This past week, the World Health Organization issued a plea for circumcision of males in those countries (mostly sub-Sahara) with the highest incidence of HIV infection. Their report and request states that circumcision is the biggest step these nations could take to reduce the spread of AIDS.
Wed, 04/04/2007 - 21:23
#1
Update on Circumcision
How do they implement circumcision in like 3rd world countries where people barely have food and shelter, much less medical care?
It's sad, b/c then they might end up w/ an infection and die from unclean procedures.
I remember learning in my HIV class how young girls were getting infected w/ HIV b/c some of the older men "believed" that if they had sex w/ a clean virgin... it would cure them. Those poor little girls!! :(
How does circumcision reduce the risk of AIDS??? Sorry - I must be really behind the times!
Can you give a link to what you're referencing? Is it more current than this?
edit - I found it, but I don't see where they address many of the points below that were included in their earlier bulletin.
http://www.who.int/bulletin/volumes/84/7/news10706/en/
"There are other concerns about circumcision. During the healing period, sexually active men are likely to be at higher risk of HIV infection. During this time — approximately three to four weeks — men should be instructed to refrain from sexual activity. There are opponents of male circumcision who see it as a violation of human rights, particularly if carried out on children or adolescents. But perhaps the largest potential problem with circumcision is the false perception of security. Male circumcision is not a magic bullet and does not provide full protection. If men perceive they are fully protected then it could lead to a decrease in condom use or an increase in risky sexual behaiour. This was seen in the Orange Farm study when the intervention groups had significantly more sexual contacts. Dr Venter says: “There is a danger that men will see circumcision as an invisible condom and take part in more risky sexual behaviour. However, it would be the same with an HIV vaccine. The message has just got to be put across carefully that circumcision is part of the jigsaw puzzle of prevention.” Male circumcision needs to be promoted as part of the range of methods to reduce the risk of HIV, including avoidance of unprotected penetrative sex, reduction in the number of sexual partners and consistent condom use."
Pretty much echoes the same concerns that were brought up in an earlier thread on this subject. While no doubt helpful in areas of the world where HIV is rampant it's a poor second to aggressive education in condom use and safe sex behavior.
Bear,
You cite the basic study, Thanks. There have been continung efforts and the UN, like governments, moves slowly. The updates are mostly an iteration of the original study. Last week there notices circulated through medical channels throughout the world and I also read it in The Independent (a nationally distributed paper in the UK).
Canoodle,
The volume under the foreskin on an uncircumcised man requires constant hygiene. In some local studies, swabs have been taken from the corona of uncricumcised men and circumcised. The uncircumcised men carried many more bacteria of various types than the circumcised men. This area carries both virus' and bacteria and increases the chance of both contracting and giving STDs of all sorts. The classic studies, first noted 100 years ago and seriously studied for forty years, focus on cervical cancer in different populations. Those cultures who have traditionally practiced circumcision have (Jews and Muslims) have much lower incidence of cervical cancer than other cultures. In a large German study about ten years ago and with ongoing follow up, women with circucised partners have lower rates of cervical cancer than those with uncircumcised partners.
Demon,
In groups throughout sub-Sahara Africa, education has been attempted, condoms have been distributed by the millions and circumcision has been tried. The most successful attempts have been those group using circumcision. Some NGOs that give health care (Medicins sans Frontieres, for example) do hold patients for a few days after circumcision and educate them in the process.
Imagina a population that will have in excess of fifty percent babies born already infected and you can see this is a seemingly intractable problem.
Whatever works and, in this case, the WHO is pleading with richer countries to help pay for the effort.
This may be controverscial, but... wouldn't hygiene and safe sex habits do the trick? Quite frankly, I'm scared about this.
In the news, they give a bad POV. They almost sell circumcision as the AIDS vaccine! Get it done, do sex all you want, when you want, how you want with as many people as you want.
Considering hygiene and safe sex (either condoms / same partner, etc) are two absolutely basic premisses in a good sexual development and sex life, this situation almost parallels blaming videogames as the cause for violence in kids. Nevermind tv, radio, newspapers, etc. Same here. Let's cut ourselves, never mind the hygiene and safe sex habits...
My 2 cents
HIV and circumcision
This is a good link... basically it says that in one study the people of Uganda had access to condoms and education... but like 89% of men didn't use them.
The transmission had something to do w/ certain cells located in the foreskin?!?
Alban:
The issue is the extra tissue which is present causing bacteria and viruses to trap and breed. All the hygiene will not stop this. It's the same as those who have skin folds. You can keep your areas clean but the extra folds do not allow the warm moist areas to dry, expose themselves to air nor to rid themselves of the disease. Hygiene helps but is not nearly effective as the alternative.
[QUOTE=sera300;177213]Alban:
The issue is the extra tissue which is present causing bacteria and viruses to trap and breed. All the hygiene will not stop this. It's the same as those who have skin folds. You can keep your areas clean but the extra folds do not allow the warm moist areas to dry, expose themselves to air nor to rid themselves of the disease. Hygiene helps but is not nearly effective as the alternative.[/QUOTE]True enough, but let's keep one fact straight here. If you are uncircumsized and NOT using a condom you stand a better chance of catching a sexually transmitted disease. If you ARE using a condom and practicing safe sex I don't think the statistics are significant. In areas of the world like Uganda it may be a valid point to promote the procedure, but alban is right in that it's very dangerous to (perhaps unintentionally) give the impression circumsion as a preventative measure will lesson chances of infection, therefore people conclude they can lighten up on normal safe sex practices. In developed nations where education in this area is high and people understand the importance of protected sex these kinds of news items, given in short headline or sound bites can be problematical.
