UN recommends circumcision

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    May 04, 2007 7:03 PM GMT

    Circumcision urged to fight HIV
    Evidence indicates it can reduce spread of HIV by up to 60 percent
    The Associated Press
    Updated: 3:56 p.m. CT March 28, 2007

    GENEVA - U.N. health agencies recommended Wednesday that heterosexual men undergo circumcision because of “compelling” evidence that it can reduce their chances of contracting HIV by up to 60 percent.

    But World Health Organization and UNAIDS experts said men must be aware that circumcision is only partial protection against the virus and must be used with other measures.

    “We must be clear,” said Catherine Hankins, of UNAIDS. “Male circumcision does not provide complete protection against HIV.”

    Men and women who consider male circumcision as an HIV preventive method must continue to use other forms of protection such as male and female condoms, abstinence, delaying the start of sexual activity and reducing the number of sexual partners, she said.

    Otherwise, they could develop a false sense of security and engage in high-risk behaviors that could undermine the partial protection provided by male circumcision, the agencies said.

    Men also should be warned that they are at a higher risk of being infected with HIV if they resume sex before their wound has healed. Likewise, an HIV-positive man can more easily pass on the disease to his partner if the wound is still unhealed.

    The recommendations were based on a meeting earlier this month in Montreux, Switzerland, where experts discussed three trials — in Kenya, Uganda and South Africa — that produced “strong evidence” of the risk reduction resulting from heterosexual male circumcision.

    “Based on the evidence presented, which was considered to be compelling, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men,” a joint statement said.

    Much depends on the situation in a given country, and little general benefit will result in countries where the HIV epidemic is concentrated among sex workers, injecting drug users or men who have sex with men, the agencies said.

    The public health impact is likely to be most rapid where there is a high rate of HIV infection among men having sex with women.

    “It was therefore recommended that countries with high prevalence, generalized heterosexual HIV epidemics that currently have low rates of male circumcision consider urgently scaling up access to male circumcision services,” the agencies said.

    Impact on women unknown
    Studies suggest 5.7 million new cases of HIV infection and 3 million deaths over 20 years could result from male circumcision in sub-Saharan Africa, they said.

    More study is needed to determine whether male circumcision will cut the transmission of HIV to women and the impact of male circumcision on the health of women for reasons other than HIV transmission, such as whether it lessens rates of cancer of the cervix.

    More study also is required to find out whether male circumcision will reduce HIV infection in homosexual intercourse, it said, but it said promoting circumcision of HIV-positive men was not recommended.

    “The recommendations represent a significant step forward in HIV prevention”, said Dr. Kevin De Cock, director of WHO’s HIV/AIDS department. “Countries with high rates of heterosexual HIV infection and low rates of male circumcision now have an additional intervention which can reduce the risk of HIV infection in heterosexual men.”

    Increasing male circumcision in areas where it the procedure is rare will result in immediate benefit to the men circumcised, but it will take years before there will be an impact on the epidemic.

    Although the rate of circumcision varies considerably from country to country, globally an estimated 665 million men, or 30 percent of men in the world, are circumcised, the statement said.

    The agencies said the risks involved in male circumcision are generally low, but can be serious if the operation is performed in unhygienic settings by poorly trained, ill-equipped health workers.

    Priority should be given to providing circumcision to age groups at highest risk of acquiring HIV because it will have the most immediate impact on the disease. But, it said, circumcising younger males also will have a public health impact over the longer term.

    It gave no estimate how much providing the service would cost, but said more money would be needed.
    © 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

    URL: http://www.msnbc.msn.com/id/17822026/
    © 2007 MSNBC.com
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    May 05, 2007 2:46 AM GMT
    I remember when the first study on this came out some time back. The first study showed very compelling evidence that circumcision DRAMATICALLY reduced the risk of a man contracting HIV from a woman.

    The reason, as I understand it, is that there is less keratin in the foreskin then the rest of the skin on your body. Keratin, is produced by skin cells (keratinocytes) and forms a waterproof barrier to prevent infectious substances from passing from the skin into the body. Keratin is basically what your hair and nails are made of. Because of the reduced keratin production in the foreskin, the foreskin is more permeable to something like HIV to pass through. Removing the foreskin, removes these cells that lack robust keratin production...

    Interesting how circumcision began as a religious ritual and has now been proven as a REAL public health disease prevention method (along with safe sex mind you)... but interesting nontheless...
  • duglyduckling

    Posts: 279

    May 05, 2007 4:19 AM GMT
    it is still genital mutilation!!! It shouldn't be done to women, and it shouldn't be done to men!
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    May 05, 2007 4:42 AM GMT
    Sounds like someone has foreskin envy... why don't you badger the mothers who take their infant sons and daughters to get their ears pierced at 4 months old...

    we aren't talking about female circumcision, just male. Female circumcision varies DRAMATICALLY and some forms are mutilation.

