005, stated that the "data on the potential medical benefits of circumcision are not sufficient to recommend routine neonatal circumcision."

The way that HIV is transmitted in the US is so different from Africa, it is hard to even compare the two. We actually have an effective social program in place with education, safe-sex practices, and consistent condom use. These methods do not require surgery, are much more cost-effective, and they work! In fact, consistent condom use reduces the lifetime risk by 20% compared to only 8% for circumcision. A recent report from South Africa shows that condom use is increasing and the HIV rates are beginning to level off. There is no evidence that circumcision will aid in this progress.

Quite honestly, it is irresponsible for the CDC to even consider promoting an intervention that will create a false sense of security, while actually increasing the risk to women. Promoting circumcision will drain resources that should be put into safe-sex education and condom promotion.


Mark Lyndon said...

In Europe, almost no-one circumcises unless they're Muslim or Jewish, and they have significantly lower rates of almost all STI's including HIV.

Even in Africa, there are six countries where men are more likely to be HIV+ if they've been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men. If circumcision really worked against AIDS, this just wouldn't happen. We now have people calling circumcision a "vaccine" or "invisible condom", and viewing circumcision as an alternative to condoms.

The one study into male-to-female transmission showed a 50% higher rate in the group where the men had been circumcised btw.

ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost lives, not save them.

Donna Ryan said...

Thank you so much for sharing that information.

Anonymous said...

I love your blog! Tonight was the first time I ever found it and I'm so glad I did! I'm also in N. TX and I'm a huge intactivist and despite being an OB RN in a hospital, I birthed my youngest at home and I'm all about natural childbirth. It's so nice to find someone else in the metroplex who understands circumcision isn't the "cure all" they are trying to make it out to be. If you want any circ pamphlets for your classes, please let me know. Keep up the good work on this blog. It looks like a great source of natural parenting info!

Donna Ryan said...

Anonymous, I'm glad you found my blog and enjoyed what you read. I'm curious where you are. I am one of the chapter leaders for the Tarrant County Birth Network. It is in the infant stages, for sure. I'd love to get your info. Are you in Dallas or Tarrant County?

I have a lot of articles on circumcision that I give my students, but sometimes I think they are totally overwhelmed by it. I'd love to see anything you might have and be willing to share.

Email me:

Anonymous said...

I'm in Denton County. I'll email you soon!

prashant said...

It's so nice to find someone else in the metroplex

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noelani said...

It hasn't worked so far, so I don't know how anyone could honestly believe it would help in the future. For decades, the USA has had both the highest percentage of sexually active men who are circumcise AND the highest rates of HIV/AIDS (and other STDs) in the industrialized world. There are physicians, many with a religious motive, who keep grasping straws to try to find excuses for cutting off part of baby boys' genitals. Instead of comparing groups in Africa, whose standard of living, access to health care, indoor plumbing, sexual practices, etc. bear little resemblance to ours, they should look all around themselves, here in America, at the high rates of those diseases in American men. They know that, but they also know that looking at rates of HIV in America and comparing them to other countries whose lives are a lot like ours would not support circumcising.

I don't know why it is so hard. No one is saying that those who have previously done circumcisions should be punished for it, forced to publicly admit wrongdoing, or anything like that. All anyone is asking is that they just STOP DOING IT!

If anyone has a hard time understanding why people like me feel that it is so important, I've got an almost fool-proof way you can do it. Just imagine a baby girl being strapped down and having part of her genitals cut off. It makes you angry, doesn't it? It might even make you cry. That is exactly how I feel about both circumcising little girls AND little boys! Cultures that perform varying forms of female circumcision cite benefits for it, too, but there really isn't any supposed "benefit" that justifies it. It is an abomination to cut the genitals of ANY child!