Circumcision saves lives: "60% reduction in HIV risk"

[MannyGoldstein]

http://www.bloomberg.com/news/2011-06-03/male-circumcision-offers-a-critical-60-reduction-in-hiv-risk-un-finds.html">Male Circumcision Offers a ‘Critical’ 60% Reduction in HIV Risk, UN Finds

The 139-page report said male circumcision offers a 60 percent reduction in HIV risk and the benefits are life-long. The number of people with HIV, the virus that causes AIDS, rose 27 percent, to 33 million, between 1999 and 2009, according to the report.

More than 350,000 men in eight African countries agreed to lose their foreskins in 2010 to lower their chances of catching HIV, six years after some studies showed the procedure was effective, the report said. That compares with 100,000 men taking part in the procedure in 2009. The countries are Kenya, Namibia, Rwanda, South Africa, Swaziland, Zambia and Zimbabwe.

Circumcision is the surgical removal of a skin that covers the tip of the penis. The UN-sponsored researchers say the pocket between the foreskin and the tip of the penis gives viruses and bacteria a spot to grow, and circumcision eliminates it. They also say foreskin has been shown in studies to be rich in cells that carry HIV into the body.

All other things being equal, it sure would be better to not circumcise boys. But all other things are not equal here. This is a life-saving procedure.

[tammywammy]

1. ...

:popcorn:

[Cant trust em]

2. What about condoms? Do they save lives too? nt

[MannyGoldstein]

3. Yep.

Do they always get used? Nope.

Do they break sometimes? Yep.

[Cant trust em]

31. How is your response "Do they always get used? Nope." any different for circumcision?

Basically what you're saying is that if you don't use the tactic, then there is no remedy.

How is this different for circumcision? If you don't get circumcised, then you still have an elevated risk for HIV.

[pnwmom]

76. The WHO studies found this 60% reduction EVEN in men using condoms.

The researchers still strongly recommend condoms, but circumcisions provide added protection.

[laconicsax]

84. What makes circumcision a likely cause of that reduction?

The mechanism by which circumcision supposedly protects against HIV is negated by condom use. If circumcised men are 60% less likely to contract HIV regardless of whether they use condoms, it doesn't seem likely that the circumcision is the cause of that reduction.

Here's a question, I've yet to see answered: if circumcision reduces HIV risk, then why aren't HIV rates correlated with circumcision rates? The US has over twice the incidence of HIV than Western Europe, but Western Europe has less than a third of the circumcision rate as the US.

Edit: formatting

[pnwmom]

91. Maybe you'll find the answer somewhere in here.

From people who work in AIDS research.

http://www.who.int/hiv/pub/malecircumcision/en/

[laconicsax]

98. You don't have an answer, just as I thought.

Perhaps you'd like to cite the relevant publication, maybe even with an excerpt? So far, none of the publications at that link contain anything remotely resembling an answer.

Think it through for a minute--the prevention mechanism given for male genital mutilation isn't a factor when condoms are used. This means that if the same 60% reduction is seen regardless of condom use, the cause cannot be male genital mutilation itself. It's far more likely that another factor, unrelated to male genital mutilation, is the actual cause.

[pnwmom]

102. Think about it for a minute. Men don't always use condoms for every minute of sexual activity.

And condoms can slip off and break. There are plenty of ways to transmit HIV even among men who use condoms.

I gave you the links, I can't make you read the research. The results were so clear that the researchers ended the last study early and offered circumcision to all the men in the study.

[laconicsax]

123. Still not an answer.

You keep dodging the issue--circumcision cannot make condoms more effective. You've made this claim several times on this thread. It's time to back it up.

[pnwmom]

129. I can't help it if you can't take in the answer. Yes, circumcisions CAN make condoms more effective

The research was conducted only among men who already were using condoms. This was done to eliminate condoms as a confounding variable. As I told you in another post, the condom-using men were divided into two groups: the control group (who only continued to practice safe sex) and a group that were given circumcisions (and continued to practice safe sex). All men, thus, continued using condoms and were followed after that for new HIV infections. The circumcised men ended up with significantly fewer infections of HIV. (40-more than 70% fewer, based on the subgroup). Therefore, the circumcision provided ADDITIONAL protection to condom using men (since all were using condoms).

How can this be? Have you ever heard of condom failure? Of condoms slipping off or breaking? Can you imagine seminal fluid leaking before a man puts a condom on, or after he takes it off? Condom use reduces but doesn't entirely eliminate the spread of HIV. It would be nice if it did, but it doesn't.

[laconicsax]

130. You're just guessing.

Show me a plausible mechanism. The guesses you made aren't affected by circumcision.

[pnwmom]

132. I'm telling you about the research. You're just ignoring it. n/t

[laconicsax]

134. No, you're adding your own conclusion that isn't supported by the data. n/t

[pnwmom]

137. This is the conclusion of the researchers, in their words, "beyond a reasonable doubt."

The three large-scale studies were designed to eliminate condoms as a confounding variable.
All the men, in both the circumcised and non-circumcised groups, were given intensive safer sex counseling and provided with condoms. And the WHO continues to strongly urge the use of safer sex along with circumcision.

http://libdoc.who.int/publications/2007/9789241595988_eng.pdf

The research evidence that male circumcision is efficacious in reducing sexual transmission of
HIV from women to men is compelling. The partial protective effect of male circumcision is remarkably
consistent across the observational studies (ecological, cross-sectional and cohort)
and the three randomized controlled trials conducted in diverse settings.

