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  • Circumcison/AIDS redux

    AP story....

    Studies: Circumcision Reduces HIV Risk

    LONDON (AP) - Scientists say conclusive data shows there is no question circumcision reduces men's chances of catching HIV by up to 60 percent - a finding experts are hailing as a major breakthrough in the fight against AIDS. Now, the question is how to put that fact to work to combat AIDS across Africa.

    The findings first were announced in December, when initial results from two major trials - in Kenya and Uganda - showed promising links between circumcision and HIV transmission. However, those trials were deemed so definitive that the tests were halted early.

    The full data from the trials, carried out by the United States' National Institutes of Health, were published Friday in 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."


    Circumcision has long been suspected of reducing men's susceptibility to HIV infection because the cells in the foreskin of the penis are especially vulnerable to the virus.

    A modeling study done last year projected that in the next decade, male circumcision could prevent 2 million AIDS infections and 300,000 deaths. Last year, 2.8 million people in sub-Saharan Africa became infected with HIV, and 2.1 million people died.

    Experts say the breakthrough is a significant one on par with the identification of the virus and the use of lifesaving combination drug therapy.

    The two U.S. studies confirm similar results from an earlier trial in South Africa. Given the recent failure of a microbicide trial in Africa and India, and the ongoing difficulties in developing an AIDS vaccine, the potential of circumcision as a new weapon against HIV has become even more significant.


    But they caution solid evidence is not justification for mass circumcisions.

    African health systems are already overburdened. Circumcision requires much more planning than, for example, an immunization campaign.

    "It's a tricky one, but it's something we're going to have to move on," said Dr. Catherine Hankins, a scientific adviser at UNAIDS.

    "Male circumcision is such a sensitive religious and cultural issue that we need to be careful," she said.

    Several African countries have already met with U.N. agencies to explore new strategies for increasing circumcision services. Swaziland, for instance, recently experimented with a series of "Circumcision Saturdays," where existing health care facilities, normally closed on weekends, were opened by local doctors to circumcise approximately 40 men a day on certain Saturdays.

    Providing circumcisions across Africa would not be the first time surgical procedures have been adopted by public health campaigns.

    "Cataract surgeries have been carried out extremely efficiently to prevent blindness worldwide," said Dr. Richard Hayes, an AIDS expert at the London School of Hygiene and Tropical Medicine. In some places, the cataract surgeries are performed by trained paramedics.

    In recent years, the fight against the AIDS pandemic has focused on the provision of lifesaving drugs. The circumcision data gives prevention, rather than treatment, renewed emphasis.

    "Treating people with antiretrovirals is completely unsustainable unless we can turn off the tap of infection," said Hayes.

    While circumcision may offer new hope, it is not a cure for the epidemic.

    "This is an additional tool, and it must not replace other interventions," said de Cock, who added that there will be no push for universal circumcision. "There is no one size fits all solution for AIDS."

    Together with the United Nations AIDS agency, WHO is convening a meeting in Switzerland in early March to evaluate the circumcision data, and to decide on the next steps in slowing the AIDS pandemic.

    In the Kenyan study, 1,391 circumcised men were compared to 1,393 who were not. And in Uganda, 2,474 circumcised men were compared to 2,522 men who were not. After tracking the men for two years, scientists found that circumcised men were 51 to 60 percent less likely to contract HIV than their uncircumcised counterparts. Since the studies were stopped, all the men have been offered the opportunity to be circumcised. And all the men were warned not to lapse into sexually risky behavior, such as abandoning condom use.

    Scientists theorize that women would benefit indirectly from lower HIV prevalence in men, and a study is currently ongoing in Uganda to determine this.

    In areas where HIV is spread primarily through heterosexual sex, such as sub-Saharan Africa, male circumcision could theoretically slash the infection rate in half.

    It is unknown whether circumcision would be equally effective in concentrated AIDS epidemics, as in Asia and eastern Europe, where AIDS primarily strikes gay men and drug users.
    Dr. Mordrid
    ----------------------------
    An elephant is a mouse built to government specifications.

