Comments on: Promoting infant male circumcision to reduce transmission of HIV: A flawed policy for the US http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/ Advancing global health and social justice Wed, 18 Jan 2012 19:38:27 +0000 hourly 1 http://wordpress.org/?v=3.2.1 By: Circumcision: good in Africa, bad in San-Francisco « Middle Ground View http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-7210 Circumcision: good in Africa, bad in San-Francisco « Middle Ground View Sat, 04 Jun 2011 10:03:02 +0000 http://www.hhropenforum.org/?p=1175#comment-7210 [...] the World Health Organisation is working hard to ramp up the rate of male circumcision in Africa where it decreases incidence of HIV by 50%, the city of San-Francisco is working hard to ban male [...] [...] the World Health Organisation is working hard to ramp up the rate of male circumcision in Africa where it decreases incidence of HIV by 50%, the city of San-Francisco is working hard to ban male [...]

]]> By: P Hoath http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-2416 P Hoath Thu, 04 Feb 2010 18:40:41 +0000 http://www.hhropenforum.org/?p=1175#comment-2416 This is second hand testimony with no corroborating evidence but it does agree with the facts: http://www.youtube.com/watch?v=4AfPajxmfbE This is second hand testimony with no corroborating evidence but it does agree with the facts:

http://www.youtube.com/watch?v=4AfPajxmfbE

]]> By: Frank OHara http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-1103 Frank OHara Tue, 15 Sep 2009 15:07:01 +0000 http://www.hhropenforum.org/?p=1175#comment-1103 "S," you are making the mistake of taking the African studies at face value without critical review. The evidence clearly points to them not only being false but intentionally deceptive. If male circumcision had the protective effect claimed, HIV would be conspiciously absent from The US and any country/locale where male circumcision is the dominant practice. Consider the polio epidemic of the first half of the 20th century. The vaccine was only 70% effective against a disease that is far, far more contagious yet managed to eliminate the infection in a single generation. If male circumcision had the protective effect claimed, we would see a similar situation. Instead, The US has the highest infection rate among the developed nations and among the demographic groups, the one with the highest circumcision rate also has by far the highest infection rate. African American males have both the highest circumcision rate and are estimated to represent 48% of infected males and African Amercan females represent 80% of all infected females. Why has circumcision so miserably failed African Americans? The answer is simply that circumcision provides no significant protection if any against HIV. To understand the deception, you have to look into the history of the perpetrators. The two leaders in the promotion of male circumcision and the HIV studies, Bailey and Halperin have both been rabid promoters of male circumcision for more than 25 years, well before anything was known about HIV. It appears that these studies are simply a continuation of their agenda and an effort to raise their activities to a higher level. . “S,” you are making the mistake of taking the African studies at face value without critical review. The evidence clearly points to them not only being false but intentionally deceptive.

If male circumcision had the protective effect claimed, HIV would be conspiciously absent from The US and any country/locale where male circumcision is the dominant practice. Consider the polio epidemic of the first half of the 20th century. The vaccine was only 70% effective against a disease that is far, far more contagious yet managed to eliminate the infection in a single generation. If male circumcision had the protective effect claimed, we would see a similar situation. Instead, The US has the highest infection rate among the developed nations and among the demographic groups, the one with the highest circumcision rate also has by far the highest infection rate. African American males have both the highest circumcision rate and are estimated to represent 48% of infected males and African Amercan females represent 80% of all infected females. Why has circumcision so miserably failed African Americans? The answer is simply that circumcision provides no significant protection if any against HIV.

To understand the deception, you have to look into the history of the perpetrators. The two leaders in the promotion of male circumcision and the HIV studies, Bailey and Halperin have both been rabid promoters of male circumcision for more than 25 years, well before anything was known about HIV. It appears that these studies are simply a continuation of their agenda and an effort to raise their activities to a higher level.

.

]]> By: Robert Samson http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-1016 Robert Samson Wed, 02 Sep 2009 17:48:23 +0000 http://www.hhropenforum.org/?p=1175#comment-1016 "I don’t think it’s a reasonable option to wait until men are mature/already sexually active to perform the procedure, especially in light of new evidence published recently in the Lancet from the Uganda trials indicating that men did not wait the full time to heal before resuming sexual activity. Thus their female, previously HIV-negative, partners got HIV at a much higher rate than the partners in the control group. This is great evidence for performing the procedure at birth, and proof of the damage caused by waiting.: Gee, yet ANOTHER flaw in the African studies? Started too early, ended too early--the known flaws keep piling up. Talk about "GREAT" evidence--NOT! “I don’t think it’s a reasonable option to wait until men are mature/already sexually active to perform the procedure, especially in light of new evidence published recently in the Lancet from the Uganda trials indicating that men did not wait the full time to heal before resuming sexual activity. Thus their female, previously HIV-negative, partners got HIV at a much higher rate than the partners in the control group. This is great evidence for performing the procedure at birth, and proof of the damage caused by waiting.:

Gee, yet ANOTHER flaw in the African studies? Started too early, ended too early–the known flaws keep piling up.

Talk about “GREAT” evidence–NOT!