    However, male circumcision is not mutilation. And while once just a religious preference, now has medical significance.

    It's mindsets like above that keep preventive medicine from gaining the support it needs to be effective...
  • duglyduckling

    Posts: 279

    May 05, 2007 4:49 AM GMT
    Excuse me, but I don't have foreskin envy. I have my foreskin completely thank you. And I thank my parents for not mutilating my body.

    The UN article merely says that it helps in decreasing the transmission rate of the disease, it does NOT prevent it. The only prevention is safe sex.

    So if it only decreases it, then why mutilate any boys' bodies just for that? Wouldn't sexual education be just as effective, if not more so?

  • duglyduckling

    Posts: 279

    May 05, 2007 4:53 AM GMT
    rhythm1438, you may want to read up some more before commenting!!


    just because you lost your skin, don't inflict this madness and pain on future generations!!
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    May 05, 2007 5:03 AM GMT
    Why don't you tell the African people that. You gonna supply them with the condoms they need? If you don't know how bad things are there then let me give it to ya plain and simple:

    Men pick up plastic bags off the street, wrap them around their dicks and go have sex with some girl. Then they toss the bag and leave it for the next guy to use. Condoms may cut it here, but they don't in third world countries where condoms aren't available to everyone. It's part of a lot of African culture to have multiple sex partners outside of their marraige. Then the men get angry at their wive's for wanting to use condoms, usually beating them. Then they give their wives HIV and divorce them and the women are austrisized from their communities and families... people in africa are dying by the thousands because of HIV/AIDS...so what would you rather have them take from you? Your foreskin, or your life?

    Sexual education has met many barriers mainly due to language barriers... Sex educators demostrate putting on a condom by using their fingers, so then men go around thinking that they are practicing safe sex by putting a condom on their fingers and not their dicks...

    While sexual education is very important, we need to use all of our known resources to fight this horrible disease. A disease that is far more prevalent in blacks then in whites, asians, or hispanics...

    You may have luxories here, but most people in the world don't have them...

    I mean please... there is already a huge population of people in the western world that get off on not using condoms...no amount of sexual education is going to change that...
  • duglyduckling

    Posts: 279

    May 05, 2007 5:09 AM GMT
    don't mean to offend, but you obviously are an idiot.

    Do you not understand that circumcision does NOT prevent the transmission of AIDS??

    From the link as mentioned:

    Male circumcision might only reduce infection by the last method, so the overall influence on the HIV epidemic in Africa, at best, would be likely to be slight, however, the risk of male-to-female transmission is much higher than that of female-to-male transmission, so a means of partial prevention that targets only the second means at the expense of the first would be counterproductive.

    Effectiveness. Circumcision does not prevent HIV infection. The Auvert study in South Africa reported 20 infections in circumcised males.17 A study in Kenya reported 22 infections in circumcised males. Brewer & found higher rates of HIV infection in circumcised virgins and adolescents.23 The United States has the highest rate of HIV infection and the highest rate of male circumcision in the industrialized world. Male circumcision, therefore, cannot reasonably be thought to prevent HIV infection.

    Opposing evidence. Both the public and the medical community must guard against being overwhelmed by the hyperbolic promotion of male circumcision and must receive these new studies with extreme caution. There is contradictory evidence that male circumcision is not as effective as proponents claim. One study found that male circumcision had no protective effect for women50 and another study found that male circumcision increased risk for women.51 Grosskurth found more HIV infection in circumcised men.52 Barongo et al. found no evidence that lack of circumcision is a risk factor for HIV infection.53 A study from India found little difference between circumcised and non-circumcised men in the conjugal relationship.54 A study carried out in South Africa found that male circumcision offered only a slight protective effect.55 A study carried out among American naval personnel found no difference in the incidence of HIV infection between non-circumcised and circumcised men.

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    May 05, 2007 5:28 AM GMT
    Actually, I'm not an idiot...

    And I'm a Public Health Professional...so I think I know a little more then you do... Why don't you try reading the articles they give for support....

    One, we aren't talking about women!!!! female circumcision doesn't have protective benefits...

    As far as the website you gave, you commented that men who were circumsized were more likely to have HIV...if you read the actual paper you would read that "HIV prevalence was significantly higher in circumcised men, but not when adjustment was made for other risk factors."

    You are reading an unreliable website... that is twisting the words in these papers to suit their own agenda...do you're freakin' research man...

