Washington Blade - April 20, 2007
Joshua Lynsen

The strategy, which asks city hospitals to perform the procedure for free on uninsured men, emerged this month after three studies in Africa showed that circumcision reduced HIV transmission among heterosexual partners.

But the strategy has drawn harsh criticism from several experts.

Gay Men's Health Crisis in New York, the National Organization of Circumcision Information Resource Centers in suburban San Francisco and others said circumcision is unproven to help protect gay men from HIV.

"The effect of circumcision on HIV transmission for gay men and other men who have sex with men is unknown," the Gay Men's Health Crisis said in a statement. "The effect of circumcision for anal intercourse is unknown."

Marilyn Milos, executive director of the National Organization of Circumcision Information Resource Centers, agreed.

"To think that circumcision is going to prevent AIDS when it didn't prevent other STDs is insane," she said. "There are better, less risky and more cost-effective solutions to the problem."

The New York City Department of Health and Mental Hygiene is asking gay rights groups and other organizations to discuss circumcision with their members. It also has approached the agency that runs city hospitals and health clinics about the possibility of offering the procedure for free to uninsured men.

Thomas Frieden, the city's health commissioner, said the efforts are not part of any formal campaign.

In a letter to community organizations, he said the steps were taken merely to help increase the knowledge and availability of circumcision among New York men who are at risk of contracting HIV.

"The need for new effective prevention methods is urgent," he wrote.

An estimated 100,000 people are living with HIV or AIDS in New York, according to the city's health department.

'Bad science'

But critics said the strategy would do little to help gay New Yorkers.

Ryan McAllister, 30, a biophysics research fellow at Georgetown University in Washington, said findings from the three studies are inapplicable to gay men. He also noted the studies used questionable methods.

"As far as I can tell, it's pretty bad science," said McAllister, who is gay.

He said the studies, which followed groups of circumcised and uncircumcised men for two years to track emergence of HIV infections, were poorly done.

McAllister said researchers in Africa started tracking infections for both groups immediately after circumcision, even though most men cannot resume sexual activity for about six months following the operation.

He also said circumcised men were advised to use condoms while uncircumcised men were not, and men in neither group were asked whether they had engaged in anal intercourse.

Frieden acknowledged in his letter that the studies offer only "some evidence" and "no proof" that circumcision could protect men who have sex with men.

But critics said the evidence remains so weak that it gives no reason to circumcise gay men.

"These studies are bogus and I am still against circumcision," said John-Paul Morrison, 43, a gay man who lives in Costa Rica and is restoring his foreskin.

"There are a ... lot of men in the U.S. that are HIV-positive who are circumcised, so it apparently didn't help them."

Milos said the National Organization of Circumcision Information Resource Centers promotes condoms and safe practices - not circumcision - to curtail HIV transmission.

"When people are afraid of a disease, they'll look for anything to bring it to an end," she said. "But it won't work."

Milos said circumcision, which began in the U.S. in the mid 19th century to curb masturbation, has fallen out of favor with pediatrics.

She said approximately 85 to 95 percent of infant boys were circumcised 30 years ago. Today, an estimated 55 percent of newborn boys undergo the procedure.
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