Washington Blade Article on Circumcision as an HIV Prevention Strategy

Dr. Stephen Fallon has an article in today's Washington Blade discussing circumcision as HIV prevention strategy. Fallon writes "No, this isn’t a plot synopsis for “Nip & Tuck.” Circumcising adult men reduces their susceptibility to HIV infection by a large enough margin that New York City’s Department of Health is considering promoting, and possibly even paying for the procedure. The United Nations has even developed a kit to teach doctors in developing nations how to perform a circumcision safely on adults." Fallon goes on to discuss how circumcision applies to HIV prevention in detail. It's a good article, but I was disappointed to see that he didn't reference the one study that has looked at circumcision specifically in gay men. This study was not designed to look specifically at circumcision (not randomized, controlled, like the Kenya and Uganda Studies). Still, it is the best data we have. This longitudinal study which enrolled 3257 gay men in six US cities from 1995 to 1997, also found a difference between circumcised and uncircumcised men. This study followed men at high risk for HIV over a period of 18 months. The study showed "lack of circumcision was independently associated with a two fold risk of prevalent infection." [Buchbinder SP et al. Sexual risk, nitrite inhalant use, and lack of circumcision associated with HIV seroconversion in men who have sex with men in the United States. JAIDS 39(1):82-9. 2005.] Read the entire article here

An Ounce of Prevention is Worth a Pound of Cure

The DC Fights Back/C2EA Consensus Document on male circumcision as an HIV prevention strategy has been submitted to the Department of Health HIV/AIDS Administration. Click here to read the consensus statement. There is also an article on male circumcision in this month's ACTION Newsletter. I also brought this up in my group at the Mayor's Summit on HIV/AIDS, so I expect to see it in the outcome document from that meeting. I was at Howard University Hospital for the IMPAACT Community Advisory Board meeting, and I had a chance to discuss this issue with medical professionals there. It's pretty clear to me that there are folks who don't get circumcised not because they don't want it, but because it's not covered by their insurance and they don't have the money. This is a case where a small investment in this procedure could have a tremendous impact on the health and well being of District Residents, not to mention the bottom line. A circumcision procedure is a heck of a lot cheaper than a lifetime of HIV meds. For a group of DC residents who would opt to be circumcised and are at risk for HIV by heterosexual transmission, we know that we can cut that risk in half. To ignore this fact is simply unconscionable.

Circumcision: DC Needs to Act Now

Last month I wrote a detailed fact sheet and resource page about Male Circumcision as an HIV Prevention Strategy and encouraged DC to take immediate action. I was hoping DC would be the first city to respond to the new and compelling data on circumcision. That ship has sailed. Today I learned that the New York City Department of Health is moving forward with circumcision as an HIV prevention strategy according to an article in today's New York Times. The New York Health Commissioner has already done an analysis and believes that "even 1,000 circumcisions in the right subgroups might slow the spread of AIDS". The DC Department of Health, however, appears to be missing this opportunity completely. This is an important issue, and one that dispraportionately impacts people of color and immigrant populations, both of which are less likely to be circumcised. We need to take action now. Campaign to End AIDS has already endorsed this consensus statement on circumcision as an HIV prevention strategy in DC. If your organization or you as an individual would like to sign on to this letter please send an e-mail to: circumcision@fighthivindc.org by Friday April 13th. And remember, tomorrow is the deadline to sign on to the letter on comprehensive sex education.

Circumcision Studies Warrant Response from HIV/AIDS Administration

Two studies recently published in the Lancet both reach the same conclusion: men who are not circumcised are much more likely to acquire HIV through heterosexual sex than man who are circumcised. This doesn't change the fact that abstinence is the only 100% effective way to prevent HIV. It doesn't change the fact that for the rest of us, condoms are highly effective in preventing HIV. But of course not all of us are perfect all of the time, which is why the epidemic continues to grow. So circumcision can offer men another tool to lower their risk for HIV. These studies took place in Kenya and Uganda. And given the high rates of HIV in those countries, circumcision efforts are expected to quickly become an integrated part of HIV prevention in those countries. But what about the District of Columbia? Our HIV rates are comparable with those of Sub-Saharan Africa. And while we don't know how many men are circumcised in DC, we do know from national data that rates of circumcision among African Americans, Hispanic Americans, and Immigrant Populations are all relatively low. This suggests to me that there are many men (of all ages) in DC Circumcision could be an important tool in our fight against HIV in the District of Columbia, if we take action. I've compiled information about HIV and Circumcision in DC on this page, which includes a fact sheet with all the basic information and citations. Please download the fact sheet now by clicking here Read it over. Think about it. Share it with others. In the coming week I'll be adding additional posts about male circumcision in DC and how we can take action. Compelling new data such as this calls for an immediate response from the HIV/AIDS Administration. Let's make sure that happens.