The three randomised controlled trials showed that male circumcision performed by well-trained
medical professionals was safe and reduced the risk of acquiring HIV infection by approximately
60%.

The efficacy of male circumcision in reducing female to male transmission of HIV has been proven
beyond reasonable doubt. This is an important landmark in the history of HIV prevention.

Conclusion 2: Male circumcision does not provide complete
protection against HIV

Male circumcision does not provide complete protection against HIV infection. Circumcised men
can still become infected with the virus and, if HIV-positive, can infect their sexual partners. Promoting
and providing safe male circumcision does not replace other interventions to prevent heterosexual
transmission of HIV but provides an additional strategy.

In all three randomized controlled trials HIV incidence was considerably lower in the intervention
(circumcised men) than in the control group (uncircumcised men), but nevertheless remained
high overall (0.7 to 1.0 per 100 person-years in circumcised men). This high incidence persisted
in spite of intensive safer sex counselling, condom provision and the management of sexually
transmitted infections. This underlines the need to strengthen comprehensive HIV prevention
programmes even further.

It is not known whether male circumcision reduces the sexual transmission of HIV from men to
women. Although a reduction in HIV incidence among men will eventually result in lower prevalence
in men and therefore less likelihood that women will be exposed to HIV, currently there are
insufficient data to know whether male circumcision results in a direct reduction of transmission
from HIV-positive men to women.

[laconicsax]

140. "The three large-scale studies were designed to eliminate condoms as a confounding variable."

:eyes:

[pnwmom]

141. I guess you don't understand what that means.

That was the purpose of instructing them in safer sex practices and providing free condoms to all the men.

[laconicsax]

146. I understand perfectly what it means, and it isn't what you've been claiming.

Despite what you seem to think, eliminating a variable means that the variable isn't part of the conclusion. Not only that, but the WHO document you're citing isn't the study itself--it's a 4-year old interpretation of even older studies. Fortunately, it does cite the studies, the 60% one being this one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1262556/

Note this isn't the study cited in the OP. The study in the OP had over 350,000 participants in 2010, compared to the study you're citing which had 3,274 participants in 2005. I guess it's just too much work to pay attention to whether the study you're looking at was even from the same year as the one you're responding to.

In the study you cited, the circumcised group had an HIV infection rate of 1.2% and the uncircumcised group had an infection rate of 3%. (It isn't worth mentioning that if you look at the data, the error bars overlap.) And when controlled for condom use (meaning they eliminated it as a variable), circumcision correlated to a 61% reduction in risk.

The results were controlled for condom use, meaning that they are derived only from times when participants didn't use condoms. Including condom use would invalidate the study, since whenever a participant in either group used condoms, it would skew the results.

The article in the OP refers to http://www.unaids.org/en/resources/unaidspublications/2011/#c_60139">this UN report, which includes http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20110531_JC2095E_aids_at_30_section1-9.pdf">this part on circumcision.

What does it all mean? Male genital mutilation may reduce female-to-male HIV transmission by as much as 60%, making it less effective and more invasive than basic sexual education and condom use, and possibly not having any effect on male-to-female or male-to-male transmission. Global HIV/AIDS prevalence doesn't seem to correlate to circumcision rates either.

Forgive me if I think that education and condoms are a better choice than genital mutilation. It's only an opinion supported by reality.

[Crunchy Frog]

148. There actually was a randomized controlled study

to assess the effects of male circumcision on male to female transmission when the men were HIV positive, and the it showed about a 50% increase in HIV infection among the female partners of the circed men. The study was ended early due to "futility", but IMO, it was to avoid getting a sufficient number of results to achieve statistical significance, and hence to undermine the researchers' preexisting agenda. The Lancet, Volume 374, Issue 9685, Pages 229 - 237, 18 July 2009 doi:10.1016/S0140-6736(09)60998-3

In the follow up to that study, they recommended that ALL the men get circumcised anyway.

It's possible that this African circumcision campaign will actually end up making things worse, if circ really does increase male to female transmission (which they seem to not wish to evaluate), and it encourages men to believe they are immune from HIV if circed, and to therefore refuse to use condoms. (Already documented to be happening. http://www.irinnews.org/Report.aspx?ReportId=79557 )

[laconicsax]

154. That's good to know.

Looks like MGM is a good choice if you're willing to trade a 60% decrease in female-to-male transmission for a 50% increase in male-to-female transmission and tacitly encourage unprotected sex.

Looks like a win-win for psychopaths.

[JackRiddler]

155. The original study in South Africa was such a transparent sham that I doubt these are any different.

An extensive analysis of Auvert et al. (2005) here:
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5332212&mesg_id=5336085

Among many other dodgy moves they pulled the same trick of suspending the study halfway through because they felt they liked the (deceptively measured) results up to that point, just as the study you mention was suspended to prevent the "wrong" results.

It's just mind-boggling that the overwhelming majority of the African population isn't even tested for AIDS and instead of calling for an extension of health care coverage these usual suspects (Gates in the lead, on the days when they're not screwing the schools here, and the ever-trustworthy Clinton as spokesman) are financing studies and raising the banner for male genital mutilation as the cure-all.

[Crunchy Frog]

157. Thank you for that very informative link.

I'm actually running a group on an extremely large parenting forum, whose intent is to give parents and parents to be accurate information about circumcision and proper care for intact boys (of which the U.S. medical community is shockingly ignorant).

Debunking the health myths, especially with all the stuff coming out recently in the media, is a big part of what I do over there. So your info is truly valuable, and I can guarantee you that some boys will be spared the knife because of it.

