UNITED STATES: STDs May Change Stance on Circumcision

Mounting evidence of the disease-fighting benefits of male circumcision may change the way Americans feel about the procedure, some experts say. A large new study published this week [summarized in Thursday March 19th Prevention News Update] indicated that circumcised men had a 28 percent reduced risk of genital herpes infection and a 35 percent reduction in their risk of contracting human papillomavirus (HPV). Earlier studies had found circumcision reduces the risk of female-to-male HIV transmission by up to 60 percent.

Currently, Medicaid plans in 16 states do not cover circumcision, and more private insurance companies are following suit. However, "Data like this may then sway the opinions of leaders," said Dr. Anthony Fauci, a co-author of the new study and the director of the National Institute of Allergy and Infectious Diseases. Certain strains of HPV cause genital warts and about 70 percent of cervical cancer cases, and genital herpes facilitates transmission of HIV.

In a risks and benefits analysis issued in 1999 and reaffirmed in 2005, the American Academy of Pediatrics took a neutral position on male circumcision. "It does have health benefits, but it is not essential," said Dr. Susan Blank, who chairs the academy's Task Force on Neonatal Circumcision. She acknowledged, however, some "really very compelling data" that should be included in the next guidelines.

Rates of circumcision have fallen in recent years, due in part to the work of activist groups like Intact and Mothers Against Circumcision. However, economic factors come into play as well. "If you're controlling for all sorts of things that influence circumcision - race, economic standing, culture - the study still shows babies who are not covered [by insurance] are less likely to be circumcised," said Arleen Leibowitz, a professor of public policy at the University of California-Los Angeles and lead author of a large study investigating circumcision choice.