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Circumcision rates lower in states where Medicaid does not cover procedure
Date:1/28/2009

Hospitals in states where Medicaid does not pay for routine male circumcision are only about half as likely to perform the procedure, and this disparity could lead to an increased risk of HIV infection among lower-income children later in life, according to a UCLA AIDS Institute study.

Researchers found that at hospitals in the 16 states where the procedure is not covered, circumcision rates were 24 percentage points lower than at hospitals in other states, with lower rates particularly prevalent among Hispanics. The mean male circumcision rate for all states was 55.9 percent.

The study, published in the January issue of the American Journal of Public Health, is available online at www.ajph.org/cgi/content/full/99/1/138.

The findings are important because they document the effect of state Medicaid reimbursement policies on the medical services that are actually delivered, said the study's lead author, Arleen A. Leibowitz, a professor of public policy and a researcher with both the UCLA Center for HIV Identification, Prevention and Treatment Services and the UCLA AIDS Institute. These services include male circumcision, which has been shown to lead to substantial health benefits in later life.

"Since children whose childbirth expenses are paid for by Medicaid are, by definition, lower income, the Medicaid policy in 16 states of not reimbursing for male circumcision is generating future disparities in health between children born to rich and poor families," Leibowitz said.

In 1999, the American Academy of Pediatrics (AAP) stated that the medical benefits of male circumcision were not enough for the group to recommend that the procedure be made routine at all hospitals. As a result, some states began withdrawing Medicaid coverage for circumcision.

But recent clinical trials in South Africa, Kenya and Uganda have revealed that
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Contact: Enrique Rivero
erivero@mednet.ucla.edu
310-794-2273
University of California - Los Angeles
Source:Eurekalert

Page: 1 2

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