By Jennifer Thorpe
Male circumcision has been linked to the decreased transmission and contraction of HIV for men. It is being celebrated by scientists as an almost too obvious answer in the struggle to decrease HIV transmission. In South Africa, a country steeped in cultural and traditional ties to circumcision while at the same time suffering from increasing HIV prevalence (in some groups, particularly young women) this link is somewhat of a double-edged sword for women.
Firstly, when male circumcision (and I am speaking about medical circumcision performed by a “Western”* style doctor rather than traditional circumcision performed by a cultural/traditional healer) is touted as a preventative measure, many women will be faced with increased resistance from men with regards to condom use. It has become clear that behavioural changes are as necessary in the struggle against HIV as medical changes and developments are. South African men have been startlingly slow on the uptake and the struggle against HIV has been met with a struggle against condom use by many men. It is perhaps obvious, that when these men who did not use condoms before being circumcised are told about the links between circumcision and reduced HIV transmission they may be even less inclined to put a glove on their love.
Second, if these men are convinced in circumcision such that it becomes seen as an almost 100% prevention method (in reality the numbers are closer to about 60%) they may be more inclined to have multiple partners, endangering the sexual health of their partners through exposure to other STIs and reducing their feelings of responsibility in transmitting these diseases.
Third, if:
- Men have (even further) reduced feelings of responsibility for transmitting STIs and HIV and/or believe that being circumcised makes them unable to contract HIV;
- Are in a relationship with a female partner (or a number of female partners) and
- They become infected with HIV, or learn of their HIV-positive status, then
it is likely that women will be blamed for “giving” them HIV.
In a global culture where women are frequently labelled as carriers of disease and are held responsible for its spread, it is important to consider the ramifications for women in this case.
Stigma is a powerful driver in HIV transmission. It decreases the chances that people will get tested. It serves as a barrier to treatment and community support for people living with HIV/Aids. People living with HIV/Aids are often seen as dirty, sexually unclean, morally loose and are associated with a number of negative character traits regardless of their own character. To advocate for a prevention strategy that will increase stigma associated with women is to advocate for worsening the situation of some of the most socially and economically vulnerable members of society.
This strategy is still being researched and must be recognised as an attempt by the scientific society to find some sort of solution in a climate of pressure to find a cure for HIV.
It must be taken as a step forward, but not necessarily a step that can be taken at the moment. And if the step is taken it must be taken lightly and the interests of all South Africans considered, not least those living with HIV/Aids — particularly women.
*Western is a problematic term for me, as is African, European etc but the use of it here is to illustrate the distinction as it has been created in the media and in public discussion.
Jennifer Thorpe has a master’s in politics and deep commitment to women’s rights.
The newest study shows that male circumcision not only does not decrease HIV risk in women, but it INCREASES the risk of HIV in women by over 50%, about the same percentage as these researchers claim circumcision allegedly decreases the HIV risk in men. They continue to promote circumcision, even though their studies have serious flaws.
It’s pretty clear that WHO and the circumcision promoters are more concerned with advancing circumcision than they are concerned with the health of women.
Circumcision is a dangerous distraction in the fight against AIDS. There are six African countries where men are more likely to be HIV+ if they’ve been circumcised: Rwanda, Cameroon, Ghana, Lesotho, Malawi, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Cameroon, the HIV rate is 4.1% among circumcised men, but only 1.1% among intact men. If circumcision really worked against AIDS, this just wouldn’t happen. We now have people calling circumcision a “vaccine” or “invisible condom”, and viewing circumcision as an alternative to condoms.
ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.
It’s not like we’ve actually tried the things that do work. In Malawi for instance, only 57% know that condoms protect against HIV/AIDS, and only 68% know that limiting sexual partners protects against HIV/AIDS. There are people who haven’t even heard of condoms. It just seems really misguided to be hailing male circumcision as the way forward. It would help if some of the aid donors didn’t refuse to fund condom education, or work that involves talking to prostitutes. There are African prostitutes that sleep with 20-50 men a day, and some of them say that hardly any of the men use a condom. If anyone really cares about men, women, and children dying in Africa, surely they’d focus on safe sex.
Please explain to me how male circumcision assists prevention of HIV, does not seem logical to me.
