Sunday, February 25, 2007

FOR SKIPPER

From: Circumcision helps prevent HIV infection, studies confirm (CBC, February 23rd, 2007)

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?

14 comments:

erp said...

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.

Hey Skipper said...

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?

Oroborous said...

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.

Oroborous said...

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 ?

Oroborous said...

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".

Oroborous said...

Because of the huge gap in rates of disease transmission through hetero- sex between advanced and dysfunctional nations.

Hey Skipper said...

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?

Peter Burnet said...

A public interest for starters.

You must think almost every doctor in America over several generations broke his/her Hippocratic oath over this one.

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 ?

And isn't that a "public interest" ?

Hey Skipper said...

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?

Unknown said...

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.

Oroborous said...

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".

Oroborous said...

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

Hey Skipper said...

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?