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A religious panel...

September 17, 2005

NYC says Monsey rabbi will stop circumcisions

A Monsey rabbi linked to three infants who contracted herpes has agreed to stop performing oral suction circumcisions in New York City until a religious panel investigates the method, the city announced yesterday.

Yesterday, an agency spokeswoman said an agreement had been reached.

"Rabbi Fischer has agreed to stop performing metzizah bi peh in NYC pending an investigation being conducted by the Rabbinical Court of the Central Rabbinical Congress," spokeswoman Sandra Mullin said in a statement.

Fischer's lawyers, Mark J. Kurzmann and his son Hillel M. Kurzmann of Pearl River, said the rabbi agreed to the religious tribunal request.

"Rabbi Fischer has been asked by the rabbinical court to refrain from practicing metzizah bi peh and agreed," Mark Kurzmann said.

Kurzmann said no conclusive medical evidence has been shown that the infants contracted the virus from the rabbi. The rabbi took a herpes test, but the results have not been released by the state or city.

"I remain as convinced as ever that a thorough investigation will confirm that my client was not the source of any of the three unfortunate infections," he said.

The New York state Health Department had rescinded its ban on Fischer and joined New York City's plan for a committee of rabbis and medical personnel to review the oral-suction procedure and come up with guidelines.

Rockland Health Commissioner Joan Facelle was awaiting guidance from the state on how to proceed with the county's ban.

[While the practice will be abhorrent to many non-Jews, it probably makes little psychological difference to the baby who has just had part of his penis cut off. With the greatest respect to religious beliefs, it is hard not to question the motivation of those who so defiantly want to practise metzitzah bi peh.]


Three deaths, but people's freedom to practise their religion on babies comes first

New York Times

City Questions Circumcision Ritual After Baby Dies

August 26, 2005

A circumcision ritual practiced by some Orthodox Jews has alarmed city health officials, who say it may have led to three cases of herpes - one of them fatal - in infants. But after months of meetings with Orthodox leaders, city officials have been unable to persuade them to abandon the practice.

The city's intervention has angered many Orthodox leaders, and the issue has left the city struggling to balance its mandate to protect public health with the constitutional guarantee of religious freedom.

"This is a very delicate area, so to speak," said Health Commissioner Thomas R. Frieden.

The practice is known as oral suction, or in Hebrew, metzitzah b'peh: after removing the foreskin of the penis, the practitioner, or mohel, sucks the blood from the wound to clean it.

It became a health issue after a boy in Staten Island and twins in Brooklyn, circumcised by the same mohel in 2003 and 2004, contracted Type-1 herpes. Most adults carry the disease, which causes the common cold sore, but it can be life-threatening for infants. One of the twins died.


Pressure from Orthodox leaders on the issue led Mayor Michael R. Bloomberg and health officials to meet with them on Aug. 11. The mayor's comments on his radio program the next day seemed meant to soothe all parties and not upset a group that can be a formidable voting bloc: "We're going to do a study, and make sure that everybody is safe and at the same time, it is not the government's business to tell people how to practice their religion."



New Zealand AIDS Foundation warns

Dominion Post, Wellington
August 9, 2005

HIV and

The Aids Foundation is concerned at a report of circumcision being a possible defence for men against HIV infection (Safest Cut, August 1).
    Though there is evidence that circumcision might lower a man's chances of contracting HIV, there is no evidence that the reduction in risk takes unprotected sex for circumcised men out of the high-risk category. It simply puts them lower within the high-risk band than circumcised men.
    Of the millions of men worldwide with HIV, many are circumcised. Anal or vaginal sex without condoms is high-risk, regardless of the presence or not of foreskin.
    Further, men have a duty of care for their sexual partners. Circumcision might reduce the risk for the man, but it makes no difference for the partner.
    Condoms remain the most effective means of avoiding contracting HIV during penetrative sexual intercourse.

Communications coordinator
Aids Foundation

Dominion Post, August 1, 2005

Safest cut
< There's a suggestion that circumcision may be effective in preventing the spread of HIV among men. The BBC reports on a study of more than 3000 men in South Africa by the French Agency for Aids and Viral Hepatitis. The researchers presented their findings at a conference in Brazil, saying that male circumcision prevented seven out of 10 infections. However, UN health officials say more trials are needed before they can recommend circumcision as a way of protecting against HIV


Mild caution expressed against major hype and spin

This Day (Lagos)
August 4, 2005

UNAIDS Urges Caution On Male Circumcision

The Joint United Nations Programme on HIV/AIDS has reacted with considerable interest to the results of a trial examining the potential link between male circumcision and a lower risk of HIV acquisition that were presented last week at the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, being held in Rio de Janeiro, Brazil.

