Male circumcision rates in the United States could dramatically fall without health insurance coverage for the procedure, yielding greater health care costs and STD cases, new research suggests. In as many as 18 states, Medicaid coverage for the surgery has been cut, causing fewer poor parents to consent to it for their infant sons, said Dr. Aaron Tobian and colleagues from Johns Hopkins University.
Lacking reimbursement, US infant male circumcision rates could decline from over 50 percent today to as low as 10 percent, the rate in Europe, where insurers rarely cover it. Based on a model of long-term health effects, such a decline in the United States would more than double the rate of infant urinary tract infections and increase male HIV prevalence by 12 percent.
Each circumcision costs Medicaid or private insurers $250-$300, Tobias said, whereas each one foregone would cost $313 in added doctor's visits, medication, and treatment costs. These and related costs would add up to more than $4.4 billion for a one-decade cohort of babies, researchers said. The cohort could experience 27,000 added infant urinary tract infections and later see almost 5,000 additional HIV cases and 57,000 more HPV infections.
Most data for the model of health consequences came from research in Africa. However, it is reasonable to assume the findings could apply to US men, said Helen Weiss, circumcision researcher and epidemiologist at the London School of Hygiene & Tropical Medicine.
[PNU editor's note: The study, "Costs and Effectiveness of Neonatal Male Circumcision," was published in Archives of Pediatrics & Adolescent Medicine (2012;doi:10.1001/archpediatrics.2012.1440).]
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This article was provided by CDC National Prevention Information Network.
It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.