[quote=DVDBear;177241]True enough, but let's keep one fact straight here. If you are uncircumsized and NOT using a condom you stand a better chance of catching a sexually transmitted disease. If you ARE using a condom and practicing safe sex I don't think the statistics are significant. In areas of the world like Uganda it may be a valid point to promote the procedure, but alban is right in that it's very dangerous to (perhaps unintentionally) give the impression circumsion as a preventative measure will lesson chances of infection, therefore people conclude they can lighten up on normal safe sex practices. In developed nations where education in this area is high and people understand the importance of protected sex these kinds of news items, given in short headline or sound bites can be problematical.[/quote]
Agreed. I was looking as the physical dynamics associated from what I actually see.
This is news to me, but then again Im already circumcised.
Still good to know about.
Wow,after reading all the feed back,gotta say im alittle spooked,seeing is how im un-circumcised.So from my understanding,to be 'un-cut' is to be kinda not healthy? or does it mean to take better care of yourself?
Brandye has a post around here about the WHO calling for circumcision in third world countries to help decrease the risk of HIV. Also uncut men have a higher rate of infecting partners also with HPV. Where I am most men are circumcised and in the ones who are not fall susceptible to infections under the foreskin from lack of proper cleaning.
If you are not circumcised, it's important to retract the foreskin and clean well with soapy water. The be certain the area is very well dried before returning the foreskin to it's normal position. Warm moist dark environments are breeding grounds for nasty bacteria & a virus.
Basically, just wash carefully and you'll be fine.
I would think that the biggest step in reducing HIV infection would be using condoms.
Deleted Duplicate Post Made In Error. Sorry!
Did you ever attempt condom distribution in the third world? A mess.
The HPV vaccine targets those four strains that are statistically related to cervical cancer. We women are the ones at risk and those four strains have no known effect men. My guess is that the expense would be doubled with no payback. And it is not known whether they would reduce HPV in the men where it is stored differently from how we women store it.
For the States, right on.
The campaign for increased male circumcision as a way to reduce HIV transmission has got to be one of the most foolish and phallocentric public health ideas out there.
First of all, it provides no protection at all to the female or male being anally or vaginally penetrated by the circumsized man.
Secondly, transmission rates will be much higher for newly circumsized men during the healing period.
Finally, too many people all over the world will begin to equate circumcision with being HIV negative, and undoubtedly circumcized men will make it another lame excuse for not using condoms.
Washing up or urinating after sex provides minimal, if any, protection against HIV and other STIs. Not ejaculating inside a person provides the circumcised man's sex partner with more protection than washing up, but not nearly as much protection as a good condom properly used. Condoms are essential for everyone who has sex that includes a human penis.
How does circumcision reduce HIV transmission? Because when males penetrate the anus (rectum) or vagina, HIV can be absorbed through the mucous membranes of urethral opening (pee hole), any open lesions (sores) on the shaft of the penis, and through the thin delicate pink skin under the head (crown) of an uncircumcised man.
In a circumcized male, the skin beneath the head toughens up so that the skin forms a good barrier against HIV infection ONLY IN THAT AREA OF THE PENIS. Other areas are still vulnerable and need to be covered by a condom. And without a condom, you can get other nasty sexually transmitted infections as well, not to mention pregnant if you are a female.
BTDT, you are missing the key point. In areas of sub-sahara Africa where men have been circumcised have seen reduction in HIV infection. Read back through the posts and you will find my posts on HPV infection of women and the resultant cervical cancer. Circumcising does protect women. Completely, no; in this global battle, every little bit helps.
You will also find a post in which I state no uncircumcised has ever been in me without protection - and never will be. That is well thought out.
Thanks for the catch, Brandye. I should have started my last post with the fact that the New York City Health Commissioner recently was trying to push circumcision as an effective way to reduce HIV infection rates in New York. He based his policy initiative on the African research, as if the findings were readily transferable to our culture and society. That was my unstated starting point. Sorry for not being explicit.
It seems to me that something of only a little help in HIV transmission should rank far below condom education and distribution. Abstinence and marriage are being promoted in 2/3 of U.S. public schools as the only "safe sex," so we really need to get back to funding condom use basics as a spending priority. I wouldn't want to see any public health funds diverted to circumcision promotion when we still refuse to teach U.S. kids about the importance and effectiveness of condom use against HIV/STIs.
I have mixed feelings about the HPV vaccine as well. Routinely giving girls the vaccine is a promising weapon in the battle against cervical cancer, although I am a bit concerned about side effects and what sort of research was done to make sure the vaccine is safe. Are policies governing the distribution of this vaccine driven by public health needs or pharmaceutical company profit needs?
But why give the vaccine only to girls and not to all children? What about the growing recognition of anorectal cancer in gay men that appears to be directly correlated with HPV infection through anal sex? Couldn't boys benefit as well? And how would an unvaccinated girl or boy become infected? Most of them through sex with unvaccinated boys. So why not make it a universal vaccine for every child's benefit?
These questions are not a challenge to the wise and accurate thoughts you have contributed here, but rather rhetorical questions that I think deserve consideration by any reader.
Thanks!