Brent
Jennifer,
How boring a sentiment??!! I am appalled at the sorriness in your tone. In short what you seem to be saying is that circumcision is to blame for a decrease in the HIV infection rate in men. Which should not sit well with a seemingly male hating lady.
You fail to acknowledge as a fact that circumcision does actually help with the reduction in the HIV infection rate. You fail to acknowledge that when fewer men get infected lesser women are likely to contact the virus. Why? May be because you may well be not very “deep” in your “committment to women rights” but very committed to encouraging women to see men as the custodians of all ills of the universe.
I am very sorry to have read your article.
@PJ Citation needed.
We men sure are bastards. Just can’t trust us with anything. If we find that something helps prevent HIV transmission, why, us dasterdly men will find a way to use it to increase HIV transmission! How evil are we.
If an uncircunsided man is clean and healthy there should be no germs lurking in dark places. If not then who knows what is hidden there? The same applies to women. If they do not keep their private parts clean and healthy then they too may have all sorts of bugs lurking in the dirt.
Back in the dark ages again it seems. Why is it that women are always to blame and never the men?
Finally an article that gets below merely what the latest studies show – and provides some analysis and insight!
Your article points to the fantastic complexity of the HIV/AIDS pandemic: that something which at first appears to be a step towards dealing with HIV infection rates, may actually have the opposite effect.
they scream “circumcision” as a panacea for hiv on this side of the atlantic. this is funny, as in brazil, which has every single one of south africa’s serious social ills EXCEPT a high incidence of hiv/aids, there is a much lower infection rate.
brazil’s hiv prevention policy goes something like this: catch hiv, and you won’t be beautiful anymore.
south africa can’t have a policy like that, as folks this side are not particularly concerned about their appearance. [no, they're not.] the south african diet doesn’t really help either. [fewer phytoestrogens in diet: fewer beautiful people]
focusing on circumcision without focusing on, oh, respect of women, is like giving someone hollow-tipped bullets instead of regular bullets for their gun. you end up doing more damage when it’s used.
mass circumcision as a tool of hiv prevention is yet another way the “donor” community gets to pour money into here without having to do anything particularly uplifting for the place. and yet, people fall for it, as usual.
[that recent article in the new york times really pissed me off, let me tell you.]
This article raises so many issues!
First is that male circumcision affects transmission of HIV. If that were true, there would be glaring differences in HIV prevalence between circumcising cultures and those that don’t. Those differences are not observed anywhere in the world! Comparison of the polio vaccine effect and the effect of male circumcision is a good example. The Salk vaccine wiped polio from the world but The US with an 80% circumcision rate among adult males has the highest HIV infection rate among the developed nations. This is an obvious contradiction that has yet to be explained!
Research also shows circumcised men are more resistant to using condoms. The hypothesis is that circumcision reduces sensitivity and the condom reduces it further to unacceptable levels.
Does anyone else see a train wreck coming here?
.
Dithabana,
you have very clearly missed the boat – and are drowning (or should be).
The article is merely pointing out what could happen if the link between circumcision and infection rates is over-hyped.
Its really a simple point: if people come to see circumcision as the answer to HIV/AIDS (which it is not), there is the risk that when it fails and people continue to contract HIV/AIDS, women may be seen as the cause of the infection (as the man was circumcised after all). And that is a real cause for concern.
Yes, there does seem to be some link between circumcision and lowered HIV/AIDS infection rates. BUT it is important not to overstate that link because HIV/AIDS is a highly complex pandemic and solving it is not as simple as “1+1=2″ (as this author seems to grasp).
Dithabana, I am not male hating. I am however, not a fan of ignorance.
In case you were not clear, in summary my article says that it is important not to assume that because the WHO suggests that something is a quick fix, that it is necessarily true. And that it is important to deliver messages about HIV prevention measures carefully and to give consideration for the broad effects of advocating for any strategy.
Foom, I said nothing about ALL men. I said something about men already inclined towards ignorance as a starting point. Feel free to go out into the world and practice safe sex and prove everyone wrong.
Well thought and articulated article which is very rare to find these days. Yes, Dithabana you missed the boat. While the country continues to face new HIV incidents daily with ABC as our national HIV prevention anthem, what good will circumcision do.