The trial was carried out in Gauteng province in South Africa among men aged 18-24 years and was funded by the French Agence Nationale de Recherches sur le SIDA (ANRS).

Although the trial shows promising protective effects of adult male circumcision in reducing HIV acquisition [only by males, and only from heterosexual intercourse], UNAIDS emphasizes that more research is needed to confirm the reproducibility of the findings of this trial and whether or not the results have more general application.

In particular the findings from two ongoing trials in Uganda and Kenya, funded by the US National Institutes of Health, will be important to clarify the relationship between male circumcision and HIV in differing social and cultural contexts.

The results of these trials will need to be considered by governments and other key stakeholders in order to determine whether male circumcision should be promoted as an additional public health intervention to reduce the risk of sexual transmission of HIV.

If male circumcision is confirmed to be an effective intervention to reduce risk of acquiring HIV, this will not mean that men will be prevented from becoming infected with HIV during sexual intercourse through circumcision alone.

Nor does male circumcision provide protection for sexual partners against HIV infection. [There is some evidence that it it INCREASES risk.] It will therefore be essential that it be part of a comprehensive prevention package, which includes correct and consistent condom use, behaviour change, and voluntary counselling and testing. Any new prevention modality must not undermine existing protective behaviours and prevention strategies that reduce the risk of HIV transmission.

Although UNAIDS believes that it is premature to recommend male circumcision services as part of HIV prevention programmes, there is heightened interest from governments and the general public in male circumcision in a number of African countries.

News of the trial results may increase demand for male circumcision services. Governments should take steps now to ensure that male circumcision is conducted by trained practitioners in safe and equipped settings in order to reduce the rate of post-operative complications.

Abstract and discussion


Unpublished study gets hype and spin

July 27, 2005

Male circumcision 'protects against Aids'

[This headline is a gross exaggeration - but it is the factoid that will be remembered]

RIO DE JANEIRO (Brazil) - Male circumcision significantly reduces the chances of female-to-male transmission of the Aids virus, according to a new study French researchers announced on Tuesday.

The study, conducted in South Africa, found that circumcision reduced the risk of men contracting Aids during heterosexual intercourse by about 65 per cent.

'There had always been a suspicion that male circumcision prevented Aids [again, two words that grossly overstate the facts]... but this is the first randomised study using control trials,' said Dr Bertrand Auvert, who coordinated the study for France's National Aids Research Agency.

He announced the finding at the Third International Aids Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro which ends on Wednesday.

[The study has still not been published.]

Study in South Africa

The study was conducted between 2002 and 2005 with more than 3,000 healthy, sexually active males between 18 and 24 in Orange Farm, South Africa, where about 32 per cent of the female population was HIV positive.

For the study, about half of the subjects were circumcised by medical professionals, and the rest remained uncircumcised. All of the men received counselling on Aids prevention. But after 21 months, 51 members of the uncircumcised group had contracted HIV, the Aids virus, while only 18 members of the circumcised group had gotten the disease.

Circumcision 'prevented [or rather, delayed] six to seven out of 10 potential HIV infections', he said.

He said the study did not analyse the effect of circumcision on male-to-female transmission or if circumcision provides effective protection over the long term. At least three more studies are under way to confirm the effectiveness of circumcision.

Circumcised men 'not protected'

But scientists said the study was cause for guarded optimism.

'While these results are very promising, we need to put them in a broader context to see the full benefits of circumcision. So we need to look at results from other studies,' said Dr Charles Gilks, director-coordinator of treatment and prevention for the World Health Organisation.

A study funded by the US National Health Institute involving 5,000 individuals is currently under way in Uganda. Scientists expect to announce the results only in early 2007.

Dr Gilks said he was concerned that the results of the study would lead many circumcised men to think they were protected from Aids and fail to take adequate precautions.

He also worried that it would lead many men to rush to get circumcised, and said the World Health Organization was racing to set guidelines for safe and hygienic circumcision.

Gilks said his main concern was that traditional healers might try to provide circumcision without adequate training and without providing counseling on how to prevent AIDS.

In the Orange Farm study, where the circumcisions were carried out by medical professionals, about 4 percent of patients suffered minor complications.

Catherine Hankins, chief scientific adviser to UNAIDS, said that it was still too early to encourage widespread circumcision as a way to prevent the spread of AIDS. And she said many men would resist circumcision, even if other studies confirmed the findings.

"We know this is a sensitive issue, and I don't just mean biologically," Hankins said.
-- AP

Abstract and discussion

Another study at the conference suggested that female 'circumcision' also 'protects against AIDS' but this has not been treated as any news. One outlet even reported the reverse of the finding.

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