Circumcision campaign in Africa reduces HIV infections 76%, study finds

[JI7]

Source: la times

A circumcision campaign in a South African township cut new HIV infections among the treated men by 76%, researchers reported Wednesday. The simple operation provides a way to make major inroads in the HIV transmission rate in countries where the infection rate is very high, researchers said, and provides a cost-effective way to slow the pandemic.

Clinical trials have shown that circumcision can reduce HIV infection, but the new results presented at a Rome conference of the International AIDS Society show the benefits in actual practice.

It is not completely clear why circumcision is so beneficial. Some studies have shown, however, that the folds of the uncircumcised tip provide a pocket for viruses and bacteria to grow. The foreskin is also known to have high concentrations of the cells that are infected by HIV.


Each circumcision in South Africa cost about $108, said Dirk Taljaard of Progressus Research and Development Consultancy in Johannesburg, one of the study authors. He estimated that circumcising five men would prevent one new HIV infection in the next year and that every dollar spent on the procedure would save about $15 that would have later been spent on treatment.

Read more: http://www.latimes.com/health/boostershots/la-heb-hiv-prevention-circumcision-07212011,0,7720647.story

[Bonobo]

1. Uh oh, here it comes.... nt

[aquart]

2. Yes, the defenders of the teeny tiny turtlenecks will come.

Better to die with your foreskin than lose it and live!

To which I say, go for it, boys. Our herd needs thinning.

[Fumesucker]

6. If circumcision is such a protection against AIDS you'd think the rate of infection in Europe...

Would be higher than in the US, since the circumcision rate is much lower there than here in the US..

Or perhaps it's more complicated than just circumcised good, foreskin bad.

[denem]

8. Needle exchange, sex education, welfare, regulated prostitution, universal health care,

that sort of thing - you know.

[Fumesucker]

19. Ah, so indeed it _is_ more complicated than circumcised good, foreskin bad!

Thanks for your support..

:hi:

[Warren Stupidity]

7. If I made a joke about female genital mutilation it would be deleted.

[cali]

33. what about the article? Any comment on that?

[Warren Stupidity]

40. nope. the circ debate is sexist and insane.

[E-Z-B]

17. Yup, here come the foreskin huggers.

[Agent William]

23. New breaking studies reveals...

That condoms reduce HIV by roughly 100%.

The reason circumcision is being used in Africa is due to the fact that cutting the penis is approved by various Christian (read Catholic) denominations. Condoms are not. When I read that the correlation between circumcision and reduced HIV rates, I see researchers trying to rationalize the act.

I think I know the reason for a correlation. When an adult male gets cut, it takes some time to heal. I'm guessing that the extreme pain of having that done deters sex...and reduced sex rates equals reduced AIDS.

By the way, I would never be in your herd to begin with.

[midnight]

42. You might be onto something....

[harun]

9. Yup

[BigDemVoter]

24. Yep

I'm awaiting with anticipation for the onslaught of pro & anti circumcisers to hit us!

[LeftofObama]

3. Uh Oh!

:popcorn:

[muriel_volestrangler]

4. Circumcision thread in DU increases endless arguments 76%, experience finds

Move over. :popcorn:

[Cool Logic]

5. Do you suppose this news will reach San Francisco...?

[prete_nero]

10. hmm

"Some studies have shown, however, that the folds of the uncircumcised tip provide a pocket for viruses and bacteria to grow."

So what they are saying is that there is a spot for stuff to grow. Forgive me if my logic is wrong but generally when you have an enclosed space that encourages growth of something nasty you clean that place. My kitchen garbage can will get nasty and smelly if it isn't regularly emptied and any runoff garbage-juice cleaned up. But by the pro circumcision logic I should instead chuck out the garbage can instead...because thats where the bacteria grows.

Perhaps these men being exposed to medical people who not only did the circumcision but also most likely explained good hygienic practices had a part to play?

I know I'll be flamed for not being blase about this, but so far the proven benefits of circumcision can be duplicated by proper hygienic practices. And people ARE right that in the grand scheme of things this isn't a huge deal, and is no where as horrifying as female 'circumcision'...

But I request anyone to show me a study where circumcision alone was beneficial and would not able to be duplicated by teaching guys how to properly clean themselves.

It may be a joke to some that certain people would prefer to leave body modification up to the body owners own decision, but I suppose making fun of people for having that belief is not only okay but the 'normal' response to these 'wackos'.

How about a bit of respect for a valid viewpoint?

[fleabert]

11. big time respect for your comment.

exceptional response and one i wholeheartedly agree with, thank you.

-edited for clarity

[Bonobo]

16. So what you're really saying is if those Africans would just wash?

Then they wouldn't get AIDS so much?

