Benefits of Circumcision Are Said to Outweigh Risks

chlamydia transmission The American Academy of Pediatrics has shifted its stance on infant male circumcision, announcing on Monday that new research, including studies in Africa suggesting that the procedure may protect heterosexual men against H.I.V., indicated that the health benefits outweighed the risks.

But the academy stopped short of recommending routine circumcision for all baby boys, saying the decision remains a family matter. The academy had previously taken a neutral position on circumcision.

The new policy statement, the first update of the academy's circumcision policy in over a decade, appears in the Aug. 27 issue of the journal Pediatrics. The group's guidelines greatly influence pediatric care and decisions about coverage by insurers; in the new statement, the academy also said that circumcision should be covered by insurance.

The long-delayed policy update comes as sentiment against circumcision is gaining strength in the United States and parts of Europe. Circumcision rates in the United States declined to 54.5 percent in 2009 from 62.7 percent in 1999, according to one federal estimate. Critics succeeded last year in placing a circumcision ban on the ballot in San Francisco, but a judge ruled against including the measure.

In Europe, a government ethics committee in Germany last week overruled a court decision that removing a child's foreskin was "grievous bodily harm" and therefore illegal. The country's Professional Association of Pediatricians called the ethics committee ruling "a scandal."

A provincial official in Austria has told state-run hospitals in the region to stop performing circumcisions, and the Danish authorities have commissioned a report to investigate whether medical doctors are present during religious circumcision rituals as required.

Officials with the Centers for Disease Control and Prevention in Atlanta, which for several years have been pondering circumcision recommendations of their own, have yet to weigh in and declined to comment on the academy’s new stance. Medicaid programs in several states have stopped paying for the routine circumcision of infants.

"We're not pushing everybody to circumcise their babies," Dr. Douglas S. Diekema, a member of the academy’s task force on circumcision and an author of the new policy, said in an interview. "This is not really pro-circumcision. It falls in the middle. It’s pro-choice, for lack of a better word. Really, what we’re saying is, 'This ought to be a choice that's available to parents.' ”

But opponents of circumcision say no one — not even a well-meaning parent — has the right to make the decision to remove a healthy body part from another person.

Clinics Boost Efforts as STD Cases Multiply

chlamydia transmission While new cases of HIV have continued to decline, other documented instances of sexually transmitted diseases are on a continuous multi-year rise in San Francisco and across California.

Some local clinics are attempting to combat the spike with additional testing methods for syphilis, gonorrhea and chlamydia that involve checks of the throat and rectum — steps not currently endorsed as essential by the U.S. Food and Drug Administration.

In an effort set to launch next month, The City’s Magnet Clinic is using a public grant to sign up and notify high-risk individuals that it’s time for their regular checkups. And to underscore the importance of paying attention to a serious issue, the “pilot” messages will go beyond dry medical terminology.

“Syphilis, like the ’80s, is back — especially with guys who bareback,” one potential text will read. “Get to Magnet every three months if condoms aren’t your thing.”

Steve Gibson, director of Magnet Clinic, said the edgy reminders are designed to garner more trust and increase visits from gay men, which The City’s Department of Public Health has identified as the highest-risk group for STDs along with adolescent minorities.

“They’re tailored toward gay men,” Gibson said of the new messages. “In order for people to read it, it has to be relevant to them.”

Susan Philip, the health department’s director of STD prevention, said Magnet and others are key partners for combating this year’s rise in infections, which are outpacing 2011’s already troubling total. According to the most recent data in June, 1,278 cases of gonorrhea have been reported so far this year, compared with 1,015 in the same time period of 2011. The figures for chlamydia are similar, with 2,412 cases this year compared with 2,288 last year.

Total syphilis cases, which are broken into four categories, rose by 100 — from 392 to 492 — in the first half of 2012 compared with the same time period in 2011. Of those cases, Philip said, data show 60 percent are seen in HIV-positive gay men, many of whom find each other and have unprotected sex. While the HIV transmission is moot, syphilis often occurs as a result, Philip said.

The local figures are underscored by recently released California Department of Health data that show syphilis cases increased 18 percent statewide, with 80 percent of those impacted being gay men. Philip said more education is in order.

“We’re really trying to have a comprehensive approach to make sure HIV and STDs are seen as a comprehensive unit,” Philip said. “We do have concerns, and we want the rates to go down.”

Chlamydia infections growing in Finland

chlamydia transmission is the most common sexually transmitted disease (STD) in Finland and the number of reported cases is growing by the year.

Experts say the roughly 14,000 new annual infections are mainly contracted inside the country’s borders. Fifteen years ago, new infections numbered around 9,000.

Pekka Ruuska from the infectious disease unit at Kainuu Central Hospital says men are more likely to notice signs of infection than women, who may mistake symptoms for menstruation cramps. In some women chlamydia can cause complications leading to infertility.

In Finland, the STD is most prevalent among 15-24 year-old women and 20-29 year-old men.

Women are twice as often diagnosed with the disease than men.

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