Abstract
CDC's Male Circumcision Recommendations Represent a Key Public Health Measure.
Highlights
After an extensive evaluation of the scientific evidence, the United States Centers for Disease Control and Prevention (CDC) released draft policy recommendations in December 2014 affirming male circumcision (MC) as an important public health measure.[1,2,3] The CDC’s summary[1] (Box 1) was accompanied by a 61-page literature review.[2]
The CDC supported the 2012 American Academy of Pediatrics (AAP) infant MC policy[4,5] (Box 2) and recommended that providers: (1) give parents of newborn boys comprehensive counseling about the benefits and risks of MC; (2) inform all uncircumcised adolescent and adult males who engage in heterosexual sex about the significant, but partial, efficacy of MC in reducing the risk of acquiring human immunodeficiency virus (HIV) and some sexually transmitted infections (STIs) through heterosexual sex, as well as about the potential harms of MC; and (3) inform men who have sex with men (MSM) that while it is biologically plausible that MC could benefit MSM during insertive sex, MC has not been proven to reduce the risk of acquiring HIV or other STIs during anal sex.[3]
If early infant MC rates decreased to 10%, lifetime prevalence of infant urinary tract infection (UTI) would increase by 211.8%, high- and low-risk human human papilloma virus (HPV) by 29.1%, herpes simplex virus (HSV)-2 by 19.8%, and HIV by 12.2%
Summary
After an extensive evaluation of the scientific evidence, the United States Centers for Disease Control and Prevention (CDC) released draft policy recommendations in December 2014 affirming male circumcision (MC) as an important public health measure.[1,2,3] The CDC’s summary[1] (Box 1) was accompanied by a 61-page literature review.[2] The CDC supported the 2012 American Academy of Pediatrics (AAP) infant MC policy[4,5] (Box 2) and recommended that providers: (1) give parents of newborn boys comprehensive counseling about the benefits and risks of MC; (2) inform all uncircumcised adolescent and adult males who engage in heterosexual sex about the significant, but partial, efficacy of MC in reducing the risk of acquiring HIV and some sexually transmitted infections (STIs) through heterosexual sex, as well as about the potential harms of MC; and (3) inform men who have sex with men (MSM) that while it is biologically plausible that MC could benefit MSM during insertive sex, MC has not been proven to reduce the risk of acquiring HIV or other STIs during anal sex.[3]. We critically assess the evidence used by Frisch and Earp to support their thesis and respond to their main criticisms (summarized in Box 3)
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