I saw Stephen Lewis, of the Stephen Lewis Foundation, speak about the pandemic of HIV/AIDS in Africa. He was a great speaker, very vibrant and held the audiences attention. He and his foundation has done so many amazing things for the people suffering in Africa.
However, he lost me during part of his speech as a result of something he said.
He said, "Circumcision has reduced the AIDS rate in Africa by 60%."
Now, if that was true - that would be fine. I sat there thinking to myself, "If I hadn't have seen the studies he's talking about, would I be okay with this?" And I would. If that was true and the studies were done correctly - then great. Circumcise the men in Africa. The men who believe women are nothing but property and can be raped and molested as they please. The men who commit such heinous sex crimes on these women that they deserve part of their members being chopped off - without pain medications, to boot.
However, it's not true. I've read the studies and they were done very poorly. There were three studies done - two of which were published in medical journals. One study randomly chose 124 males, who had partners who were uninfected by HIV. (I do not believe they tested them, and then waited 6 months to re-test before starting to trials, however. Which can play a big factor in the outcome of the results, as HIV can take as long as 6 months to show on a blood test.)
Among 70 men who were circumcised, 11 transmitted HIV to their partners. Of the 54 who were not circumcised, four passed on the infection. Almost all new transmissions occurred in the first six months. Because there were so few cases in either group, the findings were not statistically significant and may have occurred only by chance.
An independent panel of scientists overseeing the study recommended that no new volunteers be enrolled because, even though the early findings were not statistically significant, it concluded that the original hypothesis -- that uninfected women would indirectly benefit over the short term from male circumcision -- was unlikely to prove true.
However - it's still all over the media that HIV rates drop by "60% in circumcised men!" Which is grossly exaggerated, at best.
And it doesn't explain why the United States has the highest cicumcision rate and the fastest climbing AIDS rate.
In 1990, the circumcision rate in the U.S. was 85%. And the AIDS rate was 16.9%. The closest following was Spain with a circ. rate of 1% and an AIDS rate of 14.2%. And then Italy with a 1% circ rate and a 8.9% AIDS rate.
Since 1990, the circumcision rate in the States has fallen a bit. But the AIDS rate continues to climb.
One of my biggest pet peeves is misinformation. Especially when such misinformation is being supplied by someone who has the credentials and the brain to read the studies he's quoting, but still spouts off grossly exaggerated numbers.
And then follows it with, "When I visited a tribe in Africa that practiced routine circumcision because its cuts the rate by 60%, they were telling me all about their circumcisions. And then I, of course, told them that I was circumcised. And they cheered and we danced and celebrated."
Monday, October 15, 2007
Stephen Lewis is circumcised.
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8 comments:
How pathetic. What's really bad is how many people are going to take him for someone that knows what he's talking about when he apparently does not.
Stephen Lewis is absolutely correct. Three randomised controlled trials were conducted and have all three been published (two in the Lancet, one in PloS Medicine). I am not sure why you say there were poorly conducted?
Anyway, in total, 10908 men were circumcised. In each trial, the risk of becoming infected with HIV was 50-60% lower among circumcised men compared with uncircumcised men. These findings were highly statistically significant - i.e. very unlikely to be due to chance.
The trial you cite was a fourth trial, of the impact of male circumcision in reducing transmission from males to females. As you say, the numbers involved here were small and results inconclusive.
The evidence for a reduced risk amnog men is conclusive and scientific evidence doesn't come any more rigourous than this...
Previous commenter is seriously mistaken.
First, the proprietor of this blog is correct, those studies from Africa are flawed in numerous ways, and do not support the claims many people are making based on them.
That's a problem because some people might choose to get a circumcision believing falsely that it will protect them.
Dr. Dean Edell, syndicated radio host of "The Dr. Dean Edell Show" and anchor of "Medical Minutes", a series of ten weekly radio medical reports, said that using routine male circumcision to prevent AIDS is flawed logic. "AIDS is caused by a virus, not by the foreskin," said Edell. "The foreskin is one of several possible entrance points for the AIDS virus to infect the body, but that does not mean that you should cut the entrance off. It means that you should protect the entrance, either by using condoms or by practicing safe sex. If some men want to undergo circumcision because they feel it will make them safer, then they should be free to do so. But we need to draw the line when it comes to circumcision of children, which is done without consent of the patient. The common sense thing to do here is to make circumcision an option for adults only."
Choosing circumcision for yourself based on these studies would be a mistake, but it's a mistake every informed and consenting adult is entitled to make for himself.
However even if it were true that hacking of the most sensitive parts of the penis could reduce the chance of HIV infection during unprotected heterosexual intercourse, it would not change the fact that BABIES DON'T HAVE SEX.
Infant circumcision cannot be excused in the slightest by these attempts to blame HIV on the normal male foreskin. Like all the other supposed benefits of this genital alteration which were unfounded, these claims have been prematurely accepted by those culturally primed to defend what is familiar to them.
Most men in the world have not had their genitals altered, and they prefer it that way. But the circumcised minority (and friends) relentlessly try to prove that when it comes to the penis "less is more." That worked on the pre-meedical-science age, and then in the pre-information-age, but it's failing now.
It's becoming increasingly difficult not to be informed of the reasons why parents shouldn't physically interfere with their child's sexual development, and increasingly difficult for doctors to justify complying with parental requests for cosmetic surgery which are not in child-patient's health interests.
penis. heh heh heh.
I think the lowered incidences of AIDs can be attributed to the fact that most men probably abstained from sex while their penises were healing after circumcision. Whether or not that theory is true, I still fail to see how circumcision = no AIDs. The foreskin doesn't GIVE anyone AIDs, so how does taking it away prevent anyone from getting it?
It's important to note that the cut men in the Africa trials CONTRACTED HIV at a rate SIX times higher than the rate of new infections for African-American men. And most of the US men who have died of AIDS were circumcised at birth.
These trials were "controlled" all right. They carefully avoided countries like Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Tanzania, where HIV is markedly MORE prevalent among the circumcised.
Circumcision does not prevent AIDS; in fact virgin boys in Africa were found more likely to already HAVE AIDS if they had been circumcised.
Fascinating blog entry.
Lets see the basis for Stephen Lewis's position:
New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications
http://data.unaids.org/pub/Report/2007/mc_recommendations_en.pdf
WHO and UNAIDS jointly state:
"Conclusions and Recommendations
Conclusion 1: The research evidence is compelling
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.
Recommendations :
1.1 Male circumcision should now be recognized as an efficacious intervention for HIV prevention.
1.2 Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men."
So Stephen Lewis is more accurate in what he states than many around here would like to believe. I wonder what agenda the critics of Stephen Lewis have?
And with the passing of time and the publication of additional research findings Stephen Lewis is proving to be more correct than the worst nightmares of these fringe anti-circ groups. Currently HPV Vaccine shots at $360 with an efficacy of 70% are being promoted for young girls. This followed by the publication of the research confirms that "women with circumcised partners have a reduced risk for genital cancer." And "Investigators found that circumcised men were about half as likely to have HPV as uncircumcised men..." The best protect for women then is the shots and circumcised partner. Say no more.
http://www.sciencedaily.com/releases/2008/12/081217123817.htm
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