Oh No! It's Another Thread About Circumcision.

[AdmiraalW238]

Re: Male Circumcision to Reduce Spread of HIV

If you are referrring to the Fergusson study of a Christchurch cohort of 500 men (25% circumcised), claiming to show the circumcised men got less STDs, that has been overthrown by the Dickson study of a Dunedin cohort, also of 500 men, but with 40% circumcised (because it started earlier, and circumcision was going out of fashion) so it's more accurate, showing no significant difference between them.

There are lots of problems with the three Randomised Clinical Trials claiming to show circumcision prevents HIV:

* Not double-blinded
* Not placebo-controlled
* Significant drop-out rate - 5 times as many as were known to be infected. (And if you had endured a painful and marking operation "to protect against AIDS" and then got tested elsewhere - as they were encouraged to do, because it was considered "unethical" to tell them they were HIV+ - would you go back to the people who had done that to you?)
* Non-sexual transmission ignored
* Non-identical treatment of controls and experimental group
* One of the three trials used a method that removed significantly less tissue than the others, yet the "protection" was the same.

They love quoting "60% protection" (they've now upped it to 65% by very dubious means), but that would amount to an average of 39* circumcisions - a day's work for a fast surgeon - to delay - not prevent - one HIV transmission. Compare that to the cost of condoms.

*in Africa - much more where HIV is less prevalent

In several African countries, the HIV rate is higher among circumcised men than non-circumcised, according to the National Demographic and Health Surveys.

But the circumcision enthusiasts bypassed the criticisms by going direct to the media, which LOVE circumcision (The Fergusson study got headlines worldwide, the Dickson study was buried on page F17).

Two things ...

1. If you are going to quote studies people may find it helpful if you actually provided a source.

2. As I have said in other areas of these forums not all clinical trials need to have a double-blind randomization or a placebo control. You do know what a placebo is, don't you. How can you have a placebo in a clinical trial about circumcision?

 

[Shepherd 2]

Re: Male Circumcision to Reduce Spread of HIV

If you can't get men to slip a condom on, how can you expect them to slice off part of their penis? Fuck that shit.

Lex

Lex, this answer is priceless. Thanks.
Some are always more ready to do surgery than to change attitudes.
It appears so clear cut.

Sounds a lot like when they used to give lobotomies to depressed people.

Shep+

 

[3stripes]

Re: Male Circumcision to Reduce Spread of HIV

There is sufficient evidence to show circumcision reduces transmission of syphilis.

Yet, the US with its high rates of circumcision has quadruple the rate of syphilis than scandinavia.

Circumcision is only part of the equation, and even if it were adopted I would predict a 5-10 year slowing of the epidemic before it returns to current levels unless other parts of the equation are addressed.

Overall, the benefit is likely to be minimal.

 

[CharlesII]

Re: Male Circumcision to Reduce Spread of HIV

If that huge photo up there isn't reason enough to call for mass routine circumcision, I don't know what is. Excuse me for a moment (where is my barf bag?).
All of you seem to be missing the point of the research and recommendation, and are taking the problem out of its context.
The encouragement of circumcision is aimed mainly at third world countries where people do not have the ready access to soap and hot water, condoms, sex education and common sense that we take too much for granted. Those are the cultures that are experiencing the most epidemic spread of disease, and a drastic health problem calls for drastic remedies.
Do you want to cut off their foreskins, or cut off their lives? Take your pick. And if you make the wrong choice, ask yourself if you can be sure a killer disease will be contained on "their" continent and never reach yours (again).
If it comes to life and death, a foreskin is the last thing on earth I'd have to think twice about getting rid of.

 

[mattad]

Re: Male Circumcision to Reduce Spread of HIV

...and soon enough there will be some other study to prove just the opposite of this.

 

[markriley]

Re: Male Circumcision to Reduce Spread of HIV

Uncut dicks look nasty! I never suck them.

 

[3stripes]

Re: Male Circumcision to Reduce Spread of HIV

yeh, but it aint gonna save lives, its just going to delay the time until infected!

 

[Garawr]

Re: HIV & Circumcision - is there a hidden agenda?

Yeah it's a long post...whatcha gonna do about it?

