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Published online 5 August 2008 | Nature | doi:10.1038/news.2008.1012
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Circumcision makes economic sense in fight against HIV
But too few men have access to the procedure, say advocates.
Circumcision not only saves lives by reducing the risk of HIV infection, it also has clear economic benefits, according to research presented at the 17th International AIDS Conference in Mexico City.
But advocates say that these benefits are not being realized due to controversies surrounding the procedure.
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Do they know how/ why circumcision might reduce HIV risks? Is there any reason it would?
I thought an original researcher had admitted that those claims were overstated because he had not taken into consideration the prevalance of prostitution within a region. Try a search on plosone.org for " aids overstated ". . . written by John R. Talbott. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0000543
I don't get it - why would people allow part of their body to be cut off instead of just using condoms?
Saying that "circumcising adult men can cut their risk of HIV infection by 60%" makes it sound like you catch HIV the way you catch a cold. A more careful statement of what was found: "Sexually promiscuous African men, when circumcised, acquired HIV from infected women at about half the rate of men with a whole penis." Men who engage in risky sex where HIV is epidemic will get infected sooner or later, because they don't have sex just once: they do it over and over. Promoting circumcision as a way to prevent HIV is a cruel hoax, when the true risk factors for HIV infection, and how to avoid them, have little to do with having a foreskin. In the U.S., these African studies have become a proxy for promoting neonatal circumcision of boys, which only taints the research and the intentions of those conducting it. Would it be ethical to study the medical benefits of removing the prepuce from females, as is done routinely in Indonesia?
The studies which allegedly show a reduction in HIV among circumcised men are highly questionable. Not one of them was finished, despite the protective affect appearing to decline well below the oft-reported 65%, and several of the subjects disappearing. The fact that one study described circumcision as "comparable to a vaccine of high efficacy" seems to show clear bias. They appear to have been seeking a certain result. One has to wonder how many of the people promoting circumcision in Africa are themselves circumcised. Daniel Halperin is the grandson of a mohel, and seems to think that "maybe in some small way (he's) destined to help pass along (circumcision)" so his objectivity is questionable. Other epidemiological studies have shown no correlation between HIV and circumcision, but rather with the numbers of sex workers, or the prevalence of "dry sex". The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circed men than intact men, yet they've just started a nationwide circumcision campaign. Other countries where circumcised men are *more* likely to be HIV+ are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. That's six countries where men are more likely to be HIV+ if they've been circumcised. Cameroon http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf table 16.9, p17 (4.1% v 1.1%) Ghana http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf table 13.9 (1.6% v 1.4%) Lesotho http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf table 12.9 (22.8% v 15.2%) Malawi http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf table 12.6, p257 (13.2% v 9.5%) Rwanda http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf , table 15.11 (3.5% v 2.1%) Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives not save them. If you read those reports btw, the level of knowledge about HIV is quite frightening. In Malawi for instance, only 57% know that condoms protect against HIV/AIDS, and only 68% know that limiting sexual partners protects against HIV/AIDS. There are people who haven't even heard of condoms. It just seems really misguided to be hailing male circumcision as the way forward. It would help if some of the aid donors didn't refuse to fund condom education, or work that involves talking to prostitutes. There are African prostitutes that sleep with 20-50 men a day, and some of them say that hardly any of the men use a condom. If anyone really cares about men, women, and children dying in Africa, surely they'd be focussing on education about safe sex rather than surgery that offers limited protection at best, and runs a high risk of risk compensatory behaviour. Circumcised male virgins are more likely to be HIV+ than intact male virgins, as the operation sometimes infects men. The latest news is that circumcised HIV+ men appear more likely to transmit the virus to women than intact HIV+ men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised. This is not the first time that HIV in women has been linked to partner circumcision. ABC works against HIV. Circumcision appears not to. Remember that circumcision won't make any difference unless someone is having unsafe sex with an HIV+ partner. Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that. For a good summary of the case against promoting circumcision in Africa, see this link: http://www.doctorsopposingcircumcision.org/info/HIVStatement.html