Truth be told-this study is no good even for men. It is not the foreskin that makes us contract HIV or from passing it on to our partners (women, it just increases the risk. Even men who were participants during this study were not compelled to have sex with HIV+ female counter part. It is still not clear if whether those men who were not infected at the end of the study have had sex or whether they used condoms or not. Being that the case we can’t, therefore, rely on the findings thereof such study.
This is really misleading and burden to the country and more burden on women. This study is clearly not a solution to HIV prevention and it undermines all the efforts done by our civil society advocating for condom availability and use thereof.
What this study says to the stereotype is “You can have as many partners as you wish as long as you are circumcised. If you get infected BLAME them “Women”. If they ‘women’ get infected in the process of your experiment- its nobody’s fault they should have been more responsible”
Women have suffered and have a lot to deal with already, i.e. Rape, Cancer, infertility, unemployment etc.
I read about whether male circumcision helps AIDS or weather women benefit from it or not. WHO say 80% of women in africa support it to help with AIDS as if it is a women’s right issue and boys are medicine in a bottle. When will someone stop and think that it’s not all just about AIDS and benefits of women here, but we are talking about young defenceless boys who’s right to choose over their bodies are violated. Perhaps someone should notice they are human beings too and frighten to death for a knife cutting into their genitals. Or do boys not deserve basic human rights?
Thanks for a thoughtful article. The last time I raised this I was shouted down loudly and pointed to these ‘numerous’ studies as if they are irrefutable proof of circumcision being the miracle we’ve all been waiting for.
I can’t help but think that it’s an incredibly dangerous attitude. I read that exact same NYT article and could not believe the arrogance and ignorance displayed. Everything about it screamed ‘those ignorant Africans are missing the obvious! here we give them the holy grail and they ignore it!’
HIV is like a whole bunch of other ingrained societal issues that need to be addressed right down at their roots as well as the odd surface/perception quick win. Circumcision simply doesn’t do either. It creates a dangerous and unhealthy perception that an uncircumcised penis is just automatically clean: bodily fluids just run off it like the proverbial duck’s back. And it does absolutely nothing to address REAL education (both on HIV and generally), REAL attitudes (empowerment of women and re-activating self-esteem of both men and women) and a whole bunch of other real issues.
It just harps back for me to the old debates on routine circumcision of infant boys. Study after study telling how incidence of potentially fatal urinary tract infection is lessened…without acknowledging ever that rates in girls are far higher than even uncircumcised boys.
Let’s talk hygiene. Penis hygiene: UTI prevention. Sexual ‘hygiene’ (yes indeed, SCRUTINISE! CONDOMISE!): HIV prevention.
@ Jen, Micheal and masizole,
I must be an athletic sweemer or a diver as I failed to drown after I “missed” your “boat”. Hence I am proud of myself (padding my shoulder).
Jen
You obviously love symantics. That you cleverly demonstrate in your defence “I said nothing about ALL men”, I regret to quote “South African men have been startlingly slow on the uptake and the struggle against HIV has been met with a struggle against condom”, Jen wrote.
No further analysis necessary. It is safe for me to conclude that you failed to apply your mind (assuming that you have one) in writing glib sentiment.
masizole
Clearly, you don’t have a shred of an idea as to how the research was conducted. Let me assist you there, the research was conducted on men who had female partners who were infected with HIV they found that many of these men who were circumsized did not contact the virus unlike those who were not.
Micheal
At first you seem to have some meat in your bones but when one trys a good deep bite they get dissappointed. You are bleeding, sir!! What you put to me is a result of screwed logic. In fact you waste my time by lying that Jen is just alerting us to “what could happen” and “if people come to see”. Read this article again and you will find that she is saying that this is the case.
How dissappointing???
Jen
It is children knowledge that people get HIV through sexual intercourse so I research was conducted on male sexual partners of women found to be suffering from HIV. Of these male sexual parteners of the infected females some were circumsized and some were not. It was established (by means of medical tests) that, amoung the circumcised males many tested negative for HIV unlike the non-circumsized.
A statistical hypothesis was in order. Males who were not HIV+ and were circumsized were less likely to contact the desease from having sex with women who were infected with HIV. Obviously the infected women may have well been infected by another infected-male.
‘Conserned Man’, the issue here is not solely about the circumcision of young boys but is also about encouraging adult men to become circumcised if they are not already.
