( t be extrapolated elsewhere as in those...)New York City Plans to Promote Circumcision,Health

t be extrapolated elsewhere as in those very poor countries have always seen extremely high rates of transmission. There are no effective safe-sex efforts and very low use of condoms.

Also in the African studies, the enrolled men 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, Health Commissioner 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, he noted, 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.

Also, cutting down infections among bisexual men — some of whom do not admit to female partners that they participate in gay sex — would protect women, he felt.

Dr. Frieden also said he thought health insurance companies might agree to pay for preventive circumcisions since they already covered them for infections and urinary blockage. City hospitals also offer the operation in those cases.

Whatever the case, activists urge any widespread campaign to promote circumcision should not undercut other HIV and AIDS prevention messages. The focus should continue to be on the promotion and use of condoms and having fewer sexual partners.

Some others apprehend that the campaign in US could sound racist in that Blacks would be targeted.

Still one has to start somewhere, circumcision supporters note.

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