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20 February 2010 @ 04:05 pm
circumcision doesn't work against AIDS  

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.

 
 
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ml66uk on February 20th, 2010 04:10 pm (UTC)
references
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
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