But I also disagree with your point that it is not all about AIDS. This article is specifically speaking about HIV infection, and so the reference to circumcision IS all about AIDS. If circumcision is seen as a foolproof means of protecting a man from HIV, and this message is communicated to men who are already adverse to condom use, it is dangerous for everyone that that man sleeps with.
I have my own concerns about traditional and ritual circumcisions, and the many young lives that are lost during this practice, but this article is not about that particular issue.
Kit, you bring up another of the Great Deceptions of male circumcision, urinary tract infections.
There have been a number of studies evaluating and quantifying the prevalence of urinary tract infections in circumcised and uncircumcised infants. Every single one of them except one found that the difference is within one percent. That is statistically insignificant. The one that did find a difference though is always the one that is quoted. The difference was about 2.5%, also insignificant but in discussing this differnce, the difference is always stated as 3X, 10X and up to 30X the infection rate. This is an obvious attempt to “cook” the results to make infant circumcison look better than it really is.
The deception became obvious. The author was Thomas Wiswell, a rabid proponent of infant male circumcision. At the time, Wiswell was a military doctor stationed in a military hospital in Hawaii. Later, Wiswell was on The AAP’s Taskforce on Circumcision. When the deception was discovered, the Taskforce removed him along with his very vocal supporter, Edgar Schoen.
Continued .. . .
Continued . . .
While Wiswell was stationed in Hawaii, there was another study to evaluate the decision by prospective parents if they were given full information on infant circumcision. The physicians were given a scripted information presentation. As a result, the infant circumcision rate dropped from over 80% to less than 20% during the study.
Apparently, Wiswell decided to add some fraudulent research to support infant circumcision. He claimed to have reviewed almost a half million birth records, a task that would have taken him and an assistant more than 30 years to complete. He also segregated his participants into premature and full term babies. Premies are known to be at higher risk of urinary tract infections.
The evidence is that Wiswell didn’t do the research claimed but instead segregated the participants into the two groups and reported the results and did it simply to supprt his fetish. This is well known in medical circles yet the medical machine continues to use his study as proof that infant male circumcision has benefits.
There are simply no benefits to anyone except the one that provides the circumcision. Wiswell himself has stated that a busy circumciser could make $70,000 per year from this one procedure alone and that was in 1987 dollars. It’s little wonder they push it so hard. Wiswell stated that it was like a $100 bill under every foreskin.
.
Dithabana, your comment beginning ‘it is children knowledge’ adds nothing new to the argument. The argument is not about statistics, it is about making sure that we are not jeopardizing women’s rights in search of a ‘quick fix’ for HIV.
Again, missing the boat.
Jen
I got circumcised as part of my culture not because of a WHO report on HIV and circumcision and FYI many of us who share the same culture when coming to circumcision have never and need not to have met any story about circumcision saving us from AIDS. We do it the way we do it primarily because our forefathers did it the way. The idea is to tie ourself to our ancestors ways; and it feels great!
I don’t understand why in your culture men don’t pay lobola or magadi when they get married to their women. It doesn’t make sense to me and it will probably not for the rest of my life on earth. Does my lack of understanding for your way of marriege make your marriege less valid and desirable to you? NOT!
Dithabana, you clearly on quick sand and you’l end up in self distruction.
You are missing the point- this is not about whether Traditional (or any other form of)circumcision is right or wrong. or how we feel, generally, about circumcision or why doing it. It’s about ” can we really rely on circumcission as a solution to HIV transmition, as the reachers claim it to be?
You saying that i seem not have an idea how the study was conducted- swallow those word as they say more about you more that you could ever imagine. All these findings about circumcision being a method of HIV prevention were taken on the bases of three main studies conducted i.e. Orange farm(S.A),Kenya and Uganda studies (research) and participants were randomly selected and blindly evaluated (they were not aware of what the follow up and evaluation after two years of the sudy was all about). it was not on bases of having uninfected circumcised men with HIV positive partners, NO! Your conclusion on the topic is based on assumptions and that’s bad man, DO YOUR HOME WORK!
let me help you here in enriching your mind- check the following links- http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020298
http://linkinghub.elsevier.com/retrieve/pii/S0140673607603122
Being circumcised myself, there’s nothing wrong with circumcision. But that does not simply mean i need not to use a condom.
