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Gingersnap
04-01-2009, 12:55 PM
Should all males be circumcised?
Some U.S. doctors are reconsidering their position

Duane Hoffmann / MSNBC
Updated 6:30 a.m. MT, Wed., April. 1, 2009

The day your wife gives birth to a baby boy, the kind, bespectacled face of Marvin L. Wang, M.D., is one that you want to see coming through the recovery-room door. Co-director of newborn nurseries at Massachusetts General Hospital in Boston, Dr. Wang has a perky, conversational bedside manner that puts everyone at ease.

I have to hustle to keep up with him as he strides energetically between hospital rooms. Right now he's congratulating a pair of new parents. Larry is standing on wobbly legs, looking both ecstatic and shell-shocked, while Joy sits serenely, holding their newborn son to her breast.

Dr. Wang jokes with the new parents a bit and then says, "I understand you may want to have a circumcision for your baby."

Larry and Joy don't answer immediately. At last Larry says, "Well ... we don't know."

Dr. Wang smiles. He's familiar with the befuddled expression on Larry's face.

Circumcision, of course, is the surgical removal of the penile foreskin from the glans the fleshy crown of the penis. It is one of the most commonly performed procedures in American hospitals, and except for abortion, it may be the most controversial. The procedure has long been known to reduce the spread of a few rare, serious diseases, and to prevent a few annoying, uncomfortable ones. But in 1999, the American Academy of Pediatrics (AAP) determined that the risk of surgical complications, though small, nearly canceled out the benefits. They neither discouraged nor recommended the procedure. Since then, 16 states have eliminated Medicaid coverage for nearly all circumcisions.

But two years ago, a consortium of experts convened by the World Health Organization and UNAIDS (the United Nations' HIV program) announced that circumcision should indeed "be part of a comprehensive HIV prevention package." It did so because three separate, meticulous medical trials in Kenya, Uganda, and South Africa, involving more than 10,000 men, had proved that circumcision could reduce the risk of female-to-male HIV infection by approximately 60 percent. This discovery is one that, over the next two decades, could save three million lives in Africa alone.

Now, no one believes that the potential health benefits for American males are nearly as great, or as urgent, as they are for men in Africa, where HIV is spread mostly through heterosexual intercourse. Still, similar study results are turning up on this continent, as well. A team of researchers from the CDC, Johns Hopkins, and the Baltimore health department examined the records of more than 1,000 African American males all heterosexual who tested positive for HIV at Maryland clinics. Uncircumcised men were 50 percent more likely to be infected.

These results have caused many U.S. doctors to reconsider their positions. "I've always told families that the health benefits of circumcision are real, but not enough to warrant advocating that all boys be circumcised," says Lise Johnson, M.D., the director of healthy-newborn nurseries at Boston's Brigham and Women's Hospital. "But I find these HIV studies pretty striking. The weight of scientific evidence might be shifting in favor of circumcision."

Pretty interesting article - interesting for those of us who aren't personally involved, of course. :D

MSNBC (http://www.msnbc.msn.com/id/29777922//)

FlaGator
04-01-2009, 02:38 PM
Pretty interesting article - interesting for those of us who aren't personally involved, of course. :D

MSNBC (http://www.msnbc.msn.com/id/29777922//)

Or those of us past the point of caring one way or the other :D