CDC Releases First Guidelines on Circumcision

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Uncircumcised adolescent and adult males who have sex with women should be counseled about circumcision following an assessment of their HIV risk, according to new circumcision guidelines from the CDC.

These males should be told of the potential benefits and harms: Adult male circumcision has been shown to reduce the risk for HIV infection acquired through heterosexual sex by 50% to 60%, based on data from sub-Saharan Africa. In addition, the risk for genital herpes and some strains of human papillomavirus are reduced by roughly 30%. Rates of adverse events (e.g., pain, bleeding) range from 2% to 4%.

The CDC notes that no definitive data exist on whether circumcision reduces the risk for HIV and other sexually transmitted infections for men who only have sex with men.

Circumcision is not explicitly recommended for newborns. Parents should be told of the potential benefits and risks: Circumcised infants are less likely to experience urinary tract infections, a relatively uncommon event. In childhood, balanitis and balanoposthitis are less common in circumcised boys. Complication rates are roughly 0.5% in infants and increase as the child gets older.