[Federal Register Volume 79, Number 231 (Tuesday, December 2, 2014)]
[Page 71433]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-27814]



Centers for Disease Control and Prevention

[Docket No. CDC-2014-0012]

Recommendations for Providers Counseling Male Patients and 
Parents Regarding Male Circumcision and the Prevention of HIV 
Infection, STIs, and Other Health Outcomes

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.


SUMMARY: The Centers for Disease Control and Prevention (CDC), located 
within the Department of Health and Human Services (HHS), is seeking 
public comment on draft recommendations for health care providers who 
deliver information and counseling about elective male circumcision and 
the prevention of HIV and other adverse health outcomes to male 
patients and parents in the United States. The draft recommendations 
include information about the health benefits and risks of elective 
male circumcision performed by health care providers.

DATES: Written comments must be received on or before January 16, 2015.

ADDRESSES: You may submit comments identified by Docket Number CDC-
2014-0012 by any of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Division of HIV/AIDS Prevention, National Center for 
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease 
Control and Prevention, 1600 Clifton Road NE., Mailstop D-21, Atlanta, 
Georgia 30333. Attn: Male Circumcision Recommendations.
    Instructions: All submissions received must include the agency name 
and docket number or RIN. All relevant comments received will be posted 
without change to http://regulations.gov, including any personal 
information provided. CDC will not consider or post any comments that 
contain vulgar or offensive language, threats, personal accusations, 
and/or statements intended to promote commercial products or services, 
or images. Additionally, CDC will not post any pictures that are 
submitted. For access to the docket to read the recommendations, 
background document, or comments received, go to http://www.regulations.gov.

for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for 
Disease Control and Prevention, 1600 Clifton Road NE., MS D-21, 
Atlanta, Georgia 30329, phone: 404-639-5200. Email: 
[email protected].

SUPPLEMENTARY INFORMATION: These recommendations are intended to assist 
health care providers in the United States who are counseling men and 
parents of male infants, children and adolescents in decision making 
about male circumcision. Such decision making is made in the context of 
not only health considerations, but also other social, cultural, 
ethical, and religious factors. Although data have been accumulating 
about infant male circumcision for many years, clinical trials 
conducted between 2005-2010 have demonstrated safety and significant 
efficacy of voluntary adult male circumcision performed by clinicians 
for reducing the risk of acquisition of human immunodeficiency virus 
(HIV) by a male during penile-vaginal sex (``heterosexual sex''). Three 
randomized clinical trials showed that adult male circumcision reduced 
HIV infection risk by 50-60% over time. These trials also found that 
adult circumcision reduced the risk of men acquiring two common 
sexually transmitted infections (STIs), herpes simplex virus type-2 
(HSV-2) and types of human papilloma virus (HPV) that can cause penile 
and other anogenital cancers, by 30%. Since the release of these trial 
data, various organizations have updated their recommendations about 
adult male and infant male circumcision.
    In addition to obtaining public comment on the draft 
Recommendations, CDC considers this document to be important 
information as defined by the Office of Management and Budget's (OMB) 
2004 Information Quality Bulletin for Peer Review and, therefore, 
subject to peer review. CDC will share the summary of public comments 
with external experts who conduct a peer review of the evidence on this 
topic. Their review will include an evaluation of completeness, 
accuracy, interpretation, and generalizability of the evidence to the 
United States and whether the evidence is sufficient to support the 
draft counseling recommendations.
    After considering all public comment and the results of the peer 
review, CDC will publish a notice in the Federal Register announcing 
the final recommendations.

    Dated: November 19, 2014.
Ron A. Otten,
Acting Deputy Associate Director for Science, Centers for Disease 
Control and Prevention.
[FR Doc. 2014-27814 Filed 11-28-14; 4:15 pm]