But the cliff notes of course.

 

[G-Lexington]

Re: HIV & Circumcision - is there a hidden agenda?

It's not that I don't believe in conspiracies and/or hidden agendas. But serious, why one for pro-circumcision? Circumcision doesn't make anybody any money, or give someone power, or anything else. All I can come up with is:

1. It gives medical justification for those who practice it for religious reasons.

2. It makes people feel better about the fact that they were mutilated by misinformed parents back in the day.

Neither of those seems like reason enough for a large group of people to push their agenda forward.

Lex

 

[josher]

Re: HIV & Circumcision - is there a hidden agenda?

Noelie, you're a good guy, but whether or not being cut is more advantageous than being uncut doesn't even make it to the top 100 list of things that I consider important enough to care about in this world.

I've read so many ranting comments from cut adult men who are furious about their parents allowing them to be "mutilated", it isn't funny.

When I read them my only thought is, if that's your worst problem in life, get down on your knees and thank God every day.

 

[propoolplayer99]

Re: HIV & Circumcision - is there a hidden agenda?

so why is the pro-circumcision lobby getting almost all the media attention when there is a viable opposing viewpoint?

Pro-circumcision gets the media attention because it is backed by research in peer-reviewed journals. In other words, it's fact, or the closest thing we can get to the truth. Although not perfect, peer-reviewed journals produce the highest quality evidence through critically appraised studies (like the famous randomized control trial among others).

 

[Willie Boy]

Re: HIV & Circumcision - is there a hidden agenda?

I don't get this whole circ/uncirc issue. I was cut as a child, and you know what? I'm not complaining. But for the sake of argument, let's say I wanted to, what would it do? Its not like it can be undone.

It seems to me that all this came about because some uncut people didn't like being different but were to afraid to have it done. Get over it! If you can't stand being different, you might as well be straight!

For those of you who can live with yourselves as you are, kudos.

 

[OptimalOptimus]

Re: HIV & Circumcision - is there a hidden agenda?

i've also made a post on this. and is't non-sence right wing agenda

i love how religion makes people this by cutting off part of there gentials it brings them closer to god.

GIVE ME A FUCKING BREAK!

- PROUD FORESKIN OWNER -

 

[propoolplayer99]

Re: HIV & Circumcision - is there a hidden agenda?

I heard that global warming is a conspiracy too. I read it on websites. Experts told me. And even though there's overwhelming research, I read that some of the studies have design problems.

Down with circumcision! Down with climate change!

...silly people

 

[_AJ_]

Re: HIV & Circumcision - is there a hidden agenda?

I think that it makes sense that if your circumcised you have a slightly reduced risk of infection but something in the order of 10%

but that still leaves you with a 90% of the uncircumcised rate i mean you can still get infected so what difference does it make HIV does not equal a reason for circumcision unless you intend to have unprotected sex a lot

i find it interesting that people take this to the extreme though

somebody found something out so they want us to all be circumcised

rather than here are some results oh thats interesting is there any use to this meh not really maybe in developing countries where they cant get condoms
well woulden't it be cheaper to send them condoms well maybe but ........

 

[3stripes]

Re: HIV & Circumcision - is there a hidden agenda?

Circumcision - a religious procedure in search of a medical justification.

Simplistic reductionist research produces results, but the applicability of those results to a complex real world can be limited.

Lobotomy has been proven to reduce the incidence of brain tumours by 100%. I fear some Jubbers have read this research and willingly followed it - like lambs to the slaughter.

 

[blackbeltninja]

Re: HIV & Circumcision - is there a hidden agenda?

Well, being in the medical research field, it is my opinion that the infamous WHO study which started the recent debacle would have been well thought-out by experts in study design and statistics.

That's what the WHO does - finds EXPERTS in these things so that their studies are conducted ETHICALLY and PROPERLY, because nobody wants to have to tell their funding agency "actually, we kinda didn't think this one through and it's been a colossal fuck-up and a complete waste of time and money."

