Thursday, April 5, 2007

Frieden Wants Your Foreskin!

The New York Times reports:

In the United States, “New York City remains the epicenter of the AIDS epidemic,” Dr. Thomas R. Frieden, the city’s health commissioner, said in an interview. Referring to H.I.V., he said, “In some subpopulations, you have 10 to 20 percent prevalence rates, just as they do in parts of Africa.”

His department has started asking some community groups and gay rights organizations to discuss circumcision with their members, and has asked the Health and Hospitals Corporation, which runs city hospitals and clinics, to perform the procedure at no charge for men without health insurance. ...

No spontaneous outcry for circumcision has arisen in New York, Dr. Frieden conceded.

“This is not something that has a lot of buzz,” he said.

But he added that even 1,000 circumcisions in the right subgroups might slow the spread of AIDS.

You know what else might discourage the spread of AIDS? Not promoting sex with strangers.

Interestingly, though, Frieden's latest campaign has no actual scientific grounding, as he himself concedes:
In three recent clinical trials in Africa, circumcision was shown to lower a man’s risk of contracting the virus from heterosexual sex by about 60 percent. On March 28, the World Health Organization officially recommended that countries adopt the procedure as part of their AIDS prevention plans. ...

The studies, done in Uganda, Kenya and South Africa, enrolled men who said they had sex with women, while New York’s highest-risk groups are men who have sex with men, men who inject drugs and people who have sex with those men.

Nonetheless, Dr. Frieden said, it is logical to assume that circumcision would offer protection in some types of gay sex.

A man’s risk from performing penetrative anal sex is about the same as his risk from vaginal sex, Dr. Frieden said, so circumcision would presumably confer the same protection as it did in the African trials.

The risk from receptive anal sex is five times higher, he said, and circumcision would obviously not protect those men. Oral sex is much less risky.
From extrapolation, to projection, to social policy. So runs the mind of Dr. Frieden.

UPDATE: The New York Times reports this latest Frieden adventure may be too much even for the famously maternal Mayor Bloomberg.

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