Affected or infected, HIV is here to stay. Therfore we need to find better strategies in dealing with it and circumcision is certainly not one of those. Jen, I still feel that your article is a step foward in addressing this issue and thank you. You not only rising this an a form of awareness for women but for men too.
Dithabana wrote: “We do it the way we do it primarily because our forefathers did it the way. The idea is to tie ourself to our ancestors ways; and it feels great!”
I’ve read that already this season, 53 young men have died honoring their forefathers. 53 young men struck down in their prime. The life potential for improving the fate of their tribesmen snuffed out. Their potential to father ancestors to carry on the family honor completely wiped out. The potential for achievement of 53 men completely gone.
Is this a reasonable way to honor the forefathers? Is this something the forefathers would endorse? Would they stand tall and say “My grandson killed himself needlessly to honor me?”
I think not. I think they would stand in shame that they had participated in continuing this practice. I think they would mourn for future generations that will not be in their legacy. I think they would say “Stop this insanity now!”
Frnak OHara,
You just mentioned 53. Did you get the figures of those that successfully completed the process? May be not because you are just concerned about disliking everything you don’t understand.
Dithabana wrote: “You just mentioned 53. Did you get the figures of those that successfully completed the process? May be not because you are just concerned about disliking everything you don’t understand.”
The number that were successful is immaterial. There are 53 young men who are dead. 53 ! ! ! One of these young men could have been the next Albert Einstein or a political leader that could have brought Africa out of it’s endemic poverty or another great man in history but instead, his life was wasted for a tribal superstition.
I understand perfectly well. You are all like sheep in the flock willing to buy into this murderous tradition because you have been indoctrinated from early life to believe you are less of a man if you haven’t submitted to the group think. You apparently don’t have the will to think clearly and for yourself and instead are willing to let others think for you.
In any other part of the world, this would be called murder but apparently you are willing to look the other way and let it happen unhindered.
.
Dithabana wrote: “You just mentioned 53. Did you get the figures of those that successfully completed the process?”
That must be a great comfort to the 53 mothers and fathers: “Our son is dead but many other sons are not.”
There are many reasons to question the three trials, in which 73 men may have delayed HIV infection by two years after 5,400 were circumcised. That’s very poor use of money, resources, skill etc. compared to education and condoms. (Meanwhile 673 men, 327 of them circumcised, dropped out of the trials, their HIV status unknown.)
Circumcision for HIV prevention reminds me of the “Nail Soup” story: a traveller offers to make Nail Soup for a family, dropping a large nail in the pot (and asking for onions, carrots, salt, meat, etc to help it along). The family pay a large sum for the wonderful nail that makes such delicious soup. When circumcision (accompanied by education, free condoms, testing and counselling to help it along) causes HIV to fall, people will line up for the wonderful surgery that makes people so safe.
Genital mutilation of men is somehow unfair to women? The author is engaging in communal blame by making the assumption all men are irresponsible when it comes to STD prevention. I wonder if this women realizes a female condom exists? STD prevention is a 50/50 responsibility. Also, keep in mind, women also spread AIDs. Stop blaming men and show some accountability for your own actions.
http://www.nytimes.com/2009/09/07/opinion/lweb06hiv.html?
A response to THAT article.
And a further response of mine to M. Voltaire supra:
Prevention of STDs is absolutely a 50/50 affair. I’m glad someone recognises. That means when a woman says, ‘Let’s condomise,’ the reaction from the man is to cover his penis with a latex. When a woman says, ‘No,’ that means that, for whatever reason, she is unwilling to expose herself/her partner to the implications of sexual contact and the man should curb his enthusiasm.
With rights comes responsibilities and all that. Women have both a responsibility towards prevention and a right to TAKE ACTION towards that aim. Partners need to negotiate condom use. Equal partners are not pushed into unwanted sex through violence, fear or coercion.
If a man does not recognise a woman as an equal 50/50 partner in sex, the woman does not share 50/50 equal responsibility in that relationship (not generally) – how is it possible?
