New CDC recs on circumcision for teen boys

Sexually active teenaged boys can benefit from circumcision and should be given that information, according to new draft recommendations from the Centers for Disease Control and Prevention (CDC) published in the Federal Register.

The first federal guidelines on circumcision recommend advising teenaged boys-as well as uncircumcised adult men and expectant parents-that the procedure can decrease the risk of being infected by female partners with human immunodeficiency virus (HIV), herpes simplex virus type 2, and strains of human papillomavirus (HPV) that can cause penile and other anogenital cancers. 

The guidelines recommend counseling teenaged boys in company with their parents and involving them in the decision-making process, which should include social, cultural, ethical, and religious considerations as well as health concerns.

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The CDC says that strong evidence from randomized clinical trials supports a 50% to 60% reduction in HIV risk by circumcision and a 30% or greater decrease in the risk of genital herpes and HPV. Circumcision also reduces the likelihood of urinary tract infection in infants and penile cancer in adults.

However, circumcision doesn’t protect women from contracting HIV infection from men and may not protect men who have sex with men, the CDC points out.

The guidelines note that circumcision has a higher rate of complications, such as bleeding and inflammation, in older children and adults-9% in children aged 1 to 9 years and 5% in everyone older than 10 years compared with less than 0.5% in newborns. Although most boys in the United States are circumcised as newborns, the rate of newborn circumcision has declined recently.

The CDC began formulating its recommendations about 7 years ago in the wake of studies in Africa suggesting that circumcision could impede the spread of HIV. It will finalize the draft recommendations following a 45-day public comment period and peer review.

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