Circumcision Benefit for HIV Doubted for Gay Men

Circumcision, which has been shown to slow the spread of the AIDS virus from women to men during sex by 50%, doesn't appear to provide a statistically significant protective effect for men having sex with other men, U.S. researchers said today. 

The review is the most comprehensive analysis of the subject to date. It encompasses data from 15 studies conducted in seven countries, involving more than 53,000 men, most of whom were Caucasian and approximately half of whom were circumcised. The authors concluded that being circumcised reduced a man's risk of acquiring H.I.V. by 14%. That finding was statistically nonsignificant, but the authors say it should be regarded as a launching point for future trials. "This study gives us a more complete picture than we've ever had before," says Gregorio Millett, the study's lead author and a senior behavioral scientist at the Centers for Disease Control and Prevention (CDC). "The next step is to design better quality studies to see if there is an association we aren't detecting."

One such question, says Millett, is whether circumcision can reduce infection rates among the subset of men who have only insertive sex with other men, as opposed to those who have only receptive sex or both. Millett's review suggested that among the former group, circumcision lowered H.I.V.-infection risk by 29%, a finding that also showed statistical nonsignificance. But targeting that distinct population in future studies may prove useful for distilling the specific effect of circumcision — and perhaps for future public-health strategies.

Catholic Hospital Under Fire for Allowing Abortion Referrals and Contraception Prescriptions

Catholic campaigners and some medical practitioners are criticizing a North London Catholic Hospital for its new ethics code that permits issuing referrals for abortion procedures and prescriptions for birth control.  Months of upheaval and debate over patient care and Catholic teaching at the 150 year-old institution have resulted in a compromise to provide patients who seek abortion care and contraception with a referral so they may obtain it elsewhere.  Some, however, do not see the new code as a compromise: 

Helen Watt, the director of the Linacre Centre, a traditionalist bioethics facility that campaigns on life issues, said Catholic teaching was "absolutely opposed" to all deliberate facilitation of abortion and other "anti-life" procedures.

"A woman who is facing a difficult pregnancy should be offered not abortion, but positive and life-affirming support with having her baby. If it is wrong to perform a procedure oneself, it is also wrong to refer for that procedure. A Catholic hospital must make this unambiguously clear to everyone working on the premises."

The code is backed by the hospital's new chairman:

The hospital's new chairman, Lord Guthrie of Craigiebank, a former army chief of staff, welcomed the ethics code, saying "doctors and other staff are presumed to be of goodwill and good conscience".

The new ethics code at the Catholic institution does retain restrictions on some procedures, however:

To clarify which activities were permissible, the hospital announced last month that it would uphold its ban on sex changes and permanent sterilization operations.

Ohio Supreme Court Mulls Planned Parenthood Files

The top court in Ohio is considering whether or not to permit patients' medical files as evidence in trying charges brought against Planned Parenthood that claim the family planning organization failed to recognize and report potential sexual abuse. 

Ohio Supreme Court justices appeared skeptical Tuesday that an abortion clinic's medical records on other patients are relevant to a lawsuit brought by parents of a 14-year-old girl who had an abortion without their consent.

Lawyers for the girl's family argued that the information they seek is necessary to prove that Planned Parenthood of Cincinnati had a pattern of violating Ohio's parental consent law and failing to report abuse. The unusual case pits a single plaintiff against the privacy interests of a decade's worth of patients.

...

The case involves a girl who was 14 at the time of her abortion in 2004, when the state's parental consent law had not been completely settled by the courts. She had been impregnated by her 21-year-old youth soccer coach, John Haller.

The family's lawsuit accuses the Planned Parenthood clinic of failing to get parental consent, report suspected abuse or to inform the girl of risks and alternatives. It seeks unspecified damages.

Court records say the girl gave Haller's cell phone number as her father's, and clinic officials thought they had reached the father when they called inquiring about parental consent. Haller was later convicted on seven counts of sexual battery.

An appeals court ruled last year that records on other patients weren't necessary for the family's lawsuit.

Courts have traditionally been reluctant to permit private medical records as evidence in trial.  During a recent Kansas case in which medical records were subpoenaed by former Attorney General Phill Kline the state's Supreme Court overturned the subpoena citing insufficient evidence showing the records were relevant to the case.  

U.S. Supreme Court Refuses Missouri Abortion Rights Appeal

Yesterday the Supreme Court refused to hear an appeal from the state of Missouri regarding a woman's right to abortion in prison:

The original case against the state, Crawford v. Roe, stemmed from a 2005 incident where Missouri prison officials denied a female inmate transportation to an abortion facility. ACLU sued on behalf of the inmate, "Jane Roe," who eventually received medical treatment.

In July 2006, the ACLU filed a class-action lawsuit on the behalf of all female prisoners seeking abortions in Missouri. In the class-action lawsuit, a Missouri District Court ruled that incarceration does not deny women's rights to an abortion. The Eighth Circuit US Court of Appeals affirmed the lower court’s decision.

Reproductive Freedom Project attorney Diana Kasdan said in an ACLU press release following the Circuit Court Decision, "Today's decision is consistent with rulings from across the country that women prisoners do not lose their reproductive rights once they are incarcerated. Prison officials must ensure that women have access to the full spectrum of pregnancy-related care, including abortion."

Breast Cancer Vaccine Within Reach

The Guardian reports that "[e]nough is known about the causes of breast cancer to make a vaccine or prophylactic drug a real possibility."  Interestingly researchers have found that the more children a woman had and the longer she breastfed, the lower her risk was of later contracting breast cancer.

Women in developed countries where small families are the norm have six times the breast cancer risk of those in rural parts of Asia with large families.

Professor Valerie Beral of Oxford University, who leads the Million Women's Study into the causes of the disease, told the Guardian the study had put beyond doubt what had long been guessed - that many breast cancers are caused by the absence of hormonal changes connected with childbirth.

"But why aren't we thinking of mimicking the effects of childbirth?" she said. "We don't know how this happens and nobody is doing research on it. We should be looking at hormone production during late pregnancy and lactation."

...

"The one hormone that has to do with breast changes doesn't appear until late pregnancy. It goes up exponentially. It produces the changes in the breast that make for lactation," she said. "Why isn't anyone looking at it?" Whichever hormone or hormones are responsible, she said, short-term exposure during late pregnancy and breast-feeding provide life-long protection which is exactly what is required of a vaccine or preventive drug.