Circumcision of females and males is primitive and barbaric. Worst of all, it is child abuse of the worst kind. If it is such an important Cultural Tradition, why not leave it up to the individuals to freely choose/not choose when they are adults? About the HIV-circumcision issue, does circumcision of females reduce their risk of HIV infection? In all those “studies” of circumcised males, do the statistics include circumcised HIV-free males having sex with uncircumcised females who were HIV positive? Lasty, and perhaps most importantly, there must be virtually no HIV infected people among Jews and Islamists. Do those “studies” provide the statistics? Why all the “studies”, in the first place, when all we need are Government health statistics from Israel and all the Islamist Nations. Ofra Haza, the truly great Yemeni-Jew singer in Israel, died of Aids. She was infected by her Israeli-Jew husband. His circumcision, obviously, did not help either him or his famous wife.
Azra, you are confusing the issue with male and female circumcision. Males are largely circumcised because it is perceived to limit ones health risk.
Females are mostly circumcised in tribal rituals to prevent them enjoying sex as the clitoris is removed. This has nothing to do with health, but is seen as a way to prevent them from having affairs and deserting the marital bed, which they would be less likely to do if they experience no sexual joy or desire.
Actually chillipeppa, boys are circumcised for hundreds of reasons, some contradicting others, some utterly crazy, all inadequate. HIV is only the latest, and there are serious doubts about the studies.
Meanwhile a group of educated, circumcised Sierra Leonean women staunchly defends female genital cutting because it admits them to their secret women’s societies, and they closely compare it to male circumcision. (Well and good, that’s their right, but they claim the right to do it to their daughters too.)
In Indonesia and Malaysia, female genital cutting may be minor and surgical, quite comparable to male genital cutting. Meanwhile 56 boys have died from tribal circumcision in Eastern Cape Province this year alone. When you compare apples with apples, tribal with tribal, surgical with surgical, they’re not so different.
Chillipeppa wrote: “Females are mostly circumcised in tribal rituals to prevent them enjoying sex as the clitoris is removed. This has nothing to do with health, but is seen as a way to prevent them from having affairs and deserting the marital bed, which they would be less likely to do if they experience no sexual joy or desire.”
Chilli, you are the victim of carefully crafted western myths. The reasons for male circumciison in The US and female circumcision in AFrica and Asia are exactly the same:
http://www.fgmnetwork.org/intro/mgmfgm.html
And contrary to popular belief in the western world, FGM does not eliminate a woman’s sexual function:
http://www.fgmnetwork.org/authors/Lightfoot-klein/sexualexperience.htm
The women’s sexual experience after circumcision is much the same as American male’s experience after circumcision.
To completely eliminate the women’s enjoyment of sex would be counter prductive to the men’s aims. The women would become resistant to sexual intercourse.
Circumcsion came about as a result of a Covenant with God according to the Christian Bible. The first circumcision was done on 13 year old boys and men. Jesus is supposed to have died so that this covenant could be discontinued. That aside Jen’s article is a good one simply pointing out that there is no clear proof as yet that circumcision will prevent contracting HIV indefinitely. HIV is more complex than that. Male circumcision may well be viewed as mutilation however as a mother of three son and a daughter of a man who had to be circumcised at the age of 6 years I believe I can speak to this issue. My father remembered the agony of his circumcision with such clarity because it was done at age six that he insisted that my brother be circumcised at birth. My brother has no memory of his. I (and my husband who was not circumcised) wished to have our first son circumcised for the same reason, but the doctor who delivered him refused When he was 4 years old he developed an infection under the foreskin which was way too narrow to pull back and ended up having to have that foreskin stretched under anaesthetic and then pulled back to be cleaned that evening when it was still painfully swollen. We thus had to do the same for out other two boys before they had similar experiences. You be the judge. Do it don’t do it.
@ Jen. I do see one possible positive coming from this and that is that the men who rape little girls and old ladies because they bevieve them to be free of HIV might stop this abominable practice.
I must also take issue with the men who say it is a 50/50 issue. If a man is aroused enough there is nothing that will stop him forcing himself on a weaker in the physical sense, woman.
In the final analysis women do use sex to entrap men by falling pregnant if the men do not want to commit and they have only themselves and stupidity to blame if the man walks away. For that reason alone men shhould use a condom unless of course their culture dictates that you are more of a man the more children you have fathered which is a crock of old horsemanure. Do the women actually know about female condoms in the rest of Africa? Or are they too scared of the paternal society to use contaceptives of any kind? My housekeeper had the injection so that she couldn’t fall preganant for 10 years so that her husband wouldn’t know. She was mostly the sole breadwinner and already had 2 kids as did he and they were fostering a sister’s child. The depo defeated her and before she could be safe again she fell pregnant and almost died in childbirth. He died when the baby was a year old from appendicitis aged 47.