    The 3 studies on circumcision were stopped early because the results were so robust, predictable, and reliable that they did not need to keep the studies going...
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    May 05, 2007 6:00 AM GMT
    Everything on The Internet is real. LOL.

    Interesting topic.

    Science is science, and pseudo-science is pseudo-science.
  • duglyduckling

    Posts: 279

    May 05, 2007 1:42 PM GMT
    Ahhh.... so you're a public health professional, so your words are gospel. Trust me, there are lots of mis-informed public health professionals out there. Remember, the world was flat at one time.

    And I didn't talk about women, I said that male circumcision is mutilation as well. You seem to dwell on that for some reason.

    However, as Catherine Hankins, UNAIDS, said:
    "We must be clear: male circumcision does not provide complete protection against HIV.

    "Men and women who consider male circumcision as an HIV preventive method must continue to use other forms of protection such as male and female condoms, delaying sexual debut and reducing the number of sexual partners."

    Essentially, the argument to circumcise men in Africa to prevent the transmission of AIDS is like tossing the grand piano off the Titanic in hopes of saving it or delaying from sinking by lightening the load. It's not going to help, and only a drastic re-education program will ever do the job. And that does NOT require circumcision, which is mutilation!!

    And you may want to read up on why it is mutilation against boys and men...

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    May 05, 2007 1:57 PM GMT
    This idea is crock of shit. Male circumcision reduces the chances of transmission to men, it does not prevent transmission to men. Condoms when used properly are the most effective means of hiv prevention other than abstinence. So how about instead of chopping of part of every man's penis, we wise up and just give them condoms.

    This initiative is likely to actually have adverse public health effects especially in countries in africa where it is believed that sex with a virgin will cure HIV. If you tell people that circumcisions helps prevent HIV more people will believe that they don't need condoms (because they are circumcised after all)

    so heres an idea if even after you are circumcised you still need a condom, why don't we all just wrap it up in the first place. wow I must be a genius. additionally a lot of organizations are jumping the gun with these studies conducted in africa and trying to generalize them to the whole world which is not effective. studies between "heterosexuals" in Africa have little bearing on transmission effects in this country where one of the most prevalent forms of transmission is Man to Man. African American women may be the fast infection group, but this stems from the men they sleep with being on the DL (sleeping with men as well and not telling anyone). The theory is that circumcised men will be less likely to get it an pass it on, but if they are the receptive male partner circumcision isn't going to do anything.

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    May 05, 2007 2:13 PM GMT
    No one is saying get rid of condoms... no one is saying that circumcision is an alternative to condoms...it's in supplement to. I think I said that in my first post...

    People...everyone knows that if we were all just to use condoms then it would prevent this disease...However, that common knowledge is not practiced... Condoms are not being used, period. Your common knowledge doesn't make you a genius, and it's not really making an impact on HIV transmission either. You have to use the condoms for them to be effective. And they're not being used.

    You can't just tell someone to use a condom and expect them to use it...education goes beyond a 30 minute siminar on safe sex... Again folks, just because you can go down to your local "Wal-Mart" and purchase a 24 pack of condoms, doesn't mean third world countries have that luxery. If one method is not effective, we have to use it in conjunction with other methods to increase prevention...
  • duglyduckling

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    May 05, 2007 2:25 PM GMT
    "Interesting how circumcision began as a religious ritual and has now been proven as a REAL public health disease prevention method (along with safe sex mind you)..."


    see, this is NOT accurate from your part... proven as a disease prevention method...

    Condoms is the only real way to stop the madness, and education is the only way that will help it. NOT chopping off foreskin. Perhaps it is time to pressure each's respective governments to increase foreign aid to broaden sex education and condom distribution instead of advocating circumcision, which is genital mutilation!
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    May 05, 2007 3:10 PM GMT
    This circ recommendation it is based on a flawed study...scientific superstition. A similar "study" could determine that gays with tatoos in this country have higher HIV rates. But its not the tatoos causing the higher HIV rates. That is, the guys that get cut have lower hiv rates but...but...the guys that are cut are cut because they are directly or indirectly hooked to western health/sanitation and morality support systems. Typically the cut guys are receiving medical, spiritual /education linked to missionary work there. This is bad science because the controls for the experiment are just not there. Its not the foreskin causing the infection.
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    May 05, 2007 7:12 PM GMT
    I don't like it when stupid, uninformed Americans read studies like this, and then begin thinking that mutilation of their beautiful son's genitalia is going to somehow protect him from having to use condoms, take showers, and other routine hygiene here in the US.

    Let's look at this issue without the fear and paranoia of being "dirty." Why does any formula for controlling HIV in Africa have any significance to our son's lives if they are being rasied in the US? This is not evidence compelling enough to destroy your newborn son's penis.