[JackRiddler]

158. I hope so! I'm proud to say I've at least helped spare the knife for two boys so far.

[Saokymo]

122. Removing the foreskin removes a likely spot of microbial growth.

It's like keeping your fingernails trimmed. Washing your hands regularly does cut down on microbial transmissions, but if the nails are kept short it removes a hotspot for growth.

Removing the foreskin works the same way -- it takes out a major site for bugs to grow in and avoid being washed away even with regular cleaning. Condoms help by blocking the bugs from getting there in the first place; removing the foreskin helps make sure they don't have a place to grow and hide.

[laconicsax]

125. That mechanism cannot make condom use 60% more effective.

That's what pwnmom is claiming. That male genital mutilation makes condom use more effective in preventing HIV at exactly the same as the mutilation itself.

[Saokymo]

131. I'm not sure that I understand that last sentence.

We know condoms help prevent HIV transmission. We now know (despite whatever naysayers may claim, I'm going to trust the UN and WHO on this one) that circumcision also helps reduce (not prevent) HIV transmission. It's not a big jump in logic to assume that both taken together will be more effective than either by itself.

Let's go back to the fingernail analogy. Say you keep your nails trimmed (similar to circumcision) but never bother to wash your hands (similar to using condoms and safe sex practices). Even though you've removed the main site of bacterial growth you're still going to be spreading bacteria and such around because your hands are dirty. Conversely, if you wash your hands regularly but keep your nails long you're still going to wind up spreading more bacteria because they're constantly growing underneath the tip of the nail, no matter how thoroughly you clean each time. Use both practices together and you won't spread nearly as many germs around.

That's the point of the study -- that removing the foreskin cuts out a key site of bacterial and viral growth, thus reducing the rate of transmission. This in turn makes condoms a more effective prevention method by not giving any germs that do get through (because condoms aren't 100% effective, either) a place to propagate. Both methods taken together are more effective than one by itself or none at all.

[laconicsax]

135. It is a big jump--straight to illogical.

The mechanism given for why circumcision prevents HIV doesn't come into play when condoms are used.

Going to the fingernail analogy (and ignoring that was for something else entirely), let's say you're investigating whether keeping nails trimmed reduces the spread of pathogens to prepared food. You have two groups, trimmed and untrimmed. Both groups are given latex gloves to wear in the kitchen and the trimmed group shows a 60% reduction in contaminated food.

If you're wearing gloves, it doesn't matter what nasty shit is under your fingernails, so the correlation can't be causal.

With circumcision, the only way for the mechanism of eliminating a "key site of bacterial and viral growth" to improve condom efficacy at the same rate as without condom use is if 100% of the condoms failed.

[Saokymo]

136. I've explained the mechanisms involved as clearly as I possibly can.

Circumcision does not prevent HIV. It reduces the rate of transmission by not allowing the virus an easy foothold within the body. Condoms prevent HIV by providing a physical barrier to block transmission from happening in the first place. Both practices used together increase the efficiency of each.

Clearly, no amount of rational dialogue or evidence to back up the claims will convince you that circumcision has possible health benefits for men and their sexual partners. Have a good day.

[laconicsax]

139. Here's what could convince me:

The US has a 75% circumcision rate and a 0.5% incidence of HIV/AIDS
Western Europe has a less than 20% circumcision rate and a 0.2% incidence of HIV/AIDS

Explain how circumcision can reduce the chance of spreading HIV by 60% while being negatively correlated.

[Crunchy Frog]

150. More nerve endings = more sensitivity = less reluctance to use condoms

in the European population.

It's possible that if absolutely every other factor besides circumcision status was equal between the two populations, that there would be higher rates of HIV in Europe. But if American males are less willing to use condoms and more likely to engage in high risk activity due to less sensitivity, then that would likely negate any protective effects of circ, and then some.

At least that's my theory.

[JackRiddler]

156. Removing the testicles would end a common form of cancer.

[Bonobo]

4. Who cares about Africa and AIDS?

There are men who want to stop parents from having the rights to make medical decisions for their own children.

[Luminous Animal]

7. Hahaha! Yes, that's why parents do it! The health benefits! How about allowing

grown adults to make that decision.

[Bonobo]

9. Parents make decisions for their kids. Get over it. nt

[Luminous Animal]

17. There are a lot of physically abusive things that we bar parents from doing to their children.

Get over it.

[Bonobo]

103. Kids cannot make decisions for themselves.

You think parents should not have the right to make informed decisions about their children.

I guess our conversation eneds there.

What other decisions do you think should be taken away from parents?

How about family bed? Some kids get rolled over, right? Maybe that should be banned too, huh.

[Crunchy Frog]

118. How about getting children tatooed

or tribal scarring. Or any kind of cutting of the female genitals, even if it's just a pinprick to draw a symbolic drop of blood.

Anyway, nobody's going to take away your right to whack your son's penis, so you don't have to worry. That thing in San Francisco is purely symbolic. It has no chance of passing, but it is getting people talking about the issue and thinking about it, which is a good thing IMO.

[ohheckyeah]

20. Do you know any

men who got circumcised as adults for health reasons? Ask them if they are glad they got to make the decision.

[Luminous Animal]

33. I do know one and, for him, it was the right decision to make. Fortunately, it was his decision.

The resulting pain was considerably less than my husbands hernia operation.

[ohheckyeah]

36. Well, the adults I know who had to have it done

wished it had been done when they were infants. It was really hard on the guys as adults.