Having had some experience with clinical trial design and implementation, I'd like to point out that you don't dream up the plan on Saturday and start your study the next Monday - these things take MONTHS of planning, study design evaluation, more planning, re-evaluation, further evaluation by the relevant local (state) and national government health department, usually an external ethics body, several ethics and other committees at your university (if it's an academically conducted study). After that, once everyone is satisfied that the study is relevant and able to be carried out PROPERLY, you conduct the study and write up the results for publication. It is then sent to further experts by the journal editor to make sure that the analysis and interpretation is correct before it gets published.

I'm inclined to take the WHO study, which has been through this lengthy process and peer-reviewed by other EXPERTS in study design and say that the findings are very probably accurate. Exactly how much of the data can be extrapolated away from the environment in which it was gathered is debatable, as always, because the study population is a limited microcosm at best of any other population anywhere else in the world.

I agree with Lex, though - there's no money to be made here, so I don't see it as being a hidden agenda. I also agree with Josher - if being circumcised at birth is the worst thing which has ever happened to you, be grateful. Especially if your dick works fine, you feel all the wonderful sensations, and it gets up and does its thing when you need it to.

-d-

 

[3stripes]

Re: HIV & Circumcision - is there a hidden agenda?

WHO found EXPERTS in circumcision studies..... but the OPs premise is that these experts have a considerable personal bias. It is quite possible to design and conduct a rigorous scientific study and have it published in a peer review journal despite it having considerable short-comings.

The numerous conflicting expert peer reviewed studies on a multitude of topics proves that being expertly peer reviewed amounts to ..... (insert suitably derisive noise here).

 

[blackbeltninja]

Re: HIV & Circumcision - is there a hidden agenda?

Firstly - no one said that they dreamt "up the plan on Saturday and start your study the next Monday" and by using that tactic and identifying yourself with these 'experts' and your constant use of upper-case tells me all I need to know."

Oops. This is entirely what I was hoping to avoid.

What I was trying to put forward is that the WHO study, like any other decent study, would have taken months to plan, even longer to be approved, and then carried out over a significant period of time. The whole point of my opening three paragraphs was to demonstrate that an almighty amount of thinking went into this thing and that a likewise almighty amount of analysis and discussion would have happened before the study was published.

I have mentioned previously in other threads that my area of research is in fact malaria, and that I am most definitely not an expert even in that. However, I have worked on fifteen clinical studies - mostly commercial, but with several WHO or regulatory body-based ones - conducted by my unit and do know of the colossal amount of behind-the-scenes stuff which accompanies any such endeavour.

However, you neglected to comment on the thrust of my post, so I'll quote myself and highlight the important bits of it for the record:

I'm inclined to take the WHO study, which has been through this lengthy process and peer-reviewed by other EXPERTS in study design and say that the findings are very probably accurate. Exactly how much of the data can be extrapolated away from the environment in which it was gathered is debatable, as always, because the study population is a limited microcosm at best of any other population anywhere else in the world.

Fact of the matter remains - the WHO is unlikely to put out some drivel which will tarnish their reputation and undermine confidence in them. They are more likely to look at the study data 6 ways from Sunday before publishing it and putting spin where it needs to go.

(insert suitably derisive noise here also)

This bit made me laugh.


-d-

 

[blackbeltninja]

Re: HIV & Circumcision - is there a hidden agenda?

^Yes, I avoided doing that intentionally. I don't really have a good argument for it - we've produced and published some data which has countered some previously published (and highly regarded) data which came from some top researchers and was in a top journal. Ours was largely neglected, though, even after we shot down their premise and conclusions with some really good, solid data. We even tried for Nature, but it was bounced and ended up elsewhere.

Also, I don't want to criticise the WHO too much - my unit, and even my own research work, is too heavily entrenched in them (and their funding) for me to do so in good conscience. I guess that's what the lawyers would call a conflict of interest!

I maintain, though, that they are unlikely to go off half-cocked. All my dealings with them have left me with that impression.

And in fairness, that BMJ article about fellowships was published in 1995 - you'd need something a little more recent to really have a crack at them. And that one about the vaccines - don't forget that WHO does not have executive power. They are still largely limited by local infrastructure and willingness to participate, and in most cases the lack thereof.

-d-
EDIT: I realise I am skirting the issue here. BOT, everyone!