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22 June 2011 @ 03:55 am
A lengthy report "Levels and Spread of HIV Seroprevalence and Associated Factors: Evidence from National Household Surveys" by USAID is available here:

www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

One of the "key findings" is this:

"There appears to be no clear pattern of association between male circumcision and HIV prevalence. In 8 of 18 countries with data, as expected, HIV prevalence is lower among circumcised men, while in the remaining 10 countries HIV prevalence is higher among circumcised men".

It always says this:

"Findings from the 18 countries with data present a mixed picture of the association between male circumcision and HIV prevalence (Table 9.3). In eight of the countries (Burkina Faso, Cambodia, Côte d’Ivoire, Ethiopia, Ghana, India, Kenya, and Uganda), HIV prevalence is higher among men who are not circumcised, although the difference between circumcised and non-circumcised men is slight, except in Kenya, where the difference is substantial (HIV prevalence of 11.5 percent for non-circumcised men compared with 3.1 percent for circumcised men) (Figure 9.1). In 10 of the countries (Cameroon, Guinea, Haiti, Lesotho, Malawi, Niger, Rwanda, Senegal, Tanzania, and Zimbabwe) HIV prevalence is higher among circumcised men."

So why are so many people so keen to promote male circumcision in Africa?
 
 
 
13 June 2010 @ 02:41 am
http://knmg.artsennet.nl/Diensten/knmgpublicaties/KNMGpublicatie/Nontherapeutic-circumcision-of-male-minors-2010.htm

"The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications."
 
 
 
13 April 2010 @ 11:57 pm
Cameroon http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf table 16.9, p17 (4.1% v 1.1%)
Ghana http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf table 13.9 (1.6% v 1.4%)
Lesotho http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf table 12.9 (22.8% v 15.2%)
Malawi http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf table 12.6, p257 (13.2% v 9.5%)
Rwanda http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf , table 15.11 (3.5% v 2.1%)
Swaziland http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf table 14.10 (21.8% v 19.5%)


See also http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."

http://apha.confex.com/apha/134am/techprogram/paper_136814.htm

"Results: … No consistent relationship between male circumcision and HIV risk was observed in most countries."

The South African National Communication Survey on HIV/AIDS, 2009
"12-22% of men and 12-17% of women across age groups (15% in total) also believe that circumcised men do not need to use condoms."
http://www.politicsweb.co.za/politicsweb/view/politicsweb/en/page71656?oid=158053


The one randomized controlled trial into male-to-female transmission:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract
 
 
 
20 February 2010 @ 04:05 pm

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: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland.  Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men.  In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% 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.  The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms".

The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw.

ABC (Abstinence, Being faithful, Condoms) is the way forward.  Promoting genital surgery will cost African lives, not save them.

 
 
 

Canadian Paediatric Society
http://www.cps.ca/english/statements/fn/fn96-01.htm
"Recommendation: Circumcision of newborns should not be routinely performed."

http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
"Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."

"After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions."

Royal Australasian College of Physicians
http://www.racp.edu.au/download.cfm?DownloadFile=A453CFA1-2A57-5487-DF36DF59A1BAF527
"After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision."

 (those last nine words are in bold on their website, and almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%.  "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)

British Medical Association
http://www.bma.org.uk/ap.nsf/Content/malecircumcision2006?OpenDocument&Highlight=2,circumcision#Circumcisionformedicalpurposes
"to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."


National Health Service (UK)
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=649
"Many people have strong views about whether circumcision should be carried out or not. It is not routinely performed in the UK because there is no clear clinical evidence to suggest it has any medical benefit."

Canadian Children's Rights Council

http://www.canadiancrc.com/Circumcision_Genital_Mutilation_Male-Female_Children.aspx
"It is the position of the Canadian Children's Rights Council that 'circumcision' of male or female children is genital mutilation of children."

drops in male circumcision:

USA: from 90% to 57%
Canada: from 47% to 9.2%
UK: from 35% to about 5% (less than 1% among non-Muslims)
Australia: 90% to 12.6% ("routine" circumcision has recently been *banned* in public hospitals in all states except one, so the rate will now be a lot lower)
New Zealand: 95% to below 3% (mostly Samoans and Tongans)
South America and Europe: never above 5%

It's worth remembering that no-one except for Muslim and Jewish people would even be having this discussion if it weren't for the fact that 19th century doctors thought that :
a) masturbation caused various physical and mental problems (including epilepsy, convulsions, paralysis, tuberculosis etc), and
b) circumcision stopped masturbation.

Both of those sound ridiculous today I know, but if you don't believe me, then check out this link:
A Short History of Circumcision in North America: In the Physicians' Own Words

Over a hundred years later, circumcised men keep looking for new ways to defend the practice.

The record payout for a botched circumcision is $22.8 million.  It was said at the time that the victim "will never be able to function sexually as a normal male and will require extensive reconstructive surgery and psychological counseling as well as lifelong urological care and treatment by infectious disease specialists."

Sure, cases like that are very rare, but why should they happen at all?  If you look up the galleries of botched jobs, one thing that may surprise you is just how many jobs were botched cosmetically, rather than medically.  Skin tags and skin bridges and hair growing half way up the shaft are not normal, but would not be counted as medical complications.

News just in last week: A jury in Atlanta has awarded $1.8 million to a boy whose penis was severed in a botched circumcision five years ago. The Fulton County jury also awarded the boy's mother another $500,000.