This is the latest circumcision headline along with, “Circumcision may offer Africa AIDS hope”. I smell BULLSHIT!
I don’t see how the US can be so adamant about male circumcision. They’re now trying to change minds in other countries about it, but I don’t see anyone promoting social health effects of female circumcision. That doesn’t seem fair. Female circumcision curbs promiscuity. That would put a huge dent in teen sex and teens have the highest rates of STDs. Heck, we should terminate all teens and that will get rid of all STDs. Ok, Seriously I know there is a HUGE difference between male and female circumcisions, but if I was having a boy I wouldn’t circumcise him. I figure he’s born with a foreskin, I’m thinking he should keep it. If he hates me for it and wants it removed later on, I’ll pay for the surgery. Again, I know as an adult the surgery isn’t quite as quick and simple, but at least it would be his own choice. I’m not going to point fingers and say someone is wrong for circumcising their boy – it’s your kid, your choice. But this article is Bullshit!
From the Seattle PI
Last updated July 24, 2007 5:31 a.m. PT
Circumcision urged in curbing AIDS spread
By MERAIAH FOLEY
ASSOCIATED PRESS WRITER
SYDNEY, Australia — A U.S. health expert urged governments worldwide Tuesday to endorse circumcision to slow the spread of HIV, saying men without the procedure have a greater risk of contracting the virus from infected female partners.
A U.S. health expert? If you have the goods, the info, wouldn’t you want your name attached to this? And wouldn’t sex with an infected female partner be the key to such a risk and not having skin around the tip of your penis?
Experts at an AIDS conference in Sydney also warned that HIV infection rates were rising among men who have sex with men in developing countries because of discrimination and lack of access to health services.
Wait what does this have to do with foreskin or no foreskin? The headline, dear Ms. Meraiah says, “Circumcision urged in curbing AIDS”. Do these men having sex with men have foreskins or not? And is the HIV rate really rising due to lack of access to health services? I’m thinking the rate rises when they’re having unprotected sex. Read: CONDOMS.
The World Health Organization says male circumcision reduces the risk of female-to-male transmission of the disease by around 60 percent. But only 30 percent of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons.
Around 60 percent? Boy that sounds scientific. I’m so convinced (that was sarcasm). Plus or minus what margin of error? In the US (according to the CDC) from 1979 – 1999 65% of the males born in the US were circumcised. If circumcision is actually helpful we should have a very low percentage of HIV/AIDS, yes? And the percentage of people with HIV/AIDs should be lower than most other countries since the US is the only country that routinely circumcises the majority of infant boys even without medical necessity or religious reasons, yes? Now I don’t have any statistics on US circumcision prior to 1979, but I know it was prevalent in English speaking countries in the early 1900’s and while it slowed down in other English speaking countries around the end of WWII it continued in the US.
Here is a map (I believe it’s current) of countries and the prevalence of male circumcisions. The map is from a site that is clearly biased against circumcision, but I think the representation of where this surgery is prevalent and not seem accurate. Take note that in Mexico, central and South America circumcision is rare. It’s also rare in Europe, China, India, and Russia. Now here is a Chart of the Adult HIV/AIDS Prevalence Rate (aged 15-49). The US is at .6%, Mexico .3%, Guatemala .8%, Honduras .7%, Nicaragua .2%, Costa Rica .4%, Colombia .6%, Ecuador .3%, Brazil .4%, France .4%, Spain .5%, Germany .1%, China .1%, India .3%, Russia 1.1% Because the countries in which circumcision is rare have HIV/AIDS percentages above and below the US I’m thinking it has to do with something other than foreskin.
Robert Bailey, a professor of epidemiology at the University of Illinois, said studies in Africa showed that uncircumcised men were 2 1/2 times more likely to contract HIV from infected female partners, though many health officials were still unclear about its benefits.
