Tag Archives: circumcision

“Turning the Tide” on HIV/AIDS

In advance of the upcoming XIX International AIDS Conference, the International AIDS Society and the University of California, San Francisco, have issued the “Washington D.C. Declaration,” a nine-point action plan aimed at broadening global support for “Turning the Tide” of the AIDS epidemic.

Everyone is urged to sign the Declaration.

It calls for:

1) An increase in targeted new investments;
2) Evidence-based HIV prevention, treatment, and care in accord with the human rights of those at greatest risk and in greatest need;
3) An end to stigma, discrimination, legal sanctions, and human rights abuses against those living with and at risk for HIV;
4) Marked increases in HIV testing, counseling, and linkages to services;
5) Treatment for all pregnant and nursing women living with HIV and an end to perinatal transmission;
6) Expanded access to antiretroviral treatment for all in need;
7) Identification, diagnosis, and treatment of tuberculosis;
8) Accelerated research on new tools for HIV prevention, treatment, vaccines, and a cure;
9) Mobilization and meaningful involvement of affected communities.

Turning the Tide is the theme of this year’s biennial conference, which will take place July 22-27 in Washington.  It is expected to draw 25,000 attendees, including HIV professionals, activists, politicians, and celebrities. Sir Elton John will open the conference and Bill Clinton will close it. A large delegation of U.S. members of Congress will participate, and Bill Gates will moderate a session. An enormous “Global Village” outside the D.C. Convention Center will be open to the public. “If you haven’t been, it’s a conference like no other,” conference cochair Dr. Diane V. Havlir said at a press briefing.

The recent optimism regarding HIV/AIDS stems from major advances in knowledge regarding prevention of partner transmission with early patient treatment, pre-exposure prophylaxis, and male circumcision as HIV infection prevention (new data will be released at the meeting), all of which are viewed as breakthroughs  in the fight against HIV/AIDS. “So we have now in our hands the tools. The question is how do we combine those tools together, and how do we roll them out,” said Dr. Havlir, professor of medicine at the University of California, San Francisco, and chief of the HIV/AIDS division at San Francisco General Hospital.

Dr. Diane V. Havlir / Photo by Miriam E. Tucker

Monday’s plenary session will include an address from Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, on “Ending the HIV Epidemic: From Scientific Advances to Public Health Implementation.” Other plenary topics during the week will include viral eradication, vaccines, TB and HIV, and HIV/AIDS in specific populations including minorities, women, youth, and men who have sex with men. On Friday, there will be a plenary talk that may be of particular interest to the primary care community, “The Intersection of Noncommunicable Diseases and Aging in HIV.”

Plenaries and other conference sessions will be webcast at http://globalhealth.kff.org/aids2012.

-Miriam E. Tucker (@MiriamETucker on Twitter)

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Abortion Protests Absent at Ob.Gyn. Meeting

While covering the annual meeting of the American College of Obstetricians and Gynecologists, I noticed something similar to what I first reported in a blog post from ACOG’s 2010 meeting, when room numbers had been left out of the printed program intentionally – for security reasons – for sessions on abortion and even contraception.

There’s something very different about this year’s ACOG meeting, though. Anti-abortion and anti-contraception protesters who previously were camped outside with signs vilifying obstetricians for being “child haters” are nowhere to be seen this year. Is that a sign of the times? Or a difference between having the meeting in protest-crazy San Francisco in 2010 and this year’s meeting in more conservative San Diego?

Protesters outside ACOG’s annual meeting. (Sherry Boschert/IMNG Medical Media)

Don’t get me wrong. There still are protesters here calling obstetricians “sex criminals.” With anti-abortionists and anti-contraceptionists gone, all that were left were the anti-circumcisionists handing out cards with links to Web sites such as Doctors Opposing Circumcision (DOC).

That means there’s still a strong police presence at the doors to the convention center and workers diligently checking to see that people who come into the center are wearing registration badges.  I haven’t heard of any cases of anti-circumcisionists murdering ob.gyns. as some abortion opponents have done, though.

For the record, ACOG’s policy on circumcision is essentially the same as that of the American Academy of Pediatrics. They do not recommend routine circumcision for newborn males, but advise physicians to weigh the potential risks, benefits, and costs of circumcision with the newborn’s parents.

And looking at the ACOG program, I didn’t see “Room TBD” next to the two presentations on circumcision, one of which I’ll be reporting soon: “A Cost-effective Analysis of Male Circumcision for the Prevention of HIV in the United States.” The findings may surprise you. Stay tuned.

–Sherry Boschert

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To Cut or Not to Cut

from the American Academy of Pediatrics National Conference and Exhibition in Washington, D.C.

Photo by K. Wachter

Photo by K. Wachter

We had protesters today here at the AAP meeting.  Three of them.  They were urging pediatricians not to perform circumcisions, likening the procedure to torture.  Given my gender (that’s Ms. Wachter, thank you very much) and my lack of male offspring, it’s not a subject that I had ever given much thought. 

So I did a little research.  Both AAP and the American Academy of Family Physicians seem to take the path of least resistance: the potential health benefits of circumcision–reduced rates of STDs and urinary tract infections, prevention of certain penile problems, and reduced risk of penile cancer–are not sufficient to recommend routine circumcision.  Instead, parents should make this decision in light of available information and cultural/religious considerations. 

Opponents of circumcision argue that the procedure inflicts unnecessary pain on newborn boys and may result in surgical complications.  And then there’s the sexual pleasure argument.  Purportedly, uncircumcised men enjoy greater sexual sensation than their clipped comrades.  At a purely scientific level, a more definitive answer would require studying men who have experienced both conditions.  A quick search on PubMed confirmed my suspicion that this sample size is fairly small.  But I defer to the medical professionals–yea or nay on circumcision?

—Kerri Wachter, @knwachter on Twitter

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