    I carry a gun because I can't throw a rock 1,250 fps

  • #2
    Hurrah. Hopefully we won't have a repeat of the arguments that we had last time this story made the news.
    FT.

    Comment


    • #3
      Fat chance, Fat Tone.
      P.S. You've been Spanked!

      Comment


      • #4
        While this is nice, it isn't as nice as it sounds.

        "Circumcision is the most potent intervention in HIV prevention that has been described."
        No. Condoms are. I fear this circumcision stuff is going to make people think condoms aren't needed anymore (if any more damage can be done after what the church has done down there in the name of love).

        And the numbers aren't that impressive. 2 Million people saved from infections (Where? The whole world or just sub-sahara?) are a lot, of course. But view this against the 28 Million that are going to get infected in sub-saharan Africa alone (and that number assumes HIV won't spread any faster than it does now), and it makes a much smaller impact than what the numbers in the arcticle lead one to believe at first sight.

        Also, since this primarily affects men I fear this will make them even more careless in their sexual behaviour, infecting even more women than before, rather than less, because they feel safe. This is of course not the study's fault, but don't get your hopes too high up. And don't tell me I'm being racist or man-hating here, because disregard for both womens' needs and safety in sexual things shows in other sexual practices in that region.

        Nice find, but don't get your hopes too high up.
        There's an Opera in my macbook.

        Comment


        • #5
          I guess the director of the World Health Organization's AIDS department, Dr. Kevin de Cock, has a name predestined for the report. I hope he envelops himself in latex before kevin himself to women!
          Brian (the devil incarnate)

          Comment


          • #6
            I hope he envelops himself in latex before kevin himself to women!
            Huh????

            Kevin

            Comment


            • #7
              I wonder if, had circumcision never taken hold, the foreskin might have naturally gone the way of the appendix?

              Consider: if circumcision does indeed lower the risk of contracting HIV (and, by implication, other STDs) then that puts men with foreskins at an evolutionary disadvantage. A man born with no foreskin would have a higher resistance to STDs, giving him an edge over his naturally endowed brothers in transmitting his genes to the next generation.

              The problem with this theory is that the process which promotes infection is the same process used to pass the father's biological traits to his offspring. So maybe not.

              Kevin

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              • #8
                BTW, Mordrid, redux does not mean reduction.
                There's an Opera in my macbook.

                Comment


                • #9
                  Originally posted by az View Post
                  BTW, Mordrid, redux does not mean reduction.

                  Doc posted a thread about the initial discover a while back, so his use of redux is accurate.
                  “Inside every sane person there’s a madman struggling to get out”
                  –The Light Fantastic, Terry Pratchett

                  Comment


                  • #10
                    Originally posted by az View Post
                    No. Condoms are.
                    Funny, I always thought it was abstinence.
                    P.S. You've been Spanked!

                    Comment


                    • #11
                      Originally posted by Jammrock View Post
                      Doc posted a thread about the initial discover a while back, so his use of redux is accurate.
                      Oh right, hadn't though of that. My apologies.

                      Originally posted by schmosef View Post
                      Funny, I always thought it was abstinence.


                      But that's not really an option, is it?

                      I'm surprised I don't get more comments. Do you all agree or do you disagree with me so much that you think that discussion would be fruitless anyhow? Or was it *gasp* just not interesting? Isn't somebody at least shocked by my link to the dry sex article? I found that most disturbing when I found out about it. EDIT: OIC, the english article doesn't really mention how this is done. In the german article it is described that a powder made of ground herbs, roots and even small stones is inserted into the vagina to keep it dry, which can cause painful wounds in the vagina (of course making HIV contraction much more probable as a side effect).
                      Last edited by az; 23 February 2007, 17:55.
                      There's an Opera in my macbook.

                      Comment


                      • #12
                        Problem is that the researchers are pragmatists, folks.