I found two sources [1], [2] in which it states that the studies in Africa were halted “after their interim analyses found that medical circumcision reduced male participants’ risk of HIV infection”. The “Doctors against circumcision” site, which is obviously biased, suggests that if the studies went as scheduled the results would have been similar between the two groups. The circumcised men may not have been given adequate time to heal. From what I can tell all of the men were adults and were not circumcised prior to the study. From the CDC, “In these studies, men who had been randomly assigned to the circumcision group had a 60% (South Africa), 53% (Kenya), and 51% (Uganda) lower incidence of HIV infection compared to men assigned to the wait list group to be circumcised at the end of the study. In all three studies, a few men who had been assigned to be circumcised did not undergo the procedure, and vice versa. When the data were reanalyzed to account for these deviations, men who had been circumcised had a 76% (South Africa), 60% (Kenya), and 55% (Uganda) reduction in risk of HIV infection compared to those who were not circumcised.” So basically it’s business as usual for the uncircumcised who get a head start while the newly circumcised men wait a bit to heal. I don’t know how long it takes a newborn to heal but I’m thinking it might take an adult a bit longer before the boinking may commence again.
“If we had a vaccine that was 60 percent protective, we would be very happy and we would be rolling it out as fast as we can,” Bailey told reporters at an International AIDS Society Conference in Sydney, Australia.
It’s my understanding that vaccine tests are not halted before their scheduled date just because initial tests confirmed desired results. I don’t think the FDA would approve.
“The next step is to get the leaders of countries to actually come up with policy statements endorsing the practice,” said Bailey, who has conducted circumcision-related studies in Africa and the United States.
Without local support, international agencies would be unlikely to encourage the procedure to avoid being seen as imposing foreign cultures or values, he said.
Circumcision, the removal of the foreskin from the penis, has long been suspected of reducing men’s susceptibility to HIV infection because the skin cells in the foreskin are especially vulnerable to the virus.
I suspect that a combination of condoms and AIDS education would be even more effective than removal of the foreskin since circumcised men also contract HIV.
In March, the WHO urged heterosexual men to undergo the procedure because of compelling evidence that it reduces their risk of getting the disease. However, it cautioned that male circumcision is not a complete protection against HIV, and said men should still use condoms and take other precautions such as abstinence, delaying the start of sexual activity and reducing the number of sexual partners.
What about gay men? If the skin cells on the foreskin are truly more susceptible to HIV – wouldn’t this also help gay men? Shouldn’t the WHO urge men in general and not just the ones with the “acceptable” sexual preference?
“Circumcision could drive the epidemic to a declining state toward extinction,” Bailey said. “We must make safe, affordable, voluntary circumcision available now.”
Yep, at .6% it’s nearly extinct in the US all due to circumcision I’m sure because countries like France, Spain, China that don’t circumcise have soaring rates like .4%, .6% and .1%.
Bailey also called on international agencies to ramp up funding for circumcision in countries hardest-hit by the epidemic.
Michel Kazatchkine, the executive director of the Global fund, a leading international health agency, also called for increased funding.
“I believe that the evidence is overwhelming for the efficacy of circumcision,” Kazatchkine told The Associated Press on the sidelines of the meeting. “And if countries come to us … I see no reason at all why we wouldn’t fund that.”
Yep we want everyone to be just like us because clearly we know what’s best. We’re the greatest and have the right to tell people what to do with their bodies and their children and especially their penis.
Kazatchkine said his organization had not yet received any requests for funding for circumcision, and noted that the WHO advice on the topic was only released in March.
Also at the conference, a leading American AIDS research group said HIV infection rates among men who have sex with men were rising in Africa, Asia and Latin America, citing figures from UNAIDS.
Studies also show that less than 5 percent of that group have access to HIV-related health care, the American Foundation for AIDS Research, or amfAR, said.
Again, what does this have to do with foreskin or no foreskin? The headline, dear Ms. Meraiah says, “Circumcision urged in curbing AIDS”. Stay on track dear.
