chlamydia transmission The American Academy of Pediatrics has shifted its stance on infant male circumcision, announcing on Monday that new research, including studies in Africa suggesting that the procedure may protect heterosexual men against H.I.V., indicated that the health benefits outweighed the risks.

But the academy stopped short of recommending routine circumcision for all baby boys, saying the decision remains a family matter. The academy had previously taken a neutral position on circumcision.

The new policy statement, the first update of the academy's circumcision policy in over a decade, appears in the Aug. 27 issue of the journal Pediatrics. The group's guidelines greatly influence pediatric care and decisions about coverage by insurers; in the new statement, the academy also said that circumcision should be covered by insurance.

The long-delayed policy update comes as sentiment against circumcision is gaining strength in the United States and parts of Europe. Circumcision rates in the United States declined to 54.5 percent in 2009 from 62.7 percent in 1999, according to one federal estimate. Critics succeeded last year in placing a circumcision ban on the ballot in San Francisco, but a judge ruled against including the measure.

In Europe, a government ethics committee in Germany last week overruled a court decision that removing a child's foreskin was "grievous bodily harm" and therefore illegal. The country's Professional Association of Pediatricians called the ethics committee ruling "a scandal."

A provincial official in Austria has told state-run hospitals in the region to stop performing circumcisions, and the Danish authorities have commissioned a report to investigate whether medical doctors are present during religious circumcision rituals as required.

Officials with the Centers for Disease Control and Prevention in Atlanta, which for several years have been pondering circumcision recommendations of their own, have yet to weigh in and declined to comment on the academy’s new stance. Medicaid programs in several states have stopped paying for the routine circumcision of infants.

"We're not pushing everybody to circumcise their babies," Dr. Douglas S. Diekema, a member of the academy’s task force on circumcision and an author of the new policy, said in an interview. "This is not really pro-circumcision. It falls in the middle. It’s pro-choice, for lack of a better word. Really, what we’re saying is, 'This ought to be a choice that's available to parents.' ”

But opponents of circumcision say no one — not even a well-meaning parent — has the right to make the decision to remove a healthy body part from another person.

A Kandiyohi County coalition focused on healthy teen sexuality is turning to the public this fall to help craft a community plan that fosters adolescent health.

One of the main goals is to reduce the local incidence of chlamydia, a sexually transmitted infection that has soared to epidemic proportions in Minnesota in recent years.

The first in a series of public meetings will be Monday. Organizers hope to end up with a strategy that can be carried out over at least the next three years.

“We’d like to have a plan that really comes from the community, has a community voice and community support and is well-balanced,” said Deb Schmitzerle, coordinator with Kandiyohi County Public Health of the Coalition for Healthy Adolescent Sexuality.

The initial meeting is at 6:30 p.m. Monday at the Lakeland Auditorium on the lower level of the Lakeland Health Center building in Willmar.

Meetings will be at 6:30 p.m. the following four Mondays, Oct. 8, Oct. 15, Oct. 22 and Oct. 29, in the Rice Auditorium on the lower level of the Lakeland Health Center.

“We do want anyone in the community who has an interest to know about it,” Schmitzerle said.

Surveys suggest that sexual activity is occurring less often among American adolescents and that more teens are delaying the start of sexual activity. But chlamydia rates are moving in the opposite direction.

chlamydia transmission is now the leading infectious disease reported in Minnesota — nearly 17,000 in 2011, a record number. Almost three-fourths of cases were in teens and young adults aged 15 to 24. Rates in Kandiyohi County are among some of the highest in the state.

Although it’s readily treatable, as many as 75 percent of females and 50 percent of males with the infection go undiagnosed because symptoms often are not evident. Left untreated, chlamydia can unknowingly be spread to other partners and result in infertility, ectopic pregnancy and chronic pelvic pain. Infected women also can pass the infection to their newborn child, causing premature delivery, infant pneumonia and eye infections that may lead to blindness.

The Kandiyohi County Coalition for Healthy Adolescent Sexuality began working in 2010 with the Minnesota Chlamydia Partnership. More recently, the group also began working with the Minnesota Department of Health to not only reduce the incidence of chlamydia but to promote overall healthy behavior among teens and young adults.

“We are concerned about teens getting pregnant and we are concerned about sexually transmitted diseases,” Schmitzerle said. “But we’re really concerned about all teens and healthy sexuality. Is there something we can do as a community to support young people to be healthy?”

Chlamydia is a main focus because it’s something that can be measured, she said.

But members of the coalition want to take a broad approach that includes social factors and the attitudes and belief systems that help shape health, decisions and behavior.

One of the recommendations issued by the Minnesota Chlamydia Partnership is to use youth development as a chlamydia prevention strategy. The partnership also has called for more widespread chlamydia screening, especially among young women, and a greater emphasis on public health involvement and public policies that promote sexual health among teens and young adults.

A goal of the planning process this coming month will be to test how some of these strategies work at the local level, Schmitzerle said. “That’s what we’re hoping to do — to look at some of these ideas.”

The issue is “very sensitive,” she acknowledged. “These conversations start young and need to continue.”

A SEXUALLY active person can be carrying chlamydia without any symptoms for years until it comes time to reproduce, and that's when they discover they are infertile.

If only they knew a simple urine test, a couple of pills and a condom could make it all go away or stop the infection in the first place.

This year's Sexual Health Week theme - Check it Out - is targeted at 16-25-year-olds, the biggest risk group for the disease.

chlamydia transmission is still the most commonly reported sexually transmitted infection (STI) in NSW.

Since 2006, chlamydia notifications in NSW have risen from 12,015 to 20,469 in 2011, with about 60% of notifications in 2011 in the 15-to-25-year age range.

The advice for young people who are sexually active is to visit their doctor regularly to test for sexually transmissible infections and, in particular, chlamydia.

The Northern NSW Local Health District's sexual health staff specialist, Dr Natalie Edmiston, said chlamydia was very common among young people aged under 25.

"If you are sexually active, use condoms and water-based lubricant and see a doctor for a sexual health check-up."

Dr Edmiston said all sexually active young people should consider asking their GP for a chlamydia test at least once a year.

Alternatively, the sexual health clinic at Grafton Base Hospital offers free and confidential sexual health checks for everyone from 8am-4.30pm Monday to Friday.

 As a special offer for Sexual Health Week, the clinic has 50 fun-safe sex packs to give away, each containing a flavoured condom, lubricant, information and a tin carry pack.