Male Circumcision - Hiv Prevention

[LevelHead]

It isn't medically proven at all. Some studies in Africa have supported the theory (it remains just that) but there's not nearly enough evidence to call it medically proven.

Male Circumcision and HIV Prevention: Is There Really Enough of the Right Kind of Evidence?

Well I go with 3 organisations :

CDC

WHO

UN

As opposed to some older write up by some doctor somewhere who might be writing his "thoughts" as part of the reasins in post 2. All of these reports are latest info.........not 2006 like the one quoted above.

CDC :

http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm

WHO :

http://www.who.int/hiv/topics/malecircumcision/en/index.html

UN :

http://data.unaids.org/pub/Report/2007/mc_...ndations_en.pdf

[473geo]

Some interesting, very emotional responses to a purely scientific issue. I guess some people's attachment to their "hoodies" is very intense.

The thread is serving its purpose and that is to highlight the "resistance" to circumcision IN SPITE OF all the medical evidence to support its protection against HIV transmission into males from normal vaginal sex.

It is very clear to see that most "uncut" men are very very defensive of their postion and hate the fact that its been medically proven "cut" men are much less likely to catch HIV through normal penis to vagina sex, as the HIV receptors in the foreskin have been cut off.

In the most this can be put down to probably the "scare factor" that they do not want to be seen as a "higher risk" group and therefore become "less wanted".

This is quite easy to understand, however people should have free access to the information, and make their own minds up about their children. All "new to be" potential parents in Thailand should be told of this, and they can make a decision to not do it, or do it.

Ask most Thai's about this and they are completely in the dark about the FACT that it is a very effective part of the prevention of the spread of HIV from woman to man through vaginal sex.

I think your approach is causing some of the responses! You continually make assumptions about the other posters and their reasons for posting. Is this just to annoy people and keep your 'battering ram' methodology moving? Are you aware of the potential damage you could inflict? Try telling a male who is struggling to come to terms with using a condom he has less chance of catching AIDS because he is circumcised. Condom free sex here we come!!! It is fine to deliver scientific evidence. The evidence does not always take into account the delivery and reaction to the general public.

[jumnien]

Your "science" regarding male circumcision is undoubtedly interesting for cocktail party conversation. However, in the real world, the Judeo-Christian from the west are having a rough go at the moment in trying to persuade the "natives" that these Judeo-Christian traditions are indeed the way to go. I'd also prefer to see some research not sponsored by George Bush and Co.

I am circumcized, but am no more attracted to having sex with a potentially HIV infected woman now than I was before you made your far from convincing argument.

Edited January 3, 2009 by jumnien

[Jingthing]

I'd also prefer to see some research not sponsored by George Bush and Co.

That's kind of silly. Bush is a radical Christian fundamentalist who believes the way to prevent HIV is abstinence.

Try telling a male who is struggling to come to terms with using a condom he has less chance of catching AIDS because he is circumcised. Condom free sex here we come!!!

Also kind of silly. We are mostly talking about Africa where people either can't afford condoms or have strong cultural reasons not to use them.

Edited January 3, 2009 by Jingthing

[LevelHead]

I think your approach is causing some of the responses! You continually make assumptions about the other posters and their reasons for posting. Is this just to annoy people and keep your 'battering ram' methodology moving? Are you aware of the potential damage you could inflict? Try telling a male who is struggling to come to terms with using a condom he has less chance of catching AIDS because he is circumcised. Condom free sex here we come!!! It is fine to deliver scientific evidence. The evidence does not always take into account the delivery and reaction to the general public.

The battering ram can be effective is getting all points of a discussion out in the open very quickly.

To be honest, the results of the tests have been far more compelling that is let on. However, you must consider :

a/Condoms make money, you sell loads of them, its a near perfect sales item. Money from this goes into research, and so, in terms of HIV, more condom use is better.

b/Condoms stop unwanted pregnancies, circumcision does not - so its better to promote condom use, and of course see item a/

c/Condoms stop STD's, circumcision does not - so its better to promote condom use, and of course see item a/

d/ Condom use will prevent "morphing" of diseases, resulting if far less "new strains" - so its better to promote condom use, and of course see item a/

So although the results are "compelling" it is just not in anyones interest to promote this too much, and its why the CDC/WHO/UN will always prefer promoting condom use (even though they are "flawed" and not offer 100% protection).