Great piece Jennifer! I am male medical doctor, with research/public health background, as well as reproductive health training, so I have read a lot around the biological, social, ethical, and whatever view around medical male circumcision (MMC) for HIV prevention. Randomised controlled trials (RCTs) that showed MMC reduces risk for men (and NOT IN WOMEN!!) are not the scientific holy grail regarding truth about MMC as a prevention tool in the real world. Remember in the world of RCTs, confounders such as religion etc are “controlled”, so that they do not have a undue effect on the research result. And every research has limitaions, and unfortunately many of those uninitiated in the art of scientific medical or health research do not read this section of the research paper, or question the methodology. And these limitations have serious implications on the validity of the study, especailly on the generalisabilty and implementability of the reseach findings outside the research setting.
In short, the jury is still out regarding the MMC effectivenesss as an HIV prevention alternative, as there are serious fears of escalating the epidemic given what WE men do, including raping infants and virgins in the vain search for own own cure for HIV.
Instead, we men must first circumcise our rogue sexual behaviours, and stop being John Terry’s, Tiger Wood’s, and maybe, JZ’s, and we won’t need to undergo a potentially surgically futile procedure.
Do not circumcise the kids, teach them how to BEHAVE!!!!!
Doctor, thanks for a bit of well written sanity. Maybe you could address exactly why this disease has spread widely in populations that are almost exclusively circumcised. For instance, in Swaziland, 98% of the men are circumcised yet the HIV infection rate there is 22%. If circumcision provides a 60% protective effect, is this even remotely possible? Wouldn’t the vectors of transmission be sufficiently broken that the disease would constantly be blocked preventing the spread to just a few if any?
I await your reply.
.
Hi Frank, Your submission about Wiswell says it all. There plenty of unethically bankrupt and dangerous scientists/researchers out there, very much getting scotfree with murder, literally!
I have no explanation specific question and neither do the staunchest proponents of male circumcision, some of whom are “celebrated” womanisers! The figures you used are what are described as “ecological statistics”, that is, looking at and comparing a quantity for whole populations/countries/regions. Thery have a lot of biases, and only usually a precursor for more analytical and scientific studies like randomised controlled trials.
If you have some statistical background, you could do an ??regression analysis of these ecological data found on the publication: “MC Country update 2009″ which you can google. For each country (mostly Eastern and Southern African Countries) you see estimates of population/country HIV prevalence and estimated MC prevalence. I am still trying to figure out if it would be statistically prudent, using available data, to establsih an association between MC prevalence and HIV prevalence. If MC is efffective as suggested (or observed), then countries with high MC prevalence must have a lower HIV prevalence. But this may be crude (ecological) analysis, because MC is gender specific so ideally you want to compare country MC prevalence with male HIV prevalence. Unfortunately, gender sspecific HIV prevalence was not provided in the publication.
Best regards Frank
Hopefully the idiots that get circumcised in the belief that they can have many sexual partners as they like and not get Aids will lose so much satisfaction from the circumcision that they won’t want to have as much sex anyway!
It would be interesting to know whether circumcision reduces sexual pleasure or not..my guess is that it does..a lot! The original motive for circumcision thousands of years ago by the churches was probably the same as the genital mutilation of woman..trying to reduce sexual activity.
Rick, idiots are those who thought that AIDS was just an American Idea to Destroy Sex.. circumcision as a preventative method to HIV is just fueling that thought… and it feeds heavily to the vulnerability of women in general.. to some extent it also down plays the use of condoms.. To some of us, men, it might be interpreted as if we are now having a natural and a permanent condom..Let’s just think about it comrades, HIV/Aids in our days has colour and character.. And it will not stop till thy condom come…
To circumcise or not to circumcise? This is such a stupid debate. You can be circumcised or uncircumcised and get stds, IF, you sleep around with multiple women and don’t use protection. It doesn’t make a difference when it comes to getting HIV. Use protection and don’t sleep around. Also, you can be circumcised and be dirty if you don’t shower daily. If you live in a developed country like the usa or Britain then hygiene shouldn’t even be an issue. Womens vaginas will end up smelling like fish if the skip a day or two; same goes for them. People are extremely ignorant.