    This same bullshit is behind the trend for everyone cutting off their pubic hair as well. Just dumb, idiotic, misinformed lemmings who can't think for themselves. It is lame.
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    May 05, 2007 9:05 PM GMT
    dugly wrote: "don't mean to offend, but you obviously are an idiot."

    OK, that deserves the Real Jock Quote of the Week award.
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    May 05, 2007 9:21 PM GMT
    I agree with Burniman..

    In the world of research, you can manipulate a lot, and there can be so many cofounding variables (noise) that the research in question does not conclusively show a cause and effect relationship. It may show a correlation relationship, but it can exclude many critical cofounding variables that impact the outcome measured.

    Burninman mentioned a very crtical point: Education and health care. The CORRELATION relationship between HIV infection rate of uncircumsized men is likely to be a LOT lower than HIV infection rate of men with very poor health care and education..
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    May 05, 2007 10:36 PM GMT

    there is one flaw to your argument

    you say this is a preventative method to be used as a supplement to condoms.

    here is the flaw - this is not preventative

    Prevent means to keep something from happening.

    science has shown that circumcised men still get HIV, so therefore circumcision is not stopping hiv transmission and as such is not preventative. Chopping off part of someone's penis is not going to stop them from contracting HIV.

    additionally as I said before any research that has been done has minimal corelation to HIV in the developed world.
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    May 05, 2007 10:56 PM GMT
    Um if you aren't aware, condoms aren't 100% fool proof. There is a percentage of risk involved with using a condom, even if it's low. So, in your words, you can't call condom use preventive either... Anything that lowers risk is concidered "preventive care." Keeping your cholesterol down by eating healthy and excersizing is considered preventive, but it's not gonna guarantee that you won't get heart disease...

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    May 05, 2007 11:23 PM GMT
    Lol, I remember this, it came out a month or two ago. Haha, I read the actual study and I'm pretty sure that one of their conclusions was that circumcising men is as effective at 'preventing' HIV infection as increased condom use.
    So, your choices are...mutilate your genitals (lets call a spade a spade here guys) and take longer to get hiv because you're still not using condoms, or keep sticking your uncut dick in anything that walks and get it faster...because you're still not using condoms.


    Personally, having my foreskin intact, I think I'd be more inclined to use condoms....but *shrugs* to each their own. The reality is that even with my foreskin, my use of condoms is going to protect me significantly more than some cut guy who isn't using condoms.
    This study is 'interesting' but, quite frankly, it's being over hyped - it is mutilation of you genitals, and if you wanna play Russian roulette by all means go for it...but it's not a guarantee, and it's not 'a proven method'. The only 'proven method' is abstinence. Hard to get the hivy from your hand.
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    May 06, 2007 2:12 AM GMT
    rythm lets get serious here. yes nothing is 100% foolproof. if your using a condom as long as it doesnt break your pretty damn safe. even if you shop of part of every little boys penis they still need to wear condoms to prevent HIV. So lets call a spade a spade and realize that this study and practice is useless. what it comes down to is you have to wear a condom, cut or not, so there is no need for the genital mutilation
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    May 06, 2007 3:09 AM GMT

    The actual issue that is of concern with an 'increased susceptibility' to hiv infection is that the cells around the head and inside the foreskin are a lot more protected/tender (for lack of a better word, lol). Having sex unprotected and being uncut means that secretions have a high chance of getting trapped inside the foreskin. Further to that, because the skin is tender it has a greater chance of micro-tearing, giving the virus a much more direct route into your bloodstream. Someone who is cut doesn't have this problem - the skin around their glans has been toughened enough that it makes tearing a very unlikely occurrence. But it's not something to bank on. I realize in third-world countries they don't have a store down the street selling condoms, but pitching this concept that you can help protect yourself by getting a circumcision is ludicrous - it gives people a false sense of security, leading to an increase in high-risk sex. Also, I HIGHLY doubt that the professionals in Africa holding safer-sex seminars don't speak the language, or don't go with a translator...what would be the point then?
  • duglyduckling

    Posts: 279

    May 06, 2007 4:05 AM GMT
    sounds like rythm is a guy who got mutilated and is jealous of all of us un-mutilated guys. So he is pointing to this flawed study and his flawed arguments to try to chop off the foreskins of the rest of the world, so that he wouldn't feel as lonely.

    Summed it up pretty accurately eh? ;) Move on Rythm... everyone has pointed out the flaws in your argument, move on... and salvage some dignity.
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    May 06, 2007 4:11 AM GMT
    There's no reason to flame someone...it's a discussion. Attack the ideas, not the people guys....be civil.