[NOTE: This statement was sent out to community activists in .pdf form earlier today. I have not been able to find a direct link to the statement at the Health Department's site but the LifeLube blog also received the document and has uploaded and made it available for download here]
THE CITY OF NEW YORK DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Michael R. Bloomberg, Mayor
Thomas R. Frieden, M.D., M.P.H., Commissioner
April 9, 2007
Dear Community Member:
Recent media reports misrepresent the Health Department’s response to recent studies showing that circumcision significantly reduces HIV transmission in some contexts. We do not yet know what impact circumcision could have on HIV transmission in New York City, and we have not suggested or planned any initiative or campaign. Quite to the contrary, I indicated in an interview with the New York Times (the source of the misrepresentation) that I very much doubted that even 1% of men at high risk in NYC would undergo the procedure.
As a result of rigorous studies, we now know that circumcision reduces risk of female-to-male spread of HIV by about 60%. There is some evidence, but no proof, that circumcision may reduce male-to-female transmission. There is also some evidence, but again no proof, that it may protect men who engage in insertive anal sex from male-to-male transmission.
Our goals are the following:
• Inform the community of the facts regarding what is known and what is not known about circumcision’s effects on HIV transmission;
• Promote discussion among community groups and health care providers to explore how circumcision may be relevant in New York City;
• Increase access to circumcision for men who want the procedure.
The need for new effective prevention methods is urgent. But even if circumcision is as effective in preventing male-to-male transmission as it is in preventing female-to-male transmission, it does not by any means eliminate the risk of becoming infected with, or spreading, HIV. Any new approach, including circumcision, needs to be seen as an addition to our existing portfolio of proven HIV prevention strategies, including reduction of unsafe sexual encounters and consistent condom use.
There will be a community forum in the next few weeks to discuss these issues and we hope you can attend.
Thomas R. Frieden, M.D., M.P.H.