"The goal is to circumcise 20 million African men by 2015..."

[slackmaster]

In Summary

Getting the most of it. Now that three studies have shown that circumcising adult heterosexual men is one of the most effective “vaccines” against Aids—reducing the chances of infection by 60 per cent or more—public health experts are struggling to find ways to make the process faster, cheaper and safer....

http://www.monitor.co.ug/News/World/-/688340/1319384/-/120xdup/-/

[aquart]

1. lol! And THAT for the teeny tiny turtleneck worshippers!

[msongs]

2. ritual mutilation in the name of $$ - changing sex habits would be more effective nt

[slackmaster]

3. And...

[Lionessa]

5. Wow, that's the argument that's made for ending women's sexual/body rights. We just need to change

our sex habits, then we won't need contraception, HPV vaccine, or abortions.

Please reconsider your POV here.

[pitohui]

15. thanks lionessa

i am stunned that anyone in 2012 would voice the opinion that people should just "change their sex habits" and, like magic, poof! hiv/aids will vanish...

do these people NEVER have any contact w. human nature or biological reality at all? is there any scientific evidence at all that people can change their "sex habits"?

[msongs]

23. actually its only a specific strategy to stop the spread of specfic disease and has nothing to do

with your other issues.

[MineralMan]

8. And far more difficult, too.

Still, I doubt that many adult men will be interested in circumcision. So, they're going to have a tough time convincing them. Changing sex habits? That's going to be a very, very difficult thing to do. Which habits did you have in mind to be changed, just out of curiosity?

[Lionessa]

13. Geez, you love to generalize.

I know two adult men who've chosen late-in-life circumcision, not for this reason, but nonetheless had them snipped.

I know zero men who were snipped that have even wanted to put it back, though I've certainly read about a few who have.

BTW: I did a ton of research and personal interviews when I found out my last child was a boy and I was going to have to make that decision for him. I visited with probably 250-300 men, quite literally as a pregnant woman opening the conversation to any man and every man that was around, stores, park, anywhere. Being pregnant, they all seemed to understand why I'd ask, and very few didn't answer.

[customerserviceguy]

14. I got it done at 18

Medical reasons, and I never regretted it after full recovery. Of course, there was the pain in my dorm room of changing my bandages, and screaming at my Jewish roommate (who was also a close friend since junior high school) that he was lucky to have been born into a religion who knew enough to do this at the right time!

Because I assumed that my sons would be possible heirs to the same medical condition, their mother and I made the decision to have it done for them by a trained doctor before they left the hospital. The doctor didn't like the idea, but he had taken a special class since med school on it, because he figured that he'd be asked, and wanted to be able to do it properly.

While I would never want the procedure to become coercive, I can see offering the same incentives for it that an overpopulated country would do for vasectomy.

[MNBrewer]

41. Lionessa, if you knew me, that would be one.

I'm quite pissed that a part of my body was cut off without my consent.

[Lionessa]

46. Ah, but I don't and I did already concede to having read about some that feel as you,

though I have to say, you have no valid manner to compare, those that've had it offed later in life do. So in a way, they have the most valid pov, imo. Nonetheless, if I knew you, you'd be a first, but I don't know you.

[MNBrewer]

48. That their opinion would be "most valid" because they got to make an adult choice

is pretty disturbing. Maybe this is one of those "if you don't have a uterus you don't get to have an opinion" types of topics, except it's penis in this case, not uterus.

[Lionessa]

51. No, it's just quite simply that they are the only ones that have experiential comparison

ability. For no other reason. Everyone else can only imagine if the opposite choice would be better. Sometimes people who get what they think they wanted, find out it doesn't resolve at all what they had hoped it would. That has not been the case with the men I know who were snipped late in life.

And similarly, women who've never had a full hysterectomy probably aren't the best to offer comparative analysis as to the pros and cons therein because they have no experiential comparison to work from

[MNBrewer]

52. All the more reason to do the hysterectomies in infancy

[Lionessa]

55. Wow, you're really try hard to put words in other folks' mouths. Good luck with that.

[SaintPete]

44. I'm just curious

whether you have any piercings?

[Lionessa]

47. Would tats also be considered mutilation? Hey, what about so much of the vanity dentistry?

Since in many cases the real teeth are either pulled or seriously deformed to attach the veneers, is that mutilation for money?

And boob jobs, and nose jobs, and... yes, but let's jump on a flap of skin being removed and exaggerate it's significance vs all the other "acceptable" forms.

Such a good point you bring up.