Is clean soap and water as readily available all over Africa as it is in the burbs or city where YOU live?

[zalinda]

20. In some places in Africa

water is scarce, so is used mainly for drinking and cooking. They do not have access to as much water as we have, that's the plain fact. For some, they may not bathe for months until water is more available. Life in Africa is not like life in the US or Europe.

zalinda

[Cronus Protagonist]

27. No water for bathing is NO problem if you are not circumcised

You hold the foreskin closed and get a sterile full 360 degree cleanse every time you urinate. Sorry for you circumcised people, you're just plain out of luck - your penis just stays dirty and calloused.

[Bonobo]

37. Huh?

You mean spraying urine all over the inside of your foreskin is cleaning it?

FYI, urine may be sterile when it leaves the body, but it quickly becomes not so and changes to a great environment to harbor all manner of bacterial growth.

If I was a bacteria, I suppose a smegma-smeared, moist warm tube of flesh would be heaven!

[naaman fletcher]

21. The other possibilty,

Is that people who are thoughtful enough to seek out ways to avoid aids (like getting this done) tend to be people who are thoughtful enough to avoid aids (like not having unprotected sex).

[pitohui]

25. travel to africa and then get back to me with your NONvalid delusional racist "viewpoint"

get off your couch, out of the basement, and into the real world

there are large areas where there is NO electricity and NO clean drinking water

it defies reason that you are going to be all sparkling clean mr. hygiene when it is not physically possible for you to have a source of running water

why don't people get out in the real world before they make ignorant racist comments? africans know perfectly well what they need to get clean, but political forces and poverty often stop them from getting it

i would like to YOU start with mud, palm leaves, and a match, and build your own house, or to have to grow every bite of food w. no access to running water, or to do any of a dozen other things that a poor african does just to stay alive

people who have never done anything other than turn on a computer think they know better to tell people who are in there in the real world?

circumcision is a practical answer, because it's a one time deal, for the same reason, africans are seeking an HIV vaccine because it would be a one time deal, REPEATED efforts are impossible to maintain in difficult situations

no one can be perfect at all times, esp. in the absence of running water

should i really need to explain this to people this time of century? dear god, im so TIRED of the stupid

[Cronus Protagonist]

28. Circumcision is not an "answer"

It is a barbaric medical or religious practice wielded upon the littlest and most defenseless people in society.

As an adult, go ahead, have it chopped off by your own choice. I have no problem with that. Mind you, few would be willing, as adults, to give up such a sensitive and useful part of one of their most precious organs, which is why the violence has to be forced upon infants.

And as I noted in another post, if you have a foreskin, you have a built-in cleansing system using sterile urine and also you would have the full benefit of sebum which carries infection fighting immune system to the area to keep it in great and healthy condition. The foreskin also provides excellent shielding from the sun, dust, dirty clothes, bugs and other irritants.

An intact penis is clearly better in rough climates than one that has been rendered functionally less than the original.

[Bonobo]

38. Clearly! Except for all the studies that show your claim is bullshit! NT

[prete_nero]

31. woah

Woah woah WOAH!
Excuse me but please enlighten me exactly to how ANYTHING I said was at all racist!

I would kindly suggest you learn how to argue a point without attacking the other person themselves, know what that shows? a LACK of an argument.

Besides if you actually go back and read what I wrote instead of what you are implying of me as a "basement dwelling mr hygiene" you would see that I was not in fact attacking the subjects of the study but rather the methods and results the researchers came to. I disagree with how they came to their findings or at least think its unclear from this source how it was done.
Besides as others on this thread have pointed out you don't have to have complete western facilities to be clean, that was never implied. The ammenities most of the people reading this are used to are in fact not common for most in this world, yes I know this, I also know that the body didn't evolve to NEED constant running water and soap like we think is needed now.

You might also find that I did not in fact say that these men shouldn't get circumsised...it is clear that circumcision is ONE of the porbably ways to reduce the HIV risk, and to an adult male it is completely his decision. I would probably even do it myself if the circumstances were similar for me, it would just be easier.

Finally, please don't put words into my mouth and definately don't call me a freakin racist basement dweller when you don't know me at all. Bring a real argument or shut up.

[boppers]

32. "so far the proven benefits of circumcision can be duplicated by proper hygienic practices"

Uhm, how about reducing the available surface area that can be a vector for infection?

Hygiene doesn't create less skin.

More skin = more surface area for infection.
More skin = more friction points for tearing, as well.

Of course, taking this to a logical extreme, I'd guess men who have had their entire penis removed have very low HIV transmission rates compared to control groups.