The point of the matter is though, people are not being made aware of this, do you have any suggestions as to why this is so ?

Apart from the reasons I post in post 2 as to why, do you have any other suggestons as to why this is informaiton is not being spread in places, lets say, like Thailand.

[473geo]

I'd also prefer to see some research not sponsored by George Bush and Co.

That's kind of silly. Bush is a radical Christian fundamentalist who believes the way to prevent HIV is abstinence.

Try telling a male who is struggling to come to terms with using a condom he has less chance of catching AIDS because he is circumcised. Condom free sex here we come!!!

Also kind of silly. We are mostly talking about Africa where people either can't afford condoms or have strong cultural reasons not to use them.

And I thought we were talking about circumcision, not a geographic area!! How silly of me!! But if it suits you, feel free to use your freedom of speech, and please allow others a freedom of choice.

[473geo]

I think your approach is causing some of the responses! You continually make assumptions about the other posters and their reasons for posting. Is this just to annoy people and keep your 'battering ram' methodology moving? Are you aware of the potential damage you could inflict? Try telling a male who is struggling to come to terms with using a condom he has less chance of catching AIDS because he is circumcised. Condom free sex here we come!!! It is fine to deliver scientific evidence. The evidence does not always take into account the delivery and reaction to the general public.

The battering ram can be effective is getting all points of a discussion out in the open very quickly.

To be honest, the results of the tests have been far more compelling that is let on. However, you must consider :

a/Condoms make money, you sell loads of them, its a near perfect sales item. Money from this goes into research, and so, in terms of HIV, more condom use is better.

b/Condoms stop unwanted pregnancies, circumcision does not - so its better to promote condom use, and of course see item a/

c/Condoms stop STD's, circumcision does not - so its better to promote condom use, and of course see item a/

d/ Condom use will prevent "morphing" of diseases, resulting if far less "new strains" - so its better to promote condom use, and of course see item a/

So although the results are "compelling" it is just not in anyones interest to promote this too much, and its why the CDC/WHO/UN will always prefer promoting condom use (even though they are "flawed" and not offer 100% protection).

The point of the matter is though, people are not being made aware of this, do you have any suggestions as to why this is so ?

Apart from the reasons I post in post 2 as to why, do you have any other suggestons as to why this is informaiton is not being spread in places, lets say, like Thailand.

Have you not answered your own question? All the above additional problems which condoms assist in preventing makes them the option of choice. My point about non condom sex perhaps becoming more popular if the knowledge that AIDS is not so dangerous for circumcised people becomes more valid.

[khundon]

I think your approach is causing some of the responses! You continually make assumptions about the other posters and their reasons for posting. Is this just to annoy people and keep your 'battering ram' methodology moving? Are you aware of the potential damage you could inflict? Try telling a male who is struggling to come to terms with using a condom he has less chance of catching AIDS because he is circumcised. Condom free sex here we come!!! It is fine to deliver scientific evidence. The evidence does not always take into account the delivery and reaction to the general public.

The battering ram can be effective is getting all points of a discussion out in the open very quickly.

To be honest, the results of the tests have been far more compelling that is let on. However, you must consider :

To be honest, the results of the tests have been far more compelling that is let on. However, you must consider :

a/Condoms make money, you sell loads of them, its a near perfect sales item. Money from this goes into research, and so, in terms of HIV, more condom use is better.

b/Condoms stop unwanted pregnancies, circumcision does not - so its better to promote condom use, and of course see item a/

c/Condoms stop STD's, circumcision does not - so its better to promote condom use, and of course see item a/

d/ Condom use will prevent "morphing" of diseases, resulting if far less "new strains" - so its better to promote condom use, and of course see item a/

So although the results are "compelling" it is just not in anyones interest to promote this too much, and its why the CDC/WHO/UN will always prefer promoting condom use (even though they are "flawed" and not offer 100% protection).

The point of the matter is though, people are not being made aware of this, do you have any suggestions as to why this is so ?

Apart from the reasons I post in post 2 as to why, do you have any other suggestons as to why this is informaiton is not being spread in places, lets say, like Thailand.

Do you have any evidence of your (highlighted in red) statement please???

[Jingthing]

And I thought we were talking about circumcision, not a geographic area!! How silly of me!! But if it suits you, feel free to use your freedom of speech, and please allow others a freedom of choice.