[Quantess]

4. All because the Pope doesn't like condoms.

[Lionessa]

6. I've never met the Pope, but none of the other men I've met like them either.

[MineralMan]

7. I never had any problem with condoms.

I've used them for years. Birth control pills aren't all that safe, so we used condoms. Of course, you don't know me, either.

[Lionessa]

9. You are rare.

[MineralMan]

11. Am I? Condom sales would tend to contradict that, I think.

I have no point of comparison, though, since I don't know enough men well enough to query them about their feelings about condoms.

[Lionessa]

12. Well I've had a pretty wide sampling in my life, mostly when

I was young and "love was easy". I'm not saying they aren't being used, I'm saying men don't seem to prefer them over au naturale

[MineralMan]

17. Need overcomes preference.

There's only a marginal difference, really. It's insignificant.

Some men probably prefer not using condoms, but it's really not a big deal when you think about the other person in the relationship, it seems to me.

[Lionessa]

18. Since you're agreeing, why do you sound so disagreeable in the presentation?

[MineralMan]

22. Maybe you're reading the words with the wrong

tone of voice imposed on them. I certainly don't mean to be disagreeable.

[DemocratSinceBirth]

31. Lots Of Men Pressure Women Into Unprotected Sex Under The Guise Of It Feel Better

.

[MineralMan]

63. I have no doubt that there are men who do that.

I do doubt that they are anything but a minority of men.

[DemocratSinceBirth]

70. You Should Read About Men On The Down Low Or DL As It Is Often Called

These are bisexual men who hide their bisexuality from their spouses and girlfriends.

How does a married man who wants to hide his adultery and bisexuality tell his wife he wants to start wearing a condom when they have sex?

How does anybody in an ostensibly monogamous relationship tell their partner they want to wear a condom?

[Bucky]

49. !!!

Win!

[Ikonoklast]

10. Wow, you know the Pope?

Did you ever ask him to wear his Junior Nazi uniform while, uh, well, you know?

[muriel_volestrangler]

19. Not 'all because'; Catholicism isn't the only sect or religion in Africa

The RC church's attitude does do some harm, but it's not the only reason HIV has spread so much in Africa.

[downwardly_mobile]

16. Well, as long as they don't bomb the moon, it's cool.

There was an article in the Times about this too:

AIDS Prevention Inspires Ways to Make Circumcisions Easier

http://www.nytimes.com/2012/01/31/health/aids-prevention-inspires-ways-to-simplify-circumcision.html?pagewanted=all

[Cleita]

20. Indoor plumbing, soap and clean water would do the same.

African villagers have little access to the same means of hygiene that we take for granted. Maybe they should spend that money on building infrastructure. It would create jobs too for those Africans who are forced to live off the land to subsist. Oh and free condoms and HIV testing available to all.

[Spider Jerusalem]

25. Well no they wouldn't

it's tearing of the foreskin and bleeding that are responsible for a lot of heterosexual HIV transmission; this is why circumcision reduces transmission rates by 60%. Soap and water won't do that.

[Cleita]

34. I realize there is that, however, I still think hygiene and condoms would

go a long way in not transmitting the virus without the drastic method of enforcing circumcision. However, most of the most vulnerable Africans that get this disease have a lack of both because of lack of water clean environs for hygiene and lack of money for condoms.

[Spider Jerusalem]

39. Well...

the prevalence of HIV is estimated at over 15% in South Africa, Namibia, Mozambique, Zambia, Malawi, Zimbabwe, Botswana, Lesotho and Swaziland (in Swaziland it's estimated at 26%). Given the scale of the public health crisis of HIV in many African countries, I really think that circumcision shouldn't be ruled out; if it's effective in reducing the transmission of HIV, then it should be used along with other public health approaches.

[joshcryer]

37. Yes, but hygine is still an issue, Europe doesn't have such rates of hetrosexual HIV transmission.

Of course, providing clean water to 5-10 million homes vs circumcising 20 million men, obviously the planners know which one is more cost effective.

[Spider Jerusalem]

40. You can't actually make that correlation, I'm afraid

is it a factor? Possibly. But culturally and in terms of sexual practices, Europe is not Africa; genetically, Europeans are not Africans (an estimated 10% of the European population has a genetic mutation believed to confer immunity to bubonic plague which also confers immunity to HIV infection; this mutation is not present in the African population). And the prevalent strain of HIV in Europe is a different subtype of the virus than that prevalent in Africa, which is less efficiently transmitted through heterosexual intercourse.