[Luminous Animal]

39. I hope the poor dears get over it.

[ohheckyeah]

43. How cute....

sarcasm.

[sense]

48. I do

They were not remotely happy when they had to do it for health reasons, it was very painful and it took forever to heal. I also know a 9 year old boy who had to have it done..... traumatic.

[FLAprogressive]

108. Not as an adult but I had to later on as a child for health reasons

and it hurt like an SOB. That's why it's not so easy to say "Well they can just get it later on". Trust me, it takes a LOT longer to heal and you definitely remember the pain if you get one down the road.

Do I miss my foreskin? Hell no.

[customerserviceguy]

37. I wish my parents had made that decision for me as a kid

Believe me, it's no picnic getting circumcised at eighteen. I had a medical condition that necessitated it, and figuring my sons might have the same thing, I had them done long before they could ever remember anything about it.

I'm 55, and I sometimes still have some pain at the incision after vigorous activity, as far as I know, they've never had a problem.

[Luminous Animal]

45. And I had a medical necessity that resulted in a mastectomy and recurrent pain as a result.

But, if it were probable, I wouldn't recommend mastectomies for infants so they wouldn't have to remember the trauma as adults.

[customerserviceguy]

117. No comparison

A breast is far more useful than a foreskin.

[pnwmom]

77. The health benefits were why we decided on circumcision.

We had a first child with a symptomless UTI that led to permanent kidney damage. Infant boys who are circumcised have 10 times fewer urinary tract infections.

[FLAprogressive]

107. Ask some people here and you might as well have murdered someone

it's really pathetic.

[Saokymo]

120. It's why I did it for my son.

A means of helping protect both his health and the health of any sexual partners he may have later on in life. Don't parents count as grown adults, too?

[Newest Reality]

5. So, on the down side

that news tells the circumsized that they are less likely to contract the disease.

Hopefully, they will consider that to be a gambler's game and continue to practice safe sex.

[Crunchy Frog]

56. Unfortunately not the case in Africa (I mean about practicing safe sex).

http://www.irinnews.org/Report.aspx?ReportId=79557

Hlope said SWAPO members were becoming increasingly aware of an attitude that circumcision protected men from HIV infection, while also providing an excuse not to use condoms; something Swazi men have long loathed doing.

Joy Magongo, a mother of two whose husband moved out to live with his second wife after the couple discovered they were both HIV-positive, told IRIN: "Men say, 'I've been circumcised. I don't have to wear a condom.' They get infected, and they give us HIV.

He was circumcised and felt he didn't have to wear a condom. When we found we had HIV after testing, he blamed me. He said, 'You brought HIV into this house.' It was because I tested first, when I was pregnant with my second child," she said.

"My husband did not believe he could be HIV-positive because he was circumcised. I did all I could to convince him to test, and he finally did. That was the end. He took another wife and left us," Magongo said. Polygamy is legally recognised in Swaziland.

[Hepburn]

110. O/T ~~ Those two boys are soooooooooooo cute!!!!! n/t

[pnwmom]

78. The WHO advises men to practice safe sex AND have circumcisions.

In the research in Africa, circumcision added additional protection beyond that added by safe sex.

[Crunchy Frog]

111. And unfortunately having less success with the former than with the latter.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=439&topic_id=1230622&mesg_id=1230933

IMO, this campaign will be a wash, if they get lucky, and potentially a disaster if they don't.

And just FWIW, I believe the WHO reccomendations only apply to countries where HIV occurs in epidemic proportions, and is primarily spread through heterosexual intercourse. The reccomendation mostly applies to Sub-Saharan Africa, and not to the United States or other developed countries.

[Luminous Animal]

6. Indeed. And it can be a choice for sexual active males to make for themselves.

Any pregnancy can be debilitating or fatal. Would you advocate female infants have their ovaries removed to avoid possible complications when they become fertile?

[Orrex]

8. You make a good point

We should likewise hold off vaccinations until the recipients are old enough to decide for themselves.

[Luminous Animal]

21. Really, you are going to equate cutting off part of a human being with a needle prick.

[Orrex]

22. In terms of lasting trauma, yes.

[Luminous Animal]

30. My daughter had to have a spinal tap when she was 3 days old. When we asked the doctor

on staff what would happen if we refused, he said he would report us to social services. Her scream was one of the most horrific thing I have listened to in my life. And for 22 years, I revisit that scream regularly. To purposely inflict pain on another for zero compelling reason is barbaric and I don't understand how adults can live with what they've done.

As an adult, I was choked by an ex-husband until I blacked out. That didn't give me long lasting trauma. Nevertheless, he shouldn't have choked me.

[Orrex]

34. Whatever. It simply doesn't strike me as that big a deal

And I suspect that I have more direct personal experience with it than you do.

[Bonobo]

104. I hope the poor dear got over it. nt

[blueamy66]

106. Perfect

As though a 3 day old infant will remember any medical procedure.

Let's not shove a tube down their throats to yank anything outta their lungs. Let's not prick their feet for other reasons.

Please....how many males remember being circumcised as an infant? I asked my fiance tonight...he laughed at the question.

I was adopted as a child. I soooo remember being taken from my birth mother and given to my real mother NOT

My brother was circumcised...as was my fiance. Surprisingly, neither remember the procedure.

Why the outrage? Some people have too much time on their hands.

