Published online May 1, 2007
PEDIATRICS Vol. 119 No. 5 May 2007, pp. 1006-1007 (doi:10.1542/peds.2007-0739)
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COMMENTARY

Circumcision in the Time of HIV: When Is There Enough Evidence to Revise the American Academy of Pediatrics' Policy on Circumcision?

Joseph D. Dickerman, MD

Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont

Abbreviations: STD, sexually transmitted disease • AAP, American Academy of Pediatrics • UTI, urinary tract infection

The first 20% of the full text of this article appears below.

There have been 3 recent studies in Africa, involving >10000 men, that have demonstrated a marked protective effect of male circumcision with respect to the acquisition of HIV infection.1–3 The protective effect was 60% in each of the 3 trials. Furthermore, men who were circumcised were no more likely than uncircumcised men to engage in risky sexual behavior.2–4 Commentaries5,6 appearing in the same issue that published the 2 latest trials strongly affirm circumcision as a means of preventing HIV infection. Reviews of the literature7,8 have concluded that there is substantial evidence to support the conclusion that circumcision significantly reduces the rate of HIV infection, and one review concluded that "male circumcision is the most compelling evidence-based preventive strategy to emerge since the results of mother-to-child transmission clinical trials."9 In the United States in 2005 there were 1434 new cases of HIV infection in children and young adults 19 years of age or less10 and 453 new cases of syphilis in the same age group,11 whereas the prevalence of . . . [Full Text of this Article]

Address correspondence to Joseph D. Dickerman, MD, Department of Pediatrics, University of Vermont College of Medicine, D201 Given Building, Burlington, VT 05405. E-mail: joseph.dickerman@uvm.edu


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eLetters:

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Renewed debate
Wilhelm E. Woolery
Pediatrics Online, 9 May 2007 [Full text]
Ethics always trumps evidence
Dan Bollinger
Pediatrics Online, 17 May 2007 [Full text]
AAP revision must include countervailing evidence
Gillian E Longley
Pediatrics Online, 17 May 2007 [Full text]
Unrecognized Conflicts of Interest Relating to Circumcision
Ronald Goldman, Ph.D.
Pediatrics Online, 19 May 2007 [Full text]
An Indian perspective
Siddhartha Sahu
Pediatrics Online, 22 May 2007 [Full text]
Some valid reasons to rewrite the Circumcision Policy Statement
George Hill, et al.
Pediatrics Online, 23 May 2007 [Full text]
This Commentary was reject by Pediatrics
Robert S Van Howe
Pediatrics Online, 13 Dec 2007 [Full text]