Spinal Decompression

Circumcision and AIDS

There is a growing body of evidence circumcision can prevent the transmission of HIV/aids.

So should there be public health campaigns, and even government funding supporting circumcision, especially in adult gay men?

The issue is front and center in New York City; if there is a ground zero for HIV in the U.S., this would be it.

One in four men who have sex with men in Chelsea is infected with HIV, and one in seventy New Yorkers are infected with HIV, says Dr. Antonio Urbina, Medical Director of AIDS Education and Training at St. Vincent's Catholic Medical Center.

So, in light of the latest data which showed male circumcision may reduce the risk of adult males contracting HIV through vaginal sex by as much as sixty percent, health officials here are considering the possibility of offering the procedure free to men without health insurance.

Dr. Urbina is a believer in the concept of circumcision to prevent HIV transmission. "I think that this may have legs and I'll tell you why the biology is there. This is all about the foreskin, and the foreskin has these cells called langerhans cells and they are basically magnets for HIV and the foreskin is studded with them. And if it is removed then your risk for HIV acquisition goes down. So I think it is a sound strategy."

However, what was not studied was whether circumcision reduced HIV transmission in men having sex with other men. Which is why some believe the evidence for promoting a circumcision campaign targeting men who have sex with men may be premature.

Dr. Bill Stackhouse of Gay Men's Health Crisis says, "Clearly the research is there to encourage circumcision among heterosexual men at risk for HIV. That for sure. But, for gay men, is the research sufficient to encourage it? I'm not so sure."

Dr. Stackhouse says we're forgetting the most important tool in HIV prevention: the condom.

Circumcision is a serious and intrusive medical procedure, particularly for adult men. Condoms are effective, inexpensive, readily available and has there been enough done to really promote condoms? "Let's really make sure that the condom approach is getting all that it can in terms of promoting it," states Dr. Stackhouse.

Dr. Urbina says we should not wait for more studies on circumcision."I think there is enough data. We are going to have needless new infections that could have been prevented if we accept this policy, so I think it is something that I think we should move forward with."

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