[joshcryer]

45. The 10% immunity is directly reflected in the 40% hetro transmission rate in EU. Meanwhile...

...Eastern Europe has much much higher rates of transmission than Central and Western Europe.

Eastern Europe has a much lower standard of living:





Sorry, don't buy the genetic argument.

[Spider Jerusalem]

54. That doesn't actually disprove anything I've said

a different subtype of the HIV virus is more prevalent in Eastern Europe (subtype B is prevalent in western and central Europe); see here, here, and here.

[joshcryer]

56. And drug use (needle sharing) has what to do with circumcision, how?

New heterosexual infections are attributed to sex with infected drug users.

[Spider Jerusalem]

57. Not necessarily

new heterosexual infections in Eastern Europe occur in part because HIV subtype A is more easily transmitted via heterosexual contact; intravenous drug use is one of the modes of transmission but not the only one. In Western and Central Europe one of the sources you cited actually says that heterosexually transmitted HIV cases occur mostly among migrant populations originating in areas with pandemic HIV. And the CCR5 mutation conferring genetic immunity to HIV infection is most prevalent in northwestern Europe where it's estimated to reach as high as 18%; prevalence of the mutation is lower for Eastern Europe.

[Iterate]

58. I've worked with some of the people doing the research and implimenting this program.

Hi Josh. Good to see you.

I'm not a researcher, but I did have a support role with the HIV and malaria research and prevention. Much of it is aided by and coordinated with institutions in the EU.

When I first heard of the possible HIV/circumcision connection I admit I was both skeptical and hopeful, but after seeing the results and program development over the past six years, I'm convinced. These are good, talented people trying to do the right thing.

I looked to post some research paper links from them but got a bit overwhelmed -- 161 on PubMed just for Rwanda. Instead I'll just pick one piece from the popular press, covering just one aspect:

RWANDA: "The invisible condom" and other male circumcision myths

Urgent need for an effective communication strategy

Health workers say it is important that the public understands how circumcision protects men from sexually transmitted infections, and that they also know the procedure is not a guarantee of protection.

"There are many different reasons that people get circumcised ... medical, cultural, religious ... it has to be accompanied by counselling," Rwego said. "We have to develop the right message for the population."

The Rwandan government is embarking on a Knowledge Attitude and Practice (KAP) survey to ascertain the levels of awareness and information about male circumcision.

"Some people can think that male circumcision is a full protection, like an invisible condom, so with the KAP study we will know what to tell the people and what message to develop," Rwego said. "After that we have to develop guidelines, train staff and buy equipment."

http://d69791.info-gate-now.com/go?article_group_id=2664068&article_id=11056916&article_pos=3

Circumcision is just one part of a comprehensive program in Rwanda, and a cost-effective one at that. People who come up with marginal, American-centric arguments against it just don't realize what the African medical community is up against, nor do they seem to acknowledge that these are very bright and thoughtful people using the best research available, but with limited resources otherwise.

[joshcryer]

59. Thanks for the post. Perhaps my desire to see African living standard improve...

...is clouding my judgment in my analysis.

For me it's basically: EU is mostly uncircumcised, has 10% immunity for HIV transmission, 40% of cases are heterosexual transmission, IDU makes up a huge chunk of HIV cases, living standard as the largest component for HIV transmission.

I am not discounting circumcision as a partial remedy, I just think it's the most cost effective remedy from the point of view of analysts and planners, so that's why there's focus in that area. I would prefer the focus be improving living standards along with a comprehensive health care approach.

[Iterate]

60. If there was any one thing, I was most surprised to learn how interrealated it all is.

Last edited Wed Feb 8, 2012, 11:41 AM - Edit history (1)

Just the act of education, publication, and coordination of the circumcision program will have a development effect.

I seem to remember other research as well that showed greater improvement in living standards gained by "removing the brakes" so-to-speak than by pumping in cash aimed directly at development projects.

[ldf]

21. circumcision prevents aids and a double mastectomy

prevents breast cancer.

a big difference, you say? other than cosmetic, i don't know. removed breasts can always be augmented. other than breast feeding (and i don't know that the mass of the breast is necessary for that).....

cancer? breast feeding? which is more important?

the foreskin is there for a purpose.

it is nothing a little personal hygiene, 5 seconds, water, and a washing can't handle.

men who haven't had a foreskin OBVIOUSLY don't miss it. irrelevant.

the few medical instances where grown men need it, fine. there are always exceptions. but if the problem is the foreskin not stretching to retract, it is amazing how the skin CAN stretch, if done in a regular and purposeful manner.

but no, it is easiest to chop it off.

i think there should be a movement promoting automatic breast removal of all females before the breasts have a chance to start developing. prevention can never start too early. think of the reduction in instances of breast cancer, and the saving of hundreds of billions of dollars in health care.

