Sunday 5 July 2009

Circumcision and HIV/AIDS: UPDATES

Rather than lots of short posts with updates and additional information, this post will collect them all together.

July 5 2009

The debate continues with two pieces in the Observer today, both by the same journalist, Alex Renton. They are both strongly pro-circumcision and, although detailed, don't look at the case against. Renton is a food journalist.

July 16 2009

A piece on the BBC website about how research from John Hopkins School of Public Health found that circumcision does not prevent HIV positive men transmitting  the virus to women:

"Circumcision of HIV-infected men did not reduce HIV transmission to female partners over 24 months; longer-term effects could not be assessed."

The trial was stopped because of the rates of infection. However, they continue to recommend circumcision, in conjunction with condom use. They suggest both circumcising earlier (ie circumcising boys)  and continuing to circumcise HIV positive men in order not to stigmatize them.

"Women are disproportionately affected by HIV in sub-Saharan Africa, and - as this study shows - will still be at risk whether their partners are circumcised or not (...) The best way to guard against HIV is by always using a condom".

July 20

The link to the source article for the BBC story above, in The Lancet .

9 comments:

  1. After I posted a comment pointing out the flaws in these African studies, which question the validity of their findings, my comment wasn't posted and no more comments can be posted now. They apparently prefer ignorance over knowledge, and pro-circumcision activists prefer to spread that ignorance among unsuspecting men in Africa.

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  2. Absolutely shameful that they took away the comment feature.

    Circumcision is a dangerous distraction in the fight against AIDS. There are seven African countries where men are more likely to be HIV+ if they've been circumcised: Rwanda, Cameroon, Ghana, Lesotho, Malawi, Swaziland, and Tanzania. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Cameroon, the HIV rate is 4.1% among circumcised men, but only 1.1% among intact men. If circumcision really worked against AIDS, this just wouldn't happen. We now have people calling circumcision a "vaccine" or "invisible condom", and viewing circumcision as an alternative to condoms.

    ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.

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  3. Except the A part doesn't actually work and the B part is pretty hit and miss.

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  4. Abstinence and Being faithful work if people try them, but I think the main focus should be on Condoms. They work way better than anything that's ever been claimed for circumcision. Sadly, there are some religious groups (mostly Catholics and fundamentalist Christians) that are against promoting condoms (or focussing on sex workers). I believe their policies have already killed literally millions of Africans.

    Part of the enthusiasm for circumcision in Africa is that it deflects criticism of the religious groups for being against condoms.

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  5. You're right, they work when they're practised but as a link in one of my posts shows, in America at least, abstinence doesn't work.

    I agree completely about the Church's attitude to condoms. They routinely ignore human nature when it comes to sex. It is, of course, something bestial and fallen to be overcome through the grace of God.

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  6. This comment has been removed by the author.

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  7. I've been asked to provide references for my list of countries where circumcised men are more likely to be HIV+ :

    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%)
    Swaziland http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf table 14.10 (21.8% v 19.5%)

    See also http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

    Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs.

    http://apha.confex.com/apha/134am/techprogram/paper_136814.htm

    Results: … No consistent relationship between male circumcision and HIV risk was observed in most countries.

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  8. Comprehensive sex education for young people is an essential part of HIV prevention. This should include training in life skills such as negotiating healthy sexual relationships, as well as accurate and explicit information about how to practise safer sex. Studies have shown that this kind of comprehensive sex education is more effective at preventing sexually transmitted infections than education that focuses solely on teaching abstinence until marriage.

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