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prophylactic circumcision

Apr 15, 2006

I am an ob-gyn, and when my son was born 18 years ago, I did not have him circumcised. Recently he told me that he is gay, I have read the reports of 50-70% reduction in HIV transmission for MSM even if the circumcision is done as a young adult. I would like to convince my son to be circumcised. Do you have any advice? Are there any handouts I can give him that discuss this issue in laymen's terms? He's in college. I know he is drinking, and may be using drugs. He says he knows all about safe sex, but I am worried. Thanks for your help. Worried Mom

Response from Dr. Frascino

Hello Worried Mom,

You want to convince your 18-year-old gay son to have a prophylactic circumcision???? OUCHAMAGOUCHA! Gosh, I wish I could be there to witness what happens when you break the news that you've invited a Mohel to dinner next week.

Mom, despite what you may have read concerning the preliminary studies related to that age-old question, "to circ or not to circ," no one is recommending prophylactic circumcision for young gay men as an HIV-prevention measure at this time. What we do recommend is proper use of latex condoms. Talk to him about safe sex. He may well "know all about it," but then again, he may just think he knows all about it. There are a wide variety of resources that discuss safer sexual practices for MSM, many of which are available on this Web site and related links. Even if you could convince your son to trim his drapes (which I very strongly doubt), and if elective circumcision did reduce HIV transmission 50% (which we are still evaluating), this is still not nearly "safe enough." Effective HIV prevention requires that a latex condom be used properly whether someone has a foreskin or not. That is the message you should impart to your son. Elective circumcision may seem like cutting-edge (pun intended) HIV prevention, but in reality, even in best case scenarios, it's far inferior to condom use.

Dr. Bob

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