[Crunchy Frog]

112. The one tiny flaw in your analogy being

that vaccinations given to babies and children are to protect against diseases that they are at risk of right now, whereas circumcision to "prevent" STDs is done to babies to "protect" them from something they are at no risk of before becoming sexually active (and of an age where they have the capacity to consent to surgery for themselves based on their own risk factors).

Also, circumcision is surgery, with much higher risks (and MUCH lower efficacy) than any vaccine currently given in this country.

[Bonobo]

10. Government taking away parent's rights to make health decisions for their kids...

Not a good precedent.

[Luminous Animal]

19. Infants aren't having sex. And just like young women accessing birth control...

when they become sexually active, young men can make the choice to weigh the benefits and the risks.

[pnwmom]

79. Infants have a much greater chance of having UTI's than

adult men because of their short urinary tract -- and these UTI's can be symptomless and result in permanent kidney damage. Circumcised babies have 10 times fewer UTI's than uncircumcised babies.

So don't try to force your medical decision on my family and I won't try to force mine on yours.

[Fearless]

40. Would you allow a parent to tattoo a child?

[laconicsax]

46. More appropriately, would he allow a parent to BRAND a child?

[Fearless]

49. Maybe take off a finger or toe? I mean what's a little toe anyways??

:banghead:

[Luminous Animal]

54. And if you take off that toe when they an infant, they'll never remember the trauma!

It's all good when you slice off a piece of an infant because they'll never remember it and growing up without that piece is totally normal!

[Luminous Animal]

51. When my daughter was born, a friend who was a recent immigrant from Spain

was amazed that my daughter's ears were not pierced at the hospital as was the custom in Spain. I found that an unnecessary infliction of pain on an infant.

[Bonobo]

147. And so you would propose a law to criminalize it? nt

[Bonobo]

105. Would you allow a parent to have earrings put on a child? nt

[Crunchy Frog]

119. Where is this happening?

Not that the government doesn't already highly restrict your rights in that department.

[catabryna]

11. My 10 year old son would disagree with you...

I'll make sure I bring him back in 20 years to relieve you of your concern about his early demise.

edited to fix typo

[Orrex]

12. You shouldn't be letting him run around having unprotected sex in Namibia at his age anyway.

[catabryna]

15. LOL! I'll make sure I let him know. :)

[bhikkhu]

13. No control group = questionable results

Which is to say - that the group of 350,000 men willing to undergo circumcision to lower their chances of getting HIV demonstrated 60% less infections means little, as their rates were measured against the population as a whole,

The portion of the population willing to undergo circumcision as a precaution against HIV is also more likely to educate themselves, and willing to change their behavior, all of which could be expected to reduce HIV rates. At least there is some theory behind the study, but it proves nothing.

[Cant trust em]

14. I wonder if this was a regression analysis.

If so, the words "on average" would probably be helpful.

[David__77]

69. And that regression analysis would have to be properly specified.

As an economist, I can say that I can generate a statistically valid regression model to support ANYTHING, no matter how ludicrous. We need transparency with research models, test group construction, etc., to make informed analyses of these studies.

[laconicsax]

26. Worldwide data also mean questionable results.

The US has a much higher circumcision rate than Europe, yet the incidence of HIV/AIDS in Europe is less than half what it is in the US.

[aquart]

16. BE QUIET! No need to alert the teeny tiny turtleneck people.

Let them go on their merry way and wave bye bye.

Just be careful not to screw with them.

This is what's called "natural selection."

[Petrushka]

18. And, too: "Male circumcision cuts women's cervical cancer risk."

http://www.webmd.com/cancer/cervical-cancer/news/20110106/male-circumcision-cuts-womens-cervical-cancer-risk

[Fearless]

41. So does an innoculation for HPV. Do that instead.

[Petrushka]

74. The long-term effects of the HPV vaccine are unknown.

When, however, some of the short-term effects of the vaccine
are known to include: fainting; seizures; blood-clots in the
heart, lungs, legs; Guillain-Barre Syndrome; unexplained death?
Oh! by all means, "Do that instead."
:sarcasm:

Global Parental Concerns:
http://www.youtube.com/watch?v=O7LH9TRCHuA&feature=relate

Vaccine Proves Lethal:
http://www.youtube.com/watch?v=HcamPe0cqDI&feature=related

[laconicsax]

75. And right on cue, the anti-vaxers arrive on the scene.

Butcher an infant and skip a vaccine, right?

Out of 33 million doses of Gardasil, fewer than 1500 unconfirmed serious adverse reactions were reported. That's a whopping 0.00004%. If we include all of the non-serious reactions (still unconfirmed, we get up to 0.0006%.

In the year and a half since Cervarix was licensed, there have only been 26 unconfirmed reports of adverse reactions, one of which was serious.

FEAR! FEAR! FEAR! FEAR! FEAR!

[Petrushka]

96. No "anti-vaxer" here! Just an olde biddy who doesn't believe it's necessary to vaccinate

young children and sexually inactive adolescents & young adults
against a sexually transmitted virus, especially not when the
long-term effects of the HPV vaccine is unknown, meaning that
children, adolescents & young adults are being used as guinea-pigs
---in my opinion, of course.

Also: When you say, "Butcher an infant....", I hope you aren't
trying to describe and/or define circumcism because, if you are,
it's a bit much too hyperbolic a phrase to be convincing---in my
opinion, that is.

Anyway . . . Have a nice day! I'm out o' here.

[laconicsax]

99. Yes, in your uninformed opinion, a 0.00004% risk is too dangerous.

Oh, and do you have a better term than "butcher" for tearing layers of flesh apart so that the outer one can be cut off? 'Cause that's what happens when infants are 'circumcised.'