Sure, we are talking about a lot of things. But the research on cutting has largely been an African phenom for reasons explained here:

Africa is without doubt the region most affected by the virus. Inhabited by just over 12% of the world's population, Africa is estimated to have more than 60% of the AIDS-infected population.

wiki

[sbk]

Off-topic comments as well as insulting inflammatory remarks and their responses have been deleted. Further such posts will result in formal moderator action.

[PeaceBlondie]

Most Christians are uncircumcised, as far as I know. I think that the argument is not about Christianity.

[mommysboy]

Having blue eyes also reduces the risk of HIV transmission. Most of the HIV positive people in the world have brown eyes. It's a simple fact. Beware of simple facts and be highly suspect of studies and statistics.

Yes I agree, far too many studies like these. It's at times like these that I wished I'm had kept the links:it was discredited.

[sbk]

Not according to Time magazine quoting a JAMA article from October 2008.

http://www.time.com/time/health/article/0,...feed-cnn-topics

[LevelHead]

Not according to Time magazine quoting a JAMA article from October 2008.

http://www.time.com/time/health/article/0,...feed-cnn-topics

sbk, the trouble with the newer reports is that have been statistically "altered".

If they keep the trials and results and percentages to "men who have vaginal sex with women", you would see a very high and significant reduction.

As they want to keep the push on condom use they have added in now, male to male sex, male to female anal sex, and all sorts of others and now quote in some reports the percentages low, however they do not quote the "subject group" with the low rate.

EG they do not say which target group, they group them all together and rather dilute the pure "male to female vaginal" figures.

I would prefer these reports to stick to pure target groups and therefore allow the true picture to be seen :

EG

male to women vaginal sex reduction of ??%

male to women with anal sex thrown in reduction of ??%

male to male anal sex ??%

If it were reported like this the true "preventative" nature of it in pure male to woman vaginal sex only would shine through.

[LevelHead]

Having blue eyes also reduces the risk of HIV transmission. Most of the HIV positive people in the world have brown eyes. It's a simple fact. Beware of simple facts and be highly suspect of studies and statistics.

Yes I agree, far too many studies like these. It's at times like these that I wished I'm had kept the links:it was discredited.

I think any attempt to portay "blue eyes" as protection would be discredited LOL

It may be representative of target groups, but not obviously in any way to do with transmission rates of infected to as yet not infected.

[wensiensheng]

a/Condoms make money, you sell loads of them, its a near perfect sales item. Money from this goes into research, and so, in terms of HIV, more condom use is better.

b/Condoms stop unwanted pregnancies, circumcision does not - so its better to promote condom use, and of course see item a/

c/Condoms stop STD's, circumcision does not - so its better to promote condom use, and of course see item a/

d/ Condom use will prevent "morphing" of diseases, resulting if far less "new strains" - so its better to promote condom use, and of course see item a/

So although the results are "compelling" it is just not in anyones interest to promote this too much, and its why the CDC/WHO/UN will always prefer promoting condom use (even though they are "flawed" and not offer 100% protection).

The point of the matter is though, people are not being made aware of this, do you have any suggestions as to why this is so ?

Apart from the reasons I post in post 2 as to why, do you have any other suggestons as to why this is informaiton is not being spread in places, lets say, like Thailand.

I am no expert, but it seems clear that protection by circumcision is haphazard because it depends on whether you are circumcised or not, and that procedure is not carried out in relation to HIV prevention. There also seems more than enough issues about how effective a protection it actually is.

But, in my mind the real reason why it is not promoted as a method of safe sex is because it is not the most effective OR capale of being the most widely used. Promoting a lower standard of preventitive method will result in it being relied upon ore often. Promoting a higher preventitive method will resutl in that being adopted as the least acceptable standard.

I can't buy into any of the religous or cultural conspiricies that have been referenced in this thread. It just makes sense to go with whats best...and currently that is condoms.

[jumnien]

Any good statistics regarding penis size and HIV transmission rates available?

[sbk]

I am not so sure I understand the need to get personal here, alot of this research has been done in Africa which has a huge HIV/AIDS problem and where it is very common for men to have unprotected sex.

So, unless you feel that somehow the OP is targetting you personally, I fail to grasp the need to target him personally.

