Health Officials Back Circumcision in AIDS Fight

[Dardedar]

Health Officials Back Circumcision in AIDS Fight
By Robert Bazell
NBC News

Wednesday 13 December 2006

Top US agency says procedure effective way to stop HIV.

Circumcising adult men is an effective way to limit transmission of the virus that causes AIDS. The National Institutes of Health announced today that two clinical trials in Africa have been stopped because an independent monitoring board determined the treatment was so effective that it would be unethical to continue the experiment.

"We now have confirmation - from large, carefully controlled, randomized clinical trials - showing definitively that medically performed circumcision can significantly lower the risk of adult males contracting HIV through heterosexual intercourse," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease. "While the initial benefit will be fewer HIV infections in men, ultimately adult male circumcision could lead to fewer infections in women in those areas of the world where HIV is spread primarily through heterosexual intercourse."

The NIH has been sponsoring two trials - one with 5,000 men, ages 15 to 49, in Uganda and a second with 2,784 men, 18-24, in Kenya. Half the men voluntarily underwent circumcision. The men were then monitored for about two years. Far more of the uncircumcised men became infected with HIV.

The studies found that the circumcised men in the Kenyan study were 48 percent less likely to get infected and 53 percent less likely in the Ugandan study.

This finding appears to apply only to heterosexual transmission which is the main mode of spread in Africa. Officials estimate that at least 25 million people in Africa are currently infected with the AIDS virus.

These findings present enormous ethical and policy decisions which have yet to be addressed. But scientists say the reduction of infection is so much that the findings cannot be ignored.

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DAR
Maybe the uncircumcised men are having more sex because they don't have an "unresponsive stick?" (as per my presentation at the last meeting)

[Doug]

Maybe the uncircumcised men are having more sex because they don't have an "unresponsive stick?"

One way to find out. Take a poll. Or would they respond?

[Barbara Fitzpatrick]

Since a large percentage of American males are circumsized, is that supposed to explain why Africa has a higher rate of HIV?

[Doug]

"We now have confirmation - from large, carefully controlled, randomized clinical trials... Half the men voluntarily underwent circumcision. The men were then monitored for about two years. Far more of the uncircumcised men became infected with HIV.

DOUG
This looks like a flawed study, given this information. If the men who were circumsized volunteered for it, rather than being chosen at random, this could skew the results. Why it is called "randomized" is not clear, but it sure doesn't look randomized.

Unless--the men all had sex with the same women, some of whom had HIV. But I suspect that didn't happen here.

[Barbara Fitzpatrick]

I think that "voluntarily" is just to reassure people that guys weren't grabbed off the street or out of the bush and circumsized against their will. Definitely more research needs to be done, but the sample sizes on these two are good (I am so tired of MSM-touted research that turns out to have sample sizes of 32 or some other well-under 1000 number.) With a sample size that large, especially considering the HIV rates in Africa, you shouldn't get a bias just on the chance that more circumsized men had sex with non-HIV positive females.

[Tony]

I wish we had a definitive answer on this. If and when we reproduce, whether or not to sexually mutilate our kid is a big concern. If it can be shown to have valid medical benefits, ok. If not, no.
If you see any more on this let me know.

[Dardedar]

DAR
Tony, unless you kid is going to live in on an AIDS ravaged continent like Africa, and be very promiscuous, don't mutilate him. I wish you had seen my presentation on this at the last freethinker meeting.
Another way to approach it is this. Free choice. If he wants to get circumcised he can always make that choice. Don't make that choice for him.

D.

[Barbara Fitzpatrick]

Tony - as a mother of two sons who were circumcized at 3 days old just because "that's the way things are" - I'm with Darrel - don't do it to your kid unless you are taking him to some AIDS-ravaged place and aren't planning to teach him responsible sex practices. (Start early on the training for responsible sex practices - they need to know long before most parents are comfortable with teaching.)