[DemocratSinceBirth]

26. Are You Really Comparing Circumicision To A Radical Mastetomy On Both Breasts?

Have you ever seen a circumcised penis?


Have you ever seen a woman who had the grave, grave, grave misfortune of having to have both breasts removed?


If you think the results of both procedues are in any way comparable there is nothing I can do to disabuse you of that notion.

[MNBrewer]

42. I agree. Two ounces of prevention

[DemocratSinceBirth]

43. The Other Gentleman Didn't Answer

Do you really think removing the foreskin has the same effect as surgically removing the breasts on those who have had the procedures performed on them.

When I was growing up our next door neighbor had a radical double mastectomy. My mom said it was one of the saddest things she ever saw.

[MNBrewer]

50. I don't know

but if the breasts never developed, who would miss them? Why the disregard for infant boys?

[DemocratSinceBirth]

61. Maybe because it's medically indicated

.

[sosilly]

67. How is it medically indicated

on a perfectly healthy, non-sexually active infant boy? He will not get sick simply from retaining his foreskin.

[DemocratSinceBirth]

68. There's A Reasonable Chance He Might Grow Up And Grown Ups Are Known To Have Sex.

Even the unsafe kind.

[Capitalocracy]

24. If anyone wants to take a moment to explain to me why this is true and how it works...

or debunk it as BS, I will read it.

[Spider Jerusalem]

27. The foreskin tears in intercourse causing bleeding.

No foreskin, no tearing, no bleeding, significantly lower risks of female-to-male HIV transmission.

[DemocratSinceBirth]

30. I Thought That The Foreskin Traps The HiV Virus

.

[Spider Jerusalem]

32. A combination of factors:

From the South African Journal of Obstetrics and Gynaecology:

The biological reasons for decreased susceptibility to HIV in circumcised men are thought to be multifactorial. Firstly, the internal mucosal layer of the prepuce has been shown to have a greater concentration of Langerhans cells and other HIV target cells such as macrophages and CD4 dendritic cells than cervical mucosa. It therefore has the ability to absorb the HIV more efficiently, and it is plausible that removal of the foreskin is a likely mechanism in reducing the chances of HIV infection. Secondly, the foreskin is susceptible to tears, abrasions and infections, particularly near the frenulum, facilitating HIV transmission. Thirdly, circumcision results in increased keratinisation of the glans when not protected by the foreskin; this acts as a protective keratin layer, minimising HIV penetration of the surface epithelium.3-6 Lastly, it is also hypothesised that male circumcision leaves only a small mucosal surface area in the urethral meatus open to recurrent infective exposures, which may induce a mucosal immune response and further protection above that of circumcision.

more

[DemocratSinceBirth]

28. The Forsekin In An Uncircumcised Penis Gives The HIV Virus A Warm Place To Harbor

.

[Warren DeMontague]

29. That's just the tip of it

...

[Major Nikon]

33. First we need to get our heads around the problem

...before the solution will be well in hand.

[jillan]

35. There might even be an uprising...or an explosion!

[JVS]

36. Condoms work better and also prevent pregnancy.

[DemocratSinceBirth]

38. Have You Ever Researched Condom Compliance In Africa Or Even Certain Segments Of America?

[MNBrewer]

53. If foreskins were as maladaptive as the forced circumcision advocates would have us believe

we wouldn't have retained them in evolution.

[frustrated_lefty]

62. Like the appendix?

[slackmaster]

64. The invention of clothing has made the foreskin superfluous

Lots of things that are not really needed have been "retained" in evolution.

[DemocratSinceBirth]

69. Maybe Man Needed His Foreskin

Maybe man needed a foreskin to protect him from the brushes when he was running through them, wearing nothing but a loincloth.

[slackmaster]

71. I think the loincloth is overdue for a comeback

[DemocratSinceBirth]

72. I Saw Somebody Post A Sentiment Similar To What I Originallly Posted And Thought It Was Hilarious

I am amazed at the controversy this subject causes.

[ZombieHorde]

65. Notice the article says men, and not boys.

When cutting off body parts, we should give people a choice.

[TheManInTheMac]

66. Next thing you know they'll be opening Olive Gardens all over Africa.