                        They know that:

                        1. Africa is largely Catholic.
                        1a. They're all afraid of condoms, they don't want to go to hell.
                        1b. They're all afraid of condoms, they don't want to GET AIDS (re: Catholic priests telling them condoms cause AIDS)

                        2. Africa is a continent of sex freaks. Those people f*ck like there's no tomorrow, apparently.

                        So, since they won't wear condoms, and they won't stop f*cking everything that moves... what's NEXT on the list? That's the position the researchers are taking.
                        The Internet - where men are men, women are men, and teenage girls are FBI agents!

                        I'm the least you could do
                        If only life were as easy as you
                        I'm the least you could do, oh yeah
                        If only life were as easy as you
                        I would still get screwed

                        Comment


                        • #13
                          Originally posted by az View Post
                          Isn't somebody at least shocked by my link to the dry sex article? I found that most disturbing when I found out about it. EDIT: OIC, the english article doesn't really mention how this is done. In the german article it is described that a powder made of ground herbs, roots and even small stones is inserted into the vagina to keep it dry, which can cause painful wounds in the vagina (of course making HIV contraction much more probable as a side effect).
                          Y'know, having once or twice tried to have sex with a woman who had a "dry" vagina... it's extremely unpleasant. The article says that this makes it "more pleasurable" for the man. They're LYING. It HURTS to penetrate a dry orifice.
                          The Internet - where men are men, women are men, and teenage girls are FBI agents!

                          I'm the least you could do
                          If only life were as easy as you
                          I'm the least you could do, oh yeah
                          If only life were as easy as you
                          I would still get screwed

                          Comment


                          • #14
                            Originally posted by az View Post
                            But that's not really an option, is it?
                            It *is* an option. It's just an option that fewer and fewer people take these days. And apparently condoms aren't a very popular option either in parts of the world, so circumcision seems like a decent alternative to start with.

                            Jammrock
                            “Inside every sane person there’s a madman struggling to get out”
                            –The Light Fantastic, Terry Pratchett

                            Comment


                            • #15
                              Originally posted by Jammrock View Post
                              It *is* an option. It's just an option that fewer and fewer people take these days. And apparently condoms aren't a very popular option either in parts of the world, so circumcision seems like a decent alternative to start with.

                              Jammrock

                              Ok, my previous answer was a bit sardonic, so ...

                              Condoms are eschewed for many reasons in certain parts of the world. Those reasons include, but are not limited to:

                              1. The reasons we don't like them here - they're a pain in the ass to use at times, and they reduce sensation. Only here we're willing to take a small pleasure hit in order to not make babies or get diseases.

                              2. Catholicism, plain and simple. A couple hundred years of putting the FEAR OF GOD into people. The Roman Catholic Church has made condoms a HUUUUUUUGE platform. Of a lesser but also shunned nature are the other forms of avoiding babies... like pulling out or using other forms of birth control. Ironically, Catholicism has once again displayed its utter disdain for "heretical science", since they seem to be totally ok with charting ovulation using scientific methods such as basal temperature. So it's ok to only do it when it's a safe time... that's ok and isn't against god. But a little piece of rubber, well that IS.

                              3. Economics. Over here, $6.99 for 12 screws doesn't seem like such a big expense. In darkest Africa, where - as I stated before - they are all apparently sex freaks, apparently that's a bit pricey.

                              And yes, Jammy... nobody is practicing abstinence anymore. Even amongst the religious, abstinence is a lost cause. I'm not saying I approve of its downfall, but it's well and truly gone. Recent studies show that amongst the very religious (Mormons, Amish, Catholics, extreme Born Agains) there's still a HUGE overall sex-before-marriage rate, percentage-wise. And the more anti-promiscuity the religion is, the more problems it creates. Some studies show that teenagers who are counseled and educated in abstinence programs are TWICE as likely to get an STD or get pregnant as those who are not. We can get into the reasons behind that later - it's a topic unto itself. But my point is that abstinence just doesn't happen by and large in ANY population. Africa is just one extreme.
                              The Internet - where men are men, women are men, and teenage girls are FBI agents!

                              I'm the least you could do
                              If only life were as easy as you
                              I'm the least you could do, oh yeah
                              If only life were as easy as you
                              I would still get screwed

                              Comment

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