[prete_nero]

34. right

I'm assuming since you didn't say the hygenic part was 'wrong' that you would agree that its a valid alternative. Both are equally valid, the only contention on this issue comes when people insist circumcision is the ONLY choice and that it is something that should be imposed by someone other than the person who would receive the procedure.

Extreme example, removing the breasts prevents the risk of breat cancer by %100 percent! (I know its not the same, I'm being facetious).

Also, to follow your to the logical extreme point...I'd say even just living is inherently risky for disease, thus the safest thing is to not live!

Sorry I'm trying to use a little (dark) humor, maybe not appropriate.

[boppers]

36. Knowing people who have had full mastectomies, to prevent future issues, it's worth a thought.

Unfortunately, when you start mixing in consent, and agency, with pro-active medical treatment, things become rapidly complex.

Should parents, who refuse to accept common medical treatments, be held liable for "abuse", when their child is too young to understand or give consent? Since the issue at hand is hygiene, how about children unable to take care of their own hygiene?

I guess this is why we argue about it so much on DU. This is a complex issue.

[UnrepentantLiberal]

12. What an odd thing to be obsessed with.

[fleabert]

13. what exactly about the article suggests obsession? nt

[sofa king]

35. I believe that's a reference to the " 'skinheads."

For at least ten years, one off-the-chart lunatic has been annoying the more interesting message boards around the world with his one-man crusade to get his foreskin back. He has recruited an army of strange characters who maintain that circumcision is part of a global conspiracy to sap and impurify their precious bodily fluids.

The guy used to run with the name Jack Dean Tyler, or JDT, and he used to constantly search for any reference to himself or to circumcision. Then he would swoop in and hijack any conversation, like this, that dared to mention him or his pet subject. At another message board, he became known simply as, "he who shall not be named."

I haven't seen him here, but the reactions of others above suggests to me that JDT or his 'skinions have already made a name for themselves.

[Ian David]

14. We need to invent a removable, resusable foreskin so we can compromise.

Preferably, something you can run through the dishwasher.

[rbnyc]

15. LMAO

I'm actually very much against circumcision, but I do have a sense of humor and that was hilarious.

[chrisa]

18. I hope you have a nuclear, fire-proof bunker ready.

:hide:

:)

[AlphaCentauri]

22. Must be that men who had a circumcised also were educated at the same time

about AIDS or do they just got a circumcision for sports

[ZombieHorde]

26. Circumcision does seem to help adult men in third world countries in Africa.

But this does not mean routine circumcision is right for infants in first world countries. This is why the major medical communities, such as American Academy of Pediatrics, British Medical Association, and the Canadian Paediatric Society advise against it.

[cprise]

44. Making sexually-active men inactive for long periods

would have a negative impact on STD transmission. So would having your sex life monitored after having surgery done to your penis.

This is why you really don't see these HIV transmission differences between countries that generally don't circumcise and countries that generally do circumcise males when they are still infants.

[CJvR]

29. Well...

...if people want to chop bits and pieces off themselves that is their business. As long as they don't do it to someone else.

[laconicsax]

30. The biggest problem with studies like this...

It gives people the false impression that you can trade MGM for condoms, which happen to be about 100% effective in preventing the transmission of HIV.

http://www.irinnews.org/Report.aspx?ReportId=79557">Circumcision gives men an excuse not to use condoms

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.

In recent years circumcision has been lauded by Swazi public health officials as a procedure that reduces the rate of HIV transmission by about 50 percent, but it is far from the silver bullet solution some men see it as.

"The problem is not with the procedure, but the way it is abused by men, so that men think they are now immune from HIV contagion," said Siphiwe Hlope, an HIV-positive woman and founder of the support group, Swazis for Positive Living (SWAPO).

...

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.

[boppers]

39. "100% effective"?

That's dishonest.

Condoms break.

[laconicsax]

41. A two-year study of condom use in preventing the spread of HIV resulted in zero transmission.

http://www.nejm.org/doi/full/10.1056/NEJM199408113310601

Of the 256 couples who continued to have sexual relations for more than three months after enrollment in the study, only 124 (48.4 percent) used condoms consistently for vaginal and anal intercourse. Among these couples, none of the seronegative partners became infected with HIV, despite a total of about 15,000 episodes of intercourse.

So yeah, condoms are about 100% effective.
ETA: The failure rate for condoms is 0.4-2.3% and the HIV transmission rate for partners having unprotected intercourse is around 3% (based on the control group in another circumcision study). When you combine those factors, you get a transmission rate of 0.0012-0.069%.

[boppers]

43. Thanks for that edit.

I didn't check the math, but you kind of made the point.... nothing is truly 100%, it's all about reducing risk.