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Letters |

Benefits of Male Circumcision

Julie M. Croff, PhD, MPH
JAMA. 2012;307(5):455-457. doi:10.1001/jama.2012.62.
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To the Editor: Drs Tobian and Gray note the importance of reviewing the medical risks and benefits of routine neonatal male circumcision in light of recent public insurance coverage changes.1 However, the Commentary failed to adequately discuss the risks for such a procedure in relation to the benefits. Further, the public health benefits discussed lack appropriate context.

Studies from Africa suggest that male circumcision provides benefits for a population at risk of HIV infection through heterosexual contact. The unique context of these findings from sub-Saharan Africa should not be generalized to the United States. In 2009, the Centers for Disease Control and Prevention (CDC) found that only 10.5% (n = 4399) of HIV infections in the United States were among men who contracted it from heterosexual contact2; only a portion of these cases could have been prevented by routine neonatal male circumcision. The CDC also found that nearly 80% of HIV cases among men are at least partially attributable to male-to-male sexual contact,2 a group that would receive an unknown benefit from neonatal male circumcision. Only a small percentage of the population (<10%) engages in male-to-male sexual activity, requiring alternative strategies for HIV prevention.

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February 1, 2012
Robert Darby, PhD
JAMA. 2012;307(5):455-457. doi:10.1001/jama.2012.61.
February 1, 2012
Mathias Masem, MD
JAMA. 2012;307(5):455-457. doi:10.1001/jama.2012.59.
February 1, 2012
Aaron A. R. Tobian, MD, PhD; Ronald H. Gray, MD, MSc
JAMA. 2012;307(5):455-457. doi:10.1001/jama.2012.63.
February 1, 2012
Jeffrey D. Klausner, MD, MPH; Brian J. Morris, PhD, DSc
JAMA. 2012;307(5):455-457. doi:10.1001/jama.2012.60.
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