Falling Rates of STIs at a Time of Decreasing Rates of Circumcision in San Francisco

In stark contradiction to the circumcision brigade's claims of "Declining Rates in Male Circumcision amidst Increasing Evidence of its Public Health Benefit [pdf warning]*," we have this just in from the San Francisco Department of Public Health:

In 2007, declines were noted for all reportable STDs in San Francisco. Reported gonorrhea declined 19% from 2006 to 2007 from 2469 cases to 2008. Rectal gonorrhea among men also declined from 557 cases to 489- a 12% decline. Declines in syphilis were also found. Primary and secondary syphilis declined 17% in 2007 from 243 cases to 202; all early syphilis also declined by 16% in 2007. Chlamydial infections also declined, but these declines were much more modest. Overall reported Chlamydia declined from 4050 to 3937 (3%) while rectal chlamydia increased in 2007 from 512 to 592 cases for a 16% annual increase. We are exploring why rectal Chlamydia increased in 2007 and rectal gonorrhea declined. For reported gonorrhea cases, all racial/ethnic groups had declines from 2006 to 2007; African-Americans saw a 22% decline, Hispanics 19%, Asian/Pacific Islanders 22%, and Whites 18%. For Chlamydia, there was a 9% increase among Asian/Pacifdic Islanders , all other racial/ethnic groups had declines; African American 12%, Hispanic 10% and Whites 1%. More comprehensive data will be available with the publication of the 2007 Annual Summary. Download STD012008.pdf

With apologies to Michael Petrelis over on The Petrelis Files, I lifted an additional bit of info not included in the SFDPH's report, but generously provided to his readers [link to specific post] at the aforementioned blog.

The monthly report omitted discussion about adult male shigellosis, which fell by 20%, from 99 to 78 cases; speed-related visits at SF General Hospital for males fell 17%, from 488 down to 402; for female visits there was a drop from 113 to 111.

The HIV figures from the primary STD testing site on Seventh Street, which are not the full numbers for the city but certainly represent a significant portion of the tests and results that comprise the city's overall HIV infection rate, increased by 12 percent, from 102 to 115.

However, the figure for number of antibody tests performed at this one clinic skyrocketed 58%; from 3,097 to 5,283. I think we can safely attribute the rise in HIV infections to the corresponding jump in tests.

For a county whose male population is experiencing a steady and persistent fall in rates of circumcision, this is startling news for circumcision junkies, but decidedly happy news for public health and the community at large.

*You will recall this was the opinion piece whose author's conclusions were in stark contrast with its headline and was written by that strange conglomeration of circumcision advocates in high places.

Comments

[Lindsay]

Do we know what the rates of circumcision are among men who are currently sexually active?

I know circumcision has been declining in California and the Bay Area for some time, but are these young people yet old enough to influence the STD statistics?

[David]

A good observation, but we do know that circumcision is declining among sexually active individuals because the circumcisionistas did a good survery for us in the referenced opinion piece. They looked at circumcision status among those visiting STD/STI clinics in the city (all 18+). They determined that there is a steady decline in circumcised men from older to younger. And btw, it isn't just the infected who are attending these clinics in San Francisco. Regular STD/STI screening is fairly high in San Francisco thanks to a pro-active health department and UCSF's STD/STI screening program.

[Laura MacDonald]

Unfortunately the circumcisionists will not be put off by these inconvenient truths. Check out the recent promotion of circumcision in Britain by Harold Jaffe, who seems determined to ignore the evidence that MSM are not protected by genital surgery and that women might be put more at risk. And for a real corker how about this comment about circumcision and HIV from
Robert Bailey via the Belleville News Democrat, Illinois.

"It's the most effective prevention method we know about for heterosexual guys, if it's done properly," said Robert Bailey, an epidemiologist from the University of Illinois at Chicago who led the studies in Kenya and Uganda.

I'm kind of hoping Durex may sue him for this....

[Joe]

I can't seem to understand how people can let such a comment slide. The most effective prevention method we know about is clearly the condom. Making such public comments should be swiftly condemned; it leads to stories like this one discussed last week. People buy into the fallacy and ditch what really works. Bailey's statement is clearly irresponsible.