In infants, the foreskin is still fused to the glans and needs to be torn away before it can be cut off. What does "fused" mean? Well, your fingernails are fused to your fingers.

[pnwmom]

83. Better yet, do both. And continue to have yearly pap smears, too. nt

[Fearless]

144. Circumcision does not prevent cervical cancer! OR STD's!!

[Crunchy Frog]

59. The HPV vaccine is vastly more effective.

I certainly wouldn't count on a partner's circumcision status to protect me from anything.

[Petrushka]

81. "...more effective." at doing what exactly? It's long-term effects are unknown. See Reply #74.

Thank you!

[pnwmom]

85. There are many strains of HPV that aren't covered by the vaccine.

So the lowest risk is for women who are vaccinated, who have yearly pap smears, and whose partners are circumcised.

[laconicsax]

86. Yeah, it's a shame it only covers the strains that cause the vast majority of cervical cancers.

The lowest risk, really is for women who undergo infibulation, so why not advocate female genital mutilation?

[pnwmom]

87. Women who undergo infibulation are far more likely to suffer infections

and other health problems. You didn't really think that infibulation meant they didn't have sex, did you? No, after the marriage the husband cuts open the woman with a knife. FMG. unlike male circumcision, has no health benefits and huge risks.

[laconicsax]

89. Not if it's done in a nice sterile environment like a hospital.

No infections or other problems, right? Just like male genital mutilation. Let's cut up everyone's genitals! :puke:

[pnwmom]

92. The severe form, which is the most common, is NOT done in a nice clean hospital.

But even if it were, there would be a lifelong loss of all sexual feeling, as well as the dysfunction caused by removing the clitoris and all the labia and sewing the remaining tissue back together, closing everything up except for a tiny hole to allow the passage of both urine and blood.

And that horrendous procedure confers absolutely no medical benefits, unlike male circumcision.

[laconicsax]

100. You must have not read the publications at the WHO link you gave me.

Many of them refer to "traditional male circumcision" (TMC), which isn't done in a nice clean hospital. The WHO is trying to convert TMC to nice clean hospital procedures with sterile equipment and everything. If they can do that for little boys, why not with little girls.

Also, a study found that 90% of women who underwent infibulation and excision reported experiencing "sexual desire, pleasure, and orgasm" despite the procedure. Seems that this "lifelong loss of all sexual feeling" and "dysfunction" isn't an issue.

So why not, right? If it's worth it to butcher little boys so that they might have a reduced risk of HIV (results not seen globally), why not butcher little girls to reduce their risk too?

[pnwmom]

115. I can't believe you are pretending that removing the entire clitoris

and performing infibulation would allow a woman to retain sexual response. I don't care what study you don't link to.

It is reprehensible to minimize the damage done to the women who undergo that procedure, given that -- unlike male circumcision -- it has absolutely no medical benefit.

[laconicsax]

126. I'm not pretending anything. I never even suggested the procedure.

I suggested infibulation as an appropriate counterpart to male genital mutilation, and you started off on the effects of clitoral excision. There's a study that suggests that excising the clitoris doesn't negatively affect female sexuality. I thought I had linked to it, but it seems I didn't, so here it is: http://www.fgmnetwork.org/authors/Lightfoot-klein/sexualexperience.htm

Excision isn't a necessary part of infibulation, and I didn't suggest that it was. I only suggested that infibulation is an appropriate counterpart to circumcision.

[laconicsax]

23. Life-saving?

Has no one ever heard of condoms?

In the US there's about a 75% circumcision rate and in Europe, it's 20% at most. Yet the US has a higher incidence of HIV/AIDS than Europe.

Seems that there's a more significant factor.

[lynne]

24. I did not have my son circumcised -

- and have advised him not to have sex in Africa. Problem solved.

[MannyGoldstein]

25. So HIV is only in Africa?

That's good to know.

[lynne]

29. Researchers must think so as that's the only part of the world they seem to study -

- Plus, my son is now an adult and he can make the choice himself should he feel it necessary. His Body - His Choice.

[Crunchy Frog]

63. The HIV that's prevalent in Africa is a different strain.

There may be differences in transmission between the different strains. In any event, in Sub-Saharan Africa, transmission is mainly heterosexual, whereas heterosexual transmission is the least common means in the developed world.

So yes, it's highly unlikely that his circ status will have any meaningful effect on his risk of contracting HIV if he stays in the developed world. If he decides to move to Africa and adopt the local sex practices, he may want to consider getting circed first, though he would still be taking a terrible risk.

[Bluebear]

27. So HIV is only found in Africa? Have somebody responsible counsel your son about sex!

[laconicsax]

28. +1

[taught_me_patience]

57. I guarantee your son will have unprotected sex one day

with someone of unknown HIV status. If he doesn't that would be extremely rare.

[Crunchy Frog]

153. Fortunately (and a little known fact) HIV is NOT very readily transmitted.

The statistical likelyhood of contracting it in a single unprotected sexual encounter with an HIV positive partner is very low. And in this country, the statistical likelyhood that a partner of unknown HIV status would actually be HIV positive is also very low. For that reason, the risk from an occasional lapse in condom usage in this country is likely to be negligable.

No justification for radical surgery on a neonate that I can see.