[mommysboy]

I was de-hooded in 1958. I just think that telling poor Africans and Asians that if they cut off their foreskin or perform clitorectomies they won't get AIDS is a very poor idea based on very shoddy science.

IMHO this goes for the whole subject area itself.

[mommysboy]

Not according to Time magazine quoting a JAMA article from October 2008.

http://www.time.com/time/health/article/0,...feed-cnn-topics

I know it's a difficult subject area for you to deal with but it's essential mods to their job. Too often the mainstream wins the day through ignorance, fear and emotional blackmail:

Maybe the unreferenced comment supported the idea that the studies were inconclusive.

If not read this taken from your link:

The authors concluded that being circumcised reduced a man's risk of acquiring H.I.V. by 14%. That finding was statistically nonsignificant, but the authors say it should be regarded as a launching point for future trials. "This study gives us a more complete picture than we've ever had before," says Gregorio Millett, the study's lead author and a senior behavioral scientist at the Centers for Disease Control and Prevention (CDC). "The next step is to design better quality studies to see if there is an association we aren't detecting."

[mommysboy]

Some interesting, very emotional responses to a purely scientific issue. I guess some people's attachment to their "hoodies" is very intense.

The thread is serving its purpose and that is to highlight the "resistance" to circumcision IN SPITE OF all the medical evidence to support its protection against HIV transmission into males from normal vaginal sex.

It is very clear to see that most "uncut" men are very very defensive of their postion and hate the fact that its been medically proven "cut" men are much less likely to catch HIV through normal penis to vagina sex, as the HIV receptors in the foreskin have been cut off.

In the most this can be put down to probably the "scare factor" that they do not want to be seen as a "higher risk" group and therefore become "less wanted".

This is quite easy to understand, however people should have free access to the information, and make their own minds up about their children. All "new to be" potential parents in Thailand should be told of this, and they can make a decision to not do it, or do it.

Ask most Thai's about this and they are completely in the dark about the FACT that it is a very effective part of the prevention of the spread of HIV from woman to man through vaginal sex.

There is no compelling evidence. That's the only deciding factor here.

[wasabi]

Circumcision likely helps for two reasons. First you have to think of the HIV virus like a puzzle piece that is looking for another puzzle piece to connect with. When it comes to males there are various areas HIV can easily connect with, those primarily being in the anus and the tip of the penis. By reducing the type of cells that HIV can connect with on the tip of the penis you also reduce the chance the person will be infected.

Secondly because the foreskin retracts it is better at holding the bodily fluids in place at the tip of the penis giving the virus more of an opportunity to infect. Cutting off the foreskin does not eliminate the areas on the tip of the penis it only reduces them, it puts the odds more in your favor not to catch the virus.

Up to you hansum man.

[mommysboy]

Circumcision likely helps for two reasons. First you have to think of the HIV virus like a puzzle piece that is looking for another puzzle piece to connect with. When it comes to males there are various areas HIV can easily connect with, those primarily being in the anus and the tip of the penis. By reducing the type of cells that HIV can connect with on the tip of the penis you also reduce the chance the person will be infected.

Secondly because the foreskin retracts it is better at holding the bodily fluids in place at the tip of the penis giving the virus more of an opportunity to infect. Cutting off the foreskin does not eliminate the areas on the tip of the penis it only reduces them, it puts the odds more in your favor not to catch the virus.

Up to you hansum man.

An argument of small differences since it might be deemed to have a protected role too in some cases.

There is no evidence on transmission.

In my opinion, the problem with the subject area as a whole is that HIV evidence itself seems unconventional, and this has given license for many crackpots, be they denialists or mainstream to justify any theory that might sound right with the use of science fiction, and dodgy studies.

The other problem is exaggerated dogmatic argument. Again the blame for this must lie with the establishment who have been the prime example.

Little wonder then that TV arguments on this subject end up being unsubstantiated, exaggerated or dogmatic.

It's a pity, sensible debate is much needed.

Personally, I think the real argument in the thread has already been discussed and as I understand it to be that it would be much better if the girls were educated to choose wisely, say no, and instructed in the use of condoms.

One hopes this will be done.

[Tolley]

I am not sure why the OP has been attacked by so many posters here.

He is only repeating what a lot of research has indicated and that is that male circumcision seems to reduce the incidence of HIV transmission in male to female hetrosexual intercourse.

It seems that there is a fairly high amount of research to back up this claim.