“This is a massive failure of the HIV/AIDS response globally and I think one that needs to be addressed,” said Kevin Frost, amFAR’s chief executive officer.
In Kenya, around 40 percent of men who have sex with men are estimated to be HIV positive, compared to a 6 percent rate in the country’s overall population, amFAR said. In Senegal, nearly 22 percent are believed to be infected, compared to less than 1 percent of the general population.
In Uruguay and Mexico, 21 percent and 15 percent are estimated to have the disease.
Let us be clear here – we’ve switch from talking about men that are cut or uncut and their chances of contracting the virus to the percentage of HIV/AIDS positive people that are gay men. Dear Ms. Meraiah, your hard hitting reporting seems a little misleading and off topic. Please focus.
Under an initiative launched at the AIDS Society Conference, amFAR will seek to raise $3 million in the next three years to provide grants for AIDS education and research among men who have homosexual sex in developing countries.
That’s fantastic, but should probably have been in a different article under a different headline.
AIDS study halted – From the CDC site:
“Three randomized, controlled clinical trails have been undertaken in Africa to determine whether circumcision of adult males will reduce their risk for HIV infection. The study conducted in South Africa [10], was stopped in 2005 and those in Kenya [11] and Uganda [12] were stopped in 2006 after their interim analyses found that medical circumcision reduced male participants’ risk of HIV infection.”
10. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLoS Med. 2005 Nov;2(11):e298.
11. Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial. Lancet 2007; 369:643-656.
12. Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized trial. Lancet 2007;369:657-666.
In the article below, scientist John Talbot concludes most of the research pushing for male circumcision is misleading.
Male Circumcision Overstated As Prevention Tool Against AIDS
20 Jun 2007
New study finds the key to understanding the global spread of AIDS is the size of the infected prostitute community around the world.
In new academic research published today in the online, open-access, peer-reviewed scientific journal PLoS ONE, male circumcision is found to be much less important as a deterrent to the global AIDS pandemic than previously thought. The author, John R. Talbott, has conducted statistical empirical research across 77 countries of the world and has uncovered some surprising results.
The new study finds that the number of infected prostitutes in a country is the key to explaining the degree to which AIDS has infected the general population. Prostitute communities are typically very highly infected with the virus themselves, and because of the large number of sex partners they have each year, can act as an engine driving infection rates to unusually high levels in the general population. The new study is entitled “Size Matters: The Number of Prostitutes and the Global HIV/AIDS Pandemic” and is freely available online at the PLoS ONE publication website at http://www.plosone.org/doi/pone.0000543.
The study has a number of important findings that should impact policy decisions in the future. First, male circumcision, which in previous studies had been found to be important in controlling AIDS, becomes statistically irrelevant once the study controls for the number of prostitutes in a country. The study finds that the more Muslim countries of North Africa do indeed suffer much less AIDS than southern and western Africa, but this lower prevalence is not due to higher numbers of circumscribed males in these Muslim communities, but rather results from the fact that there are significantly fewer prostitutes in northern Africa on a per capita basis. It appears that religious families in the north, specifically concerned fathers and brothers, do a much better job protecting their daughters from predatory males than do those in the south. A history of polygamy in these Muslim communities does not appear to contribute to higher AIDS prevalence as previously speculated. In a frequently cited academic paper, Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development and one of the world’s leading advocates for male circumcision, weighted results from individual countries by their population. When this artificial weighting was removed Talbott found that circumcision was no longer statistically significant in explaining the variance in AIDS infection rates across the countries of the World.
Second, to date, there has not been an adequate explanation as to why Africa as a continent is experiencing an AIDS epidemic far in excess of any other region of the world with some African countries’ prevalence rates exceeding 25% of the adult population and tens of millions dying from the disease on the continent. Talbott’s new study suggests that the reason is that Africa as a whole has four times as many prostitutes as the rest of the word and they are more than four times as infected. Some southern Africa countries have as many as 7% of their adult females infected and working as prostitutes while in the developed world typically this percentage of infected prostitutes is less than .1%. If these 7% of infected prostitutes in Africa sleep with five men in a week that means they are subjecting 35% of the country’s male population to the virus weekly. The virus is not easy to transmit heterosexually, but over time with multiple exposures, infection is inevitable. These men then act as a conduit to bring the virus home to their villages, their other casual sex partners and to their wives.