]]> By: Robert Samson http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-1015 Robert Samson Wed, 02 Sep 2009 17:44:34 +0000 http://www.hhropenforum.org/?p=1175#comment-1015 "Samson – your second point is a fair one. I meant a longitudinal RCT where randomization occurs at birth (intact/cut) then follow up with lifetime number of sex partners would take a long time, instead of retrospective analysis of natural groups. To my knowledge, there hasn’t been any study anywhere (US or Africa) that has done that… so the potential for an increase in the number of sex partners (”promiscuity”) shouldn’t be used as fuel for people opposed to the recommendations." This HAS been done--in the real world and with ALL variables inherent in the study groups: Reality studies: Duration 30 yrs subjects: >300M Total conversions: millions ratio 1/6 intact/cut African studies: Duration 2 yrs subjects–10,000 total conversions <200 ratio: 2/1 intact/cut Again I have to return to the efficacy of re-doing a study that has failed so miserably in the real world. I think logic CAN be used by people opposed to infant circumcision. “Samson – your second point is a fair one. I meant a longitudinal RCT where randomization occurs at birth (intact/cut) then follow up with lifetime number of sex partners would take a long time, instead of retrospective analysis of natural groups. To my knowledge, there hasn’t been any study anywhere (US or Africa) that has done that… so the potential for an increase in the number of sex partners (”promiscuity”) shouldn’t be used as fuel for people opposed to the recommendations.”

This HAS been done–in the real world and with ALL variables inherent in the study groups:

Reality studies:
Duration 30 yrs
subjects: >300M
Total conversions: millions
ratio 1/6 intact/cut

African studies:
Duration 2 yrs
subjects–10,000
total conversions <200
ratio: 2/1 intact/cut

Again I have to return to the efficacy of re-doing a study that has failed so miserably in the real world. I think logic CAN be used by people opposed to infant circumcision.

]]> By: S http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-1014 S Wed, 02 Sep 2009 17:06:16 +0000 http://www.hhropenforum.org/?p=1175#comment-1014 Hugh7 - I don't think it's a reasonable option to wait until men are mature/already sexually active to perform the procedure, especially in light of new evidence published recently in the Lancet from the Uganda trials indicating that men did not wait the full time to heal before resuming sexual activity. Thus their female, previously HIV-negative, partners got HIV at a much higher rate than the partners in the control group. This is great evidence for performing the procedure at birth, and proof of the damage caused by waiting. Samson - your second point is a fair one. I meant a longitudinal RCT where randomization occurs at birth (intact/cut) then follow up with lifetime number of sex partners would take a long time, instead of retrospective analysis of natural groups. To my knowledge, there hasn't been any study anywhere (US or Africa) that has done that... so the potential for an increase in the number of sex partners ("promiscuity") shouldn't be used as fuel for people opposed to the recommendations. Hugh7 – I don’t think it’s a reasonable option to wait until men are mature/already sexually active to perform the procedure, especially in light of new evidence published recently in the Lancet from the Uganda trials indicating that men did not wait the full time to heal before resuming sexual activity. Thus their female, previously HIV-negative, partners got HIV at a much higher rate than the partners in the control group. This is great evidence for performing the procedure at birth, and proof of the damage caused by waiting.
Samson – your second point is a fair one. I meant a longitudinal RCT where randomization occurs at birth (intact/cut) then follow up with lifetime number of sex partners would take a long time, instead of retrospective analysis of natural groups. To my knowledge, there hasn’t been any study anywhere (US or Africa) that has done that… so the potential for an increase in the number of sex partners (“promiscuity”) shouldn’t be used as fuel for people opposed to the recommendations.

]]> By: Robert Samson http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-1013 Robert Samson Wed, 02 Sep 2009 16:30:50 +0000 http://www.hhropenforum.org/?p=1175#comment-1013 "no one has studied the between group differences in number of sex partners between circumcised at birth and un-circumcised men in the US since it would require maybe 30 years of follow-up?" So, it would require 30 years HERE, but require only 2 years in Africa? How exactly does this compute? Where is the logic? “no one has studied the between group differences in number of sex partners between circumcised at birth and un-circumcised men in the US since it would require maybe 30 years of follow-up?”

So, it would require 30 years HERE, but require only 2 years in Africa?

How exactly does this compute? Where is the logic?

]]> By: Robert Samson http://www.hhropenforum.org/2009/08/promoting-infant-male-circumcision-to-reduce-transmission-of-hiv-a-flawed-policy-for-the-us/comment-page-1/#comment-1012 Robert Samson Wed, 02 Sep 2009 16:27:09 +0000 http://www.hhropenforum.org/?p=1175#comment-1012 " They are general recommendations based on available research. In this case, the evidence points overwhelmingly to the effectiveness of infant male circumcision for HIV prevention, even if all of that evidence comes from Africa." This assumption needs to have an explanation for the discrepancy I posted above--I have yet to have ANYONE provide solid evidence for this discrepancy. Especially in light of this MUCH larger experiment: Reality studies: Duration 30 ys subjects: >300M Total conversions: millions ratio 1/6 intact/cut African studies: Duration 2 yrs subjects--10,000 total conversions <200 ratio: 2/1 intact/cut Which is logically more credible? ” They are general recommendations based on available research. In this case, the evidence points overwhelmingly to the effectiveness of infant male circumcision for HIV prevention, even if all of that evidence comes from Africa.”

This assumption needs to have an explanation for the discrepancy I posted above–I have yet to have ANYONE provide solid evidence for this discrepancy.

Especially in light of this MUCH larger experiment:

Reality studies:
Duration 30 ys
subjects: >300M
Total conversions: millions
ratio 1/6 intact/cut

African studies:
Duration 2 yrs
subjects–10,000
total conversions <200
ratio: 2/1 intact/cut

Which is logically more credible?

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