CDC poised to advocate infant circumcision?

It was quack doctor John Harvey Kellogg who helped usher in America's era of neonatal circumcision. In his 1903 book Plain Facts for Old and Young, he advocated the removal of a child's foreskin as an effective remedy against the 'evils' of masturbation.

"A remedy for masturbation which is almost always successful in small boys is circumcision. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment."

For decades afterwards, the routine circumcision of America infants went almost unchecked - with as many as 80% of children having their foreskins removed in the days following birth - all in the interests of 'hygiene' or 'aesthetics' or similarly discredited theories.

In fact, it wasn't until 1999 that the American Medical Association finally examined the issue - and rejected all the bunk 'science' that suggested circumcision was medically necessary or beneficial - stating:

“Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice.”

However, just like female circumcision in Africa and the Middle East (more accurately labeled 'genital mutilation') it was difficult to change the habits and prejudices of three generations of American parents. While routine circumcision dropped from 80% of all baby boys to just 60% - more than half of all newborns still had their foreskins unnecessarily removed.

But it did appear that the tide was changing - and that an increasing number of infants were being left intact just as God intended - until this week.

Because this week, the Center for Disease Control (CDC) in the United States considered advocating routine circumcision off all infant boys again - because studies in Africa suggested that circumcised men were 50% less likely to contract HIV than ones who were uncircumcised.

Dr. Peter Kilmarx, chief of epidemiology for the division of HIV/AIDS prevention at the CDC announced:

“We have a significant HIV epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic. What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision and that the benefits outweigh the risks.”

The problems with Kilmarx's suggested campaign of circumcision? Where do I start?

Kilmarx has presented three studies conducted in Africa to indicate that men with a circumcised penis are 50% less likely to get infected by HIV - and advocates routine circumcision in American infants to carry those benefits over to the United States.

The problem is, America isn't Africa.

Here in the United States, our HIV 'epidemic' isn't on the same scale as in Africa. In some parts of Africa, up to 20% of the population can be infected. In the USA, the CDC estimate that just over a million Americans carry HIV (either diagnosed or undiagnosed.) That's 0.3% of the population. So already, an American's chance of encountering a person with HIV (much less having sex with them) is 66 times less than in Africa.

Secondly, America is a country with has reasonable sex education (no thanks to President Bush) and easy access to condoms. Condom use in Africa is practically unheard of. Therefore, Americans already have a far more effective way of preventing HIV infection through heterosexual intercourse than somebody in Africa does.

Thirdly, 67% of all men who are infected with HIV in the United States catch it through male-to-male sexual intercourse - and according to 15 studies, circumcision does nothing to protect either the 'bottom' (receptive) partner or the 'top' (giving) partner.

A further 17% of HIV infections are through injection drug use - another area in which circumcision has no applicable benefits.

And finally, the fastest growing group of heterosexuals being infected are women - and just like with receptive male-to-male sex, circumcision offers no benefits to reduce infection amongst that group.

Oh - not to mention that it will be at least 16 to 20 years before we can expect to see the 'benefits' of this campaign. In fact, the fastest growing demographic of people infected with HIV are actually in their thirties - so we'll actually have to wait three decades to see if Kilmarx's suggestions are really right.

So on paper Dr. Kilmarx's suggestions will (according to the CDC's 2006 figures) potentially prevent over 2,074 HIV infections when the 'new batch' of circumcised Americans become sexually active.

But it will still do nothing to prevent 33,106 other men, women and children getting infected - and will require over a million infants being circumcised - meaning over 48,216 kids will have to undergo a painful, brutal, unnecessary and dangerous procedure for the sake of preventing one hypothetical infection.

Of those 48,216 kids?

According to a 1996 study by Williams and Kapilla, between 2% and 10% of them will encounter complications arising from their circumcision. A 1999 study, examining 48 boys suffering from circumcision complications, witnessed 21% of them developing serious infections and one had to have his penis amputated entirely.

Does it really make statistical sense to butcher almost 50,000 kids for the sake of possibly preventing a single HIV infection twenty or thirty years in the future?

Of course not. It's just shameful that Dr. Kilmarx and the CDC are too blinded by science to see that fact for themselves.

Please do not circumcise your child!

(Data on US HIV and AIDS rates taken from the CDC factsheets.)
(Statistics of the three randomized African trials taken from InterScience)