[pnwmom]

80. So we've eliminated HIV in this country? That's news to me. n/t

[nonperson]

32. So this barbaric procedure needed the emergence of HIV to make it acceptable

Ridiculous. That's like saying clitectomies save lives because women who are mutilated in such a fashion aren't likely to have sex as much as women who haven't been mutilated.

Would you approve of clitectomies under those circumstances?

[laconicsax]

35. It seems that some people would.

It's really horrifying to see people jump for joy the minute a poorly constructed study helps them rationalize barbarism.

[Crunchy Frog]

66. No. They've been making up "scientific" justifications for the past 150 years.

And there have been studies that showed lower rates of HIV in genitally cut women; and that was in prostitutes, so it probably didn't have to do with less frequent sex.

[joshcryer]

90. What the hell? Your comment was the first I heard of FGM = less HIV risk but I just googled...

...and the results are exactly the opposite. Are you sure you didn't remember that backwards?

[Crunchy Frog]

94. It wasn't ALL FGM.

It was a particular type of FGM in a particular population. http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138

These correlations are highly variable for both genders. There are a number of African countries where HIV rates are higher among the circed men than among the intact.

[joshcryer]

88. It's likely that the entire procedure started due to a hygienic perception.

This is scientific data that does suggest there is a hygienic element as far as one very bad virus is concerned.

[Crunchy Frog]

149. A Bronze Age sacrifice to a bloodthirsty diety

which made it's way into modern western medical practice via the Victorian era's anti-masturbation hysteria.

[Fearless]

38. Wear a fucking condom instead of mutilating children!

Also new HIV infections are DOWN 25% worldwide in the past ten years because of SEXUAL EDUCATION and CONDOM distribution. Not circumcision. The very thought that circumcising will save you from HIV is ludicrous!

[conflictgirl]

42. +1

[laconicsax]

44. But mutilating children is easier than taking responsibility for your actions.

So what if the best case scenario is little better than a coin flip?

:sarcasm:

[Fearless]

47. The sad sad truth here is that there are people cited in this "article"...

Who are going to engage in unprotected sex because they were circumcised. Either because money was focused towards circumcision instead of condoms or because they misunderstand and believe that they are immune when circumcised. Even forgetting HIV for a second, it ignores the other STD's that are out there. It baffles me that people would choose surgery over a piece of latex. The crime is that their parents are likely deciding for them anyways.

:shrugs:

[laconicsax]

55. This may make you weep.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7720784

[Fearless]

62. It certainly got the jaw dropping.

[Crunchy Frog]

67. This may make YOU weep.

http://www.irinnews.org/Report.aspx?ReportId=79557

[Luminous Animal]

70. SWAZILAND: Circumcision gives men an excuse not to use condoms

A very important point so I'm going to quote from your linked article..

Avoiding the condom
Mbabane, 31 July 2008 (IRIN) - There is a growing belief among men in Swaziland that circumcision provides complete protection against HIV, a perception that worries non-governmental organisations (NGOs) battling the highest HIV prevalence rate in the world.

http://www.irinnews.org/Report.aspx?ReportId=79557

[laconicsax]

71. Headlines like "Male Circumcision Offers a ‘Critical’ 60% Reduction in HIV Risk" don't help. n/t

[Fearless]

145. +1000

[taught_me_patience]

58. Every single guy I know has had unprotected sex with a partner

of unknown HIV status. It's easy to say "wear a condom every time", yet nearly impossible to do.

[Luminous Animal]

60. That's true for women, too. Maybe I should have had my daughter's cervix removed after she was born.

[Fearless]

61. Circumcision does not prevent HIV!

And every single guy you know should also know the risk they take. They are clearly old enough to make their own decisions, including circumcision, which is still an option if they so choose.

[Luminous Animal]

64. Truly, the posts on this thread reveal the woeful conditions of sex education in this country.

[Bluebear]

65. You said it.

[taught_me_patience]

138. No, people are educated

condoms work for preventing HIV. The reality of using them every single time with a person of unknown status... nearly impossible.

[Fearless]

142. If you want to wear a condom you will. I'm sorry I call bullshit.

Yeah people are going to engage in unsafe behavior, but circumcision does NOT prevent HIV or STD's.

[Crunchy Frog]

152. Fortunately (and a little known fact) HIV is NOT very readily transmitted.

The statistical likelyhood of contracting it in a single unprotected sexual encounter with an HIV positive partner is very low. And in this country, the statistical likelyhood that a partner of unknown HIV status would actually be HIV positive is also very low. For that reason, an occasional lapse in condom usage is very unlikely to put a person at serious risk in this country.

No justification for radical surgery on a neonate that I can see.

[pnwmom]

82. Wrong. The large scale WHO studies showed a 60% decrease in HIV

even in men who regularly wore condoms. So the WHO urges men to use condoms and also recommends circumcision for added protection.

You think the research is ludicrous? Maybe you should actually read about it before you dismiss it.

[Crunchy Frog]

95. Could you post the links to the actual studies?

[Fearless]

143. I have read it. The study is flawed. Also it isn't a good reason to get circumcized.

The chances of getting HIV are low enough regardless of whether or not they are positive. Additionally, if they are going to be irresponsible and not use protection, parents should not force (because that is what it is) children to have their penises mutilated for a negligible (alleged) amount of less likelihood for contracting HIV. Wear a condom every time and you won't get HIV. Period. Condoms or forcible surgery? 100% or allegedly 60%?

[Harmony Blue]

114. I agree

As a society we are slowly moving away from male circumcision as mandatory, and it should remain an option for those that are religious though.

