Adult male circumcision reduces the risk of HIV infection from heterosexual intercourse by up to 60 per cent, three trials suggested.
Early results of the trials conducted in Kenya, Uganda and South Africa were so positive that the studies were ended early to give all of the men participating a chance to get circumcized.
Full data from the trial appears in Saturday's issue of The Lancet.
"This is an extraordinary development," said Dr. Kevin de Cock, director of the World Health Organization's AIDS department. "Circumcision is the most potent intervention in HIV prevention that has been described."
Boy, that first-order evidence sure does have a knack of doing a one-eighty on you.
Hey, Skipper, whose idea was this crazy nonsense in the first place?
19 comments:
To those on the other side of this argument, don't despair. Pretty soon another study will show the exact opposite. You can't win, so just make the best decision you can make with the available information and hope for the best.
As for gays, I read a while back that Andrew Sullivan advocated surgically replacing the excised tissue. I don't remember if he said he had it done or not.
Peter:
What do studies show for males outside Africa, for straight males?
If the answer is "nothing," which I strongly suspect, then I continue to maintain that the practice is, in the US (or any industrialized country, for that matter), medically worthless.
For Africans, the first order evidence strongly suggests otherwise, making the procedure decidedly worthwhile.
Right?
Maybe, but that second and third order evidence I love so much says we don't impose practices we consider barbaric on other races.
I still can't figure out why you care about what people do on this question.
In the first place, this "study" is being published in The Lancet, which is a publication that has demonstrated many times that they are absolutely incompetent when it comes to statistics, so unless the study can be accepted by a respected, peer-reviewed journal, I have to suspect that it doesn't actually support what it purports to show.
Secondly, Dr. Kevin de Cock is either a moron, or is engaging in a bit of hyperbole, because "reducing the risk of HIV infection from heterosexual intercourse by up to 60 per cent" can in no way be named "the most potent intervention in HIV prevention" by any rational, learned person.
Question: In ranking sources of HIV infection, how many are the result of heterosexual intercourse, how many the result of homo- sex acts, and how many from IV drug use ?
The correct answer, of course, is that hetero- sex is by far the least dangerous of those three sources of infection, and further, using condoms in either hetero- or homo- sex cuts HIV transmission by far more than the maximum study result of 60%.
Therefore, using condoms when having homo- anal sex is much more effective in preventing the spread of HIV than is circumcizing hetero- men.
But thirdly, what Skipper says.
Since it appears that African males are very fond of having unprotected sex with virulent prostitutes, by all means, let's encourage them to shorten their penises.
Every little bit helps in that cesspool of dysfunction.
Peter:
Are you saying that if we consider circumcision to be barbaric, then it would be better to let Africans die, rather than encourage their men to be circumcized ?
Are you saying that if we consider circumcision to be barbaric...
No, I am saying there is no "we" on this issue and there shouldn't be.
Of course there's a "we".
In advanced nations, circumcision isn't a very effective means of preventing transmission of HIV through heterosexual intercourse; in undeveloped nations, it IS an effective tactic.
Those facts automatically establish an "us" and "them".
Because of the huge gap in rates of disease transmission through hetero- sex between advanced and dysfunctional nations.
I still can't figure out why you care about what people do on this question.
Okay, let's review:
1. Medical practices without medical benefit are pointless, and contradict the prime directive: first, do no harm.
2. Because of this silly practice, which is no more justifiable (with the possible exception of Africa) than female genital mutilation, my son came far too close to a very bad result.
How many reasons do I need?
A public interest for starters.
You must think almost every doctor in America over several generations broke his/her Hippocratic oath over this one.
What's the difference between criticizing the widespread non-religious practice of circumcision in America, and criticizing a movie ?
Isn't the goal, in both instances, to help people to make wiser choices ?
And isn't that a "public interest" ?
You must think almost every doctor in America over several generations broke his/her Hippocratic oath over this one.
Yes or no: In the US, does the practice convey sufficient medical benefit to outweigh the risk?
Is there any meaningful difference between circumcision and female genital mutilation?
Does the fact that both are often religiously based shield them from criticism?
Skipper:
So, I assume what you are saying is that the decision you and your wife made, which you regret, should never have been left to the two of you in the first place?
Is there any meaningful difference between circumcision and female genital mutilation?
Yes. Female circumcision is aimed at making sexual intercourse for women painful and unpleasant. Male circumcision is not aimed at making sexual intercourse for men painful and unpleasant.
Right, Duck, but there is more. Contra Skipper, there are and always have been lots of doctors who believe it does confer medical benefits. If you have to have it done after infancy, it is sheer hell. But the most important difference is that with male circumcision the barbarity is in the minds of adults, not the experience of infants.
You ignore the fact that there are documented medical risks to circumcision as well.
The question isn't "are there medical benefits", it's "do the benefits outweigh the drawbacks".
No, that would be the question if we were all doctors discussing what to counsel our patients, but we aren't. That trade-off touches just about every medical procedure and I believe the standard practice in a free country is to advise patients of pros and cons and then let them decide. I've tried asking you and Skipper many times what you are trying to accomplish here or what you think should be done, but answer comes there none. If all you are doing is expressing a personal view on what you would "encourage" folks to do, encourage away, but I suspect you are trying to say more than that
I'm actually beginning to have this fantasy of Skipper quitting his job to dedicate his life to this cause and spending all his remaining days distributing pamphlets, giving lectures to schools, appearing before congressional committees, etc. When they do a TV special on him and ask him whether he ever despairs given the continued popularity of the practice, he puts on his most sober mien, looks directly into the camera and says: "If I can save but one pecker...."
No, that would be the question if we were all doctors discussing what to counsel our patients, but we aren't.
So...
Then why did you start this discussion, if you felt that you had nothing of value to add ?
I've tried asking you and Skipper many times what you are trying to accomplish here or what you think should be done, but answer comes there none.
This didn't satisfy you? :
Oroborous said...
"What's the difference between criticizing the widespread non-religious practice of circumcision in America, and criticizing a movie ?
"Isn't the goal, in both instances, to help people to make wiser choices ?"
February 27, 2007 5:03 PM
Peter:
So, I assume what you are saying is that the decision you and your wife made, which you regret, should never have been left to the two of you in the first place?
Your assumption isn't what I was looking for; those were questions.
At the very least, the medical profession could be honest and say:
There are virtually no benefits, and they can be had with normal hygiene.
Complications can include significant disfiguring and dismemberment.
What I am trying to do is nothing more than point out it is a stupid procedure for which the only reason, when asked why, amounts to "because we have always done it."
But doctors never say that, do they?
Post a Comment