Posters going off in tangents about Judae- Christianity, female circumcision, gay transmission etc are just displaying their ignorance and their lack of actaully having read any of the research data.

[Dakhar]

Regardless, hoodless, or hooded, you should wear a glove, so what is the point?

[marc651]

Anyway, its a proven fact now that with the removal of the foreskin and therefore the HIV receptors which form part of it, the risk of catching HIV is massively reduced........so why in Thailand is there minimal awareness of this ? and no action plan to get it introduced ?

You say the risk is "massively reduced". I would rather say "somewhat reduced".

If it were truly "massively reduced" we would see clearly lower HIV rates amongst for instance religious or other groups where all men are circumcised. Not the case.

You also state that 'prostitutes should be made aware of the fact uncircumcised men have a higher HIV rate". This you made up yourself. Indeed there is a theoretical "harder" transmission path to circumcised men, but stating the HIV rates are higher amongst uncicumcised men is just your personal guess.

The small reduction in "transmission speed" between circumcised and uncircumcised men is not at all the answer or solution to the HIV epidemic. IMO condoms and safe sex education and campaigns are the way to go, together with compulsory testing of the population.

On top of it your kind of messages might have opposite effect: circumcised men could take more risks (thinking they are at 'low risk') and thereby compensating the so called extra safety factor you describe, and thus even being at higher risk.

Besides, there are disadvantages to circumcision as well. Limited medical risks during and after the procedure, limited sensitivity and related sexual problems. Note the lawsuits in the US of people circumcised at young age -as a standard procedure in the hospital, who argue they never wanted this. Also note the reverse circumcision operations for people who 'want their skin back'. You call this "misinformation".

The condom campaign that was running in Thailand (and stopped by the Taksin administration because it was bad for Thailand's image) was highly effective and praised around the world. They should restart that campaign.

[Tolley]

Again a lot of you guys miss the point.

I still don't understand why you guys are trying to discredit this research.

This research was carried out in Africa where there is a lot of cultural resistance to wearing condoms and also in some cases a lack of availability.

Therefore circumcision was being looked at as an alternative way of helping stem HIV transmission.

Africa is a different kettle of fish to the rest of the world.

[Crushdepth]

Circumcision is not 'the answer'. It may reduce risk of HIV infection but it isn't as effective as wearing a condom. Plus, once you catch *some other* STD your risk of HIV infection go way up. Stick with the condoms!

(Unless you prefer abstinence )

[marc651]

This research was carried out in Africa where there is a lot of cultural resistance to wearing condoms and also in some cases a lack of availability.

Therefore circumcision was being looked at as an alternative way of helping stem HIV transmission.

Africa is a different kettle of fish to the rest of the world.

Exactly. As condom campaigns had/have limited effect in parts of sub-saharan africa -for instance because they were actively countered by the local religious groups and community- circumcision "for people who do it without condom anyway" might have some effect, and be a theoretical strategy in those parts of the world.

But Levelhead's point is that because it is proven that circumcision somewhat reduces HIV transmission, that it should be applied to the Thai population. What he fails to see is that reduced HIV transmission risk and actual HIV transmission are not necessarily correlated, as the actual behavior of the men is crucial.

(Just like cars with ABS breaking systems are safer, but in the statistics people driving them do not have less accidents -which is said to be because of drivers compensating the extra safety by taking extra risks)

An uncircumcised man who uses condoms would have a lower risk of getting infected with HIV than a circumcised man who does not use condoms because he thinks he 'is at low risk'. There goes your benefit of circumcision.

Edited January 4, 2009 by marc651

[Jimjim]

Here ya go for doubts about this topic. Tear it apart if you must, but this feeling is out there, and by doctors. I also read a comprehensive African study recently and the researchers ended up in much doubt about how much circumcision affects HIV infection. They seemed to find that condom use was much more important and it was more like poor personal hygiene with regards to uncircumcised men. If they followed hygiene and condom use it was basically equal infection rates compared to circumcised men. So yes, it increases risk, but only if you're unsanitary. I wish I could find that story again. Basically, the danger with blaming HIV infections on not being circumcised has the risk of educating the ignorant that they can just have all the sex they want with on protection if they just get circumcised.

For more, see here and here and here and here.

It's not really quite an open and shut case as the OP thinks.

Edited January 4, 2009 by Jimjim