[Mariana]

124. I don't think anyone objects to an adult man deciding

to be circumcised for ANY reason he chooses.

[sense]

50. Circumcision also

prevents an enormous amount of cases of cervical cancer in women as the virus that causes that is not nearly as easily spread by circumcised men.

[Fearless]

52. HPV innoculations... problem solved 100% of the time... not like kinda sorta sometimes.

[Crunchy Frog]

68. Could you please provide a link?

Can you point me to some evidence that the cervical cancer rate in Europe is higher than it is in the U.S.?

[Crunchy Frog]

53. I don't trust the studies. I don't trust the agendas and biases of the researchers.

I don't trust that even if the studies were valid for the population studies (impoverished people in Sub-Saharan Africa) that the results can be extrapolated to a 1st world setting (the mostly circumcised U.S. has much higher rates of HIV and other STDs than mostly intact Europe). Actually, the studies in question only applied to heterosexual female to male transmission (the least common type of transmission in this and other developed countries). There was another study that looked at the effect of male circumcision on male to female transmission and found a 50% increase. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract This study was aborted early, the claim being because of "futility", but probably really in order to avoid getting a sufficient number of results for statistical significance which would have been severely damaging to the researchers' preexisting agenda.

There are also problems emerging now in Africa where there have been heavy campaigns to promote circumcision for AIDS "prevention", in that the belief is widespread among the affected populations that circumcision confers absolute immunity. Men are under the impression that they don't have to use condoms, and that they can have recklessly unsafe sex with impunity.http://www.irinnews.org/Report.aspx?ReportId=79557

I also have good reason to believe that the complication rate for this surgery, when done on infants, is much higher than what is generally acknowledged in the medical community.

Also, in terms of what is removed, it is far more than just "the skin that covers the tip of the penis". On the basis of observing my two sons, I would say that a full circumcision (one that left the glans completely uncovered) would easily take away 2/3 of the skin off of their penises.

I'm very happy that I kept my sons intact. I think that I avoided alot of risks and potential complications by not putting them through an unnecessary surgery, and I think that if they grow up believing that they are slightly more vulnerable to STDs, that it will be to their benefit.

[Lucian]

72. Yeah, condoms do the same.

You don't need to hack off part of a male's genitalia to prevent HIV.

[laconicsax]

73. And they do it reliably.

Unlike circumcision, which seems to be so effective that the US, with a 75% circumcision rate, has a higher incidence of HIV/AIDS than Europe, which has a less than 20% circumcision rate.

[pnwmom]

93. Wrong. According to the definitive long term, large scale WHO studies,

circumcision confers the additional benefit BEYOND that from safe sex alone. The 60% reduction applied to men who were practicing safe sex, which the WHO continues to strongly recommend.

[Luminous Animal]

97. Link. Really, it cannot be both ways. 60% without a condom and 60% with.

And the only constant is circumcision. That is a statistical impossibility.

[pnwmom]

101. All of the men who were studied were taught to practice safe sex as part of the study.

And they were all provided with condoms. Then half of them were given circumcisions and half were not. There was a 60% reduction in HIV among men who were circumcised in the study compared to the men who were not. They ended up ending the study early and offering circumcisions to all because the difference was so significant.

[laconicsax]

127. Thanks for clarifying that you're making it up as you go. n/t

[HockeyMom]

109. 2 instances when I processed medical claims

for a company for 6 years. One man developed cancer of the foreskin when he was in his 30s. In talking to him, it was very traumatic for him to have it removed at his age. He told me he wished his parents had had it removed as a baby.

The other claim was for a man who ripped it. I was friends with his wife and she described (in very graphic detail) what that was like. The man had to be rushed to the hospital immediately. You guys can think about that one, if you care to.

For what it's worth, insurance paid for both these claims.

[Crunchy Frog]

113. I had a neighbor who got cancer of the vulva.

I wonder what she wishes had been cut off of her when she was a baby.

[Cairycat]

116. Let me get this straight ....

The posters here who are for circumcision say that no one remembers circumcision as an infant, that it's not traumatic at all if done in the first couple weeks of life - yet somehow if a boy or man is circumcised, it's very painful and devastating?

How does that work? What time is the magic line? How do you know it's not devastating and excruciating for a young infant? If it were horrible and traumatic for a baby, as well as for older males, how many lives would have to be saved to make it worth performing on people who are too young to consent? Dozens, thousands, millions?

[Crunchy Frog]

121. Of course, that says nothing about the trauma of later surgeries needed to correct botches

Many, many boys have to go through recircumcisions or other corrective surgeries for problems with the original surgery.

http://www.wtvr.com/wtvr-botched-circumcisions-20110517,0,4411553.story

This story is about a pediatric urologist in Richmond VA who has performed over 1600 corrective surgeries for botched circumcisions in a 3 year period. This is in a population where only around 4500 boys are born per year, and not all of them are circed. That means that in this particular area, well over 10% of circumcised boys will have at least one later corrective surgery, probably after going through significant period of painful difficulties from the original botch.

Vaccination my ass!

[laconicsax]

128. It's conceivable that it's actually WORSE for an infant.

With infants, the foreskin is still fused to the glans and has to be torn away before it can be cut off.

It's a barbaric practice.

[Sky Masterson]

133. And it turns a floppy eared puppy into a doberman!

Every time that I see a circumcision thread,I think an angel gets it's wings. :)

[and-justice-for-all]

151. I think this is loaded horse shit....

how ironic that there is the circumsion ban matter going on and now viola! circumcision is good for ya.