The study has important policy implications. Several international AIDS organizations have begun to provide funding for male circumcisions as a deterrent to AIDS. While male circumcision may indeed reduce the risk of transmission by some 50% to 60% in each sexual encounter, reducing single encounter transmission rates alone cannot control the epidemic. The reason is that individuals in highly infected countries have multiple contacts with the infected so reducing transmission rates only defers the inevitable.
The real question is what can be done with the prostitute community. Outlawing the world’s oldest profession would most likely prove to be ineffective. If the profession can be legalized and treatment and care provided to the practitioners, there would be much more reason to be hopeful. But, and this is the key, programs of action can not just be voluntary. Too many innocent people are dying and there is too much disregard for human life among infected prostitutes to leave treatment decisions solely up to them. A program of testing and treatment for prostitutes must be mandatory and those that refuse treatment must be held liable.
Many international aid organizations are against such mandatory treatment programs for prostitutes as they find them to be discriminatory, violate the individual’s human rights and are perceived as an attack on female prostitutes who are viewed as victims of gender and income inequality. Such organizations do not properly weigh the loss of human rights and life itself that this virus, unleashed on a community, is causing. This virus, itself, is a violation of human rights and we must do everything in our power to stop it. To argue we should do nothing about infected prostitutes during an AIDS epidemic because of a fear of creating a stigma against the infected would be like an animal rights activist claiming that a rabid dog must be allowed to run free in a neighborhood regardless of how many men women and children he infected and killed.
It is not surprising that computer models rarely show the virus reaching epidemic proportions; it is very hard to transmit this illness heterosexually. Only when model building researchers introduce a highly sexually active infected subset of “prostitutes” to their mathematical models does the infection spread exponentially to the general population.
John R. Talbott is an author and a former investment banker for Goldman Sachs. Previously he was a Visiting Scholar at UCLA’s Anderson School of Management in Los Angeles. He lives in New York City and writes about finance, economics, politics, AIDS and society. He has published important empirical academic research concerning the significant role democratic and capitalist institutions play in promoting economic growth and prosperity in both the advanced and developing world. John has advised a number of developing countries including Jordan and Russia on how they might improve their economic and political institutions to garner greater economic growth and defeat poverty. John’s latest book accurately predicted the current downturn in the U.S. housing market.
Citation: Talbott JR (2007) Size Matters: The Number of Prostitutes and the Global HIV/AIDS Pandemic. PLoS ONE 2(6): e543.
http://www.plosone.org/doi/pone.0000543
It’s always easy to point the finger at prostitution, but if prostitution is the culprit than due to sheer numbers then really you’re saying that we need to do something about all promiscuity because AIDS doesn’t care if someone was paid for sex or not. Granted prostitutes generally have more partners in one 24 hour period than even the most promiscuous person I’ve ever met, but your answer to the problem only focuses on one means of HIV transmission, which is sex. And I’m sorry but for me that just doesn’t seem to cut it when a country like Zimbabwe is at 20.1% and Thailand (known for it’s prostitution) is at 1.4%. Other means to consider, which I think might be highly likely in South Africa are tainted blood transfusions and tribal circumcisions in unsanitary conditions.
Even though the United States has the highest circumcision rate in the world – it also has more people diagnosed with aids. It doesn’t jive.
That’s exactly the point I was trying to make by listing the stats that I did in my post. The US has a higher HIV/AIDS rate than most of the European countries, but less than some of the central and south American countries. This makes me think that some of the biggest factors are sanitary conditions / blood transfusions in hospitals, HIV/AIDS education, and condom use.