Friday, November 30, 2007

Circumcision does not prevent HIV transmission among gay men of color, says new US study

You might remember my reaction a few months ago when I first heard of plans by the New York City Department of Health to promote circumcision among the city's gay and bisexual Latino and African-American men as a means of HIV prevention.

This, based on a studies in Africa showing that "circumcision was shown to lower a man’s risk of contracting the virus from heterosexual sex by about 60 percent" according to an article in
The New York Times which first broke news of the City's alleged plans.

“This is not something that has a lot of buzz,” said the City's
Health Commissioner Thomas R. Frieden in discussing the study then but, as the Times noted, "he added that even 1,000 circumcisions in the right subgroups might slow the spread of AIDS."

At the time, back in April, I balked at the way the Department of Health seemed ready to promote public HIV prevention policies aimed at gay men of color in New York based on studies of heterosexual males in Africa.


As you might also remember Dr. Frieden later released a letter staring that the New York Times had misrepresented his words and that the Department of Health had no such plans in the pipeline and then appeared at a public forum where he said it was just a "discussion" on whether it made sense to explore such a policy.

Now comes word of a study published in the December 15 issue of the Journal of Acquired Immune Deficiency Syndromes that seems to indicate that the Department of Health was wrong in trying to extrapolate results from the African study to argue that it might make sense to circumcise gay men of color in New York.

The full text of the study is only available to subscribers but the abstract posted online ("
Circumcision Status and HIV Infection Among Black and Latino Men Who Have Sex With Men in 3 US Cities") says that the study engaged 1,154 black men who have sex with men and 1,091 Latino men who have sex with men in New York, Philadelphia and Los Angeles found that:
Circumcision status was not associated with prevalent HIV infection among Latino MSM, black MSM, black bisexual men, or black or Latino men who reported being HIV-negative based on their last HIV test. Further, circumcision was not associated with a reduced likelihood of HIV infection among men who had engaged in unprotected insertive and not unprotected receptive anal sex
In short, "there was no evidence that being circumcised was protective against HIV infection among black MSM or Latino MSM."

Turns out that Brazil got it right from the start.

In any case, some good news on the eve of World AIDS Day for uncut gay and bisexual men of color in New York: You may keep your hoodies! Merry Christmas and Happy New Year!

[h/t:
LifeLube]

3 comments:

Osvaldo said...

Andres,

Oddly enough, this came up recently in a discussion amongst myself and two other gay men of color. Both of them advocating for circumcision and I stating that there is no proof of circumcision helping to prevent the spread of HIV or being "more hygenic." Thanks for the blog posting. I will forward it to my friends.

Sinceramente,

Osvaldo

Andrés Duque said...

Hey Osvaldo:

Actually, the African studies did show a striking reduction if HIV transmission among heterosexual men after they became circumsized. But this new study certainly shows that the NYC Department of Health erred in assuming that the results would be similar among gay men of color in the United States.

kikisaurusrex said...

actually in Africa it was merely a corrolation. The men that were circumcised to begin with where muslim and were thus less likely to engage in sexual misconduct and drugs. Further, the uncircumcised populations were already closer to the HIV epidemic and already had higher rates of HIV. This is just an example of white medical imperialism on the brown body. I will never get circumcise or advertise it. I am an ardent intactivist.