Circumcision Studied in Africa as AIDS Preventative

[pnwmom]

http://www.nytimes.com/2006/04/28/world/africa/28africa.html?hp&ex=1146283200&en=97731fa0a8b808b5&ei=5094&partner=homepage

"Armed with new studies suggesting that male circumcision can reduce the chance of H.I.V. infection in men, and perhaps in women, health workers in two southern African nations are pressing to make circumcisions broadly available to meet what they call a burgeoning demand."

SNIP

"The most striking studies suggest that men can lower their own risk of infection by roughly two-thirds, and that infected men can reduce the odds of transmitting the virus to their partners by about 30 percent, simply by undergoing circumcision. Research suggests that the cells on the underside of the foreskin are prime targets for the virus and that tears and abrasions in the foreskin can invite the infection.

"But World Health Organization experts say it would be premature to recommend circumcision until results come in from two randomized controlled trials involving nearly 8,000 people in Kenya and Uganda. Preliminary results could be released by late June.

"Data from earlier studies is 'excitingly tantalizing, and the potential effectiveness looks pretty good,'said Kevin O'Reilly, who is in charge of H.I.V. prevention for the health organization. But it must be confirmed, he said, 'before we officially declare that circumcision is a policy that should be adopted by countries.'"

SNIP

[displacedtexan]

1. Pass the popcorn.

[depakid]

71. These threads get like that

You would think (or hope) that science was just science, especially among progressives.

I guess that goes to show.....

[SmokingJacket]

2. I love the way you put the word "snip" in there! nt

[pnwmom]

4. LOL! n/t

[Warpy]

3. Africa needs this desperately.

The west can still kid itself for a while that AIDS can't happen here the way it does there. It will eventually, but not right now.

In any case, it's a personal decision by the parents.

[pnwmom]

6. Good hygiene is supposed to help prevent disease spread (and

obviate the need for circumcision), but how easy can that be in places without indoor plumbing?

[Warpy]

10. Or water that isn't contaminated with all kinds of bugs

and parasites...

It really can be argued as a health issue in the third world, less so in the first. Here it remains more of a cultural choice.

[Maine-ah]

78. I'll have to agree with that

I've been reading alot on circumcision, I'm pregnant, and If I have a boy I don't think I'm going to circumcise him. My husband feels the same as well.

[Poll_Blind]

5. Passing out condoms does nothing if people don't use them.

For well over a decade, southern Africans have battled the spread of H.I.V. with everything from condoms and abstinence campaigns to doses of antiretroviral drugs for pregnant women — and yet the epidemic continues unabated.

It's not because those methods don't work (speaking specifically about condoms and abstinence), it's because the people do not utilize them. Circumcising everyone isn't going to change the fact that they're still going to be sticking those penises into vaginas otherwise-unprotected. Or accepting a circumcised penis into their vagina under the false belief that men with circumcised penises are less-likely to carry AIDS.

And more people will die.

PB

[Fredda Weinberg]

7. You may be wrong

The studies will show if circumcision reduces transmission rates between heterosexuals.

[Poll_Blind]

8. Fredda, give it a rest. You know as well as I do that circumcision...

...offers nothing in the way of protection versus a condom.

That you would even argue this is...unsuprising, knowing you.

PB

[Fredda Weinberg]

9. Enjoy your ignorance - for the rest ...

The most striking studies suggest that men can lower their own risk of infection by roughly two-thirds, and that infected men can reduce the odds of transmitting the virus to their partners by about 30 percent, simply by undergoing circumcision. Research suggests that the cells on the underside of the foreskin are prime targets for the virus and that tears and abrasions in the foreskin can invite the infection.

http://www.nytimes.com/2006/04/28/world/africa/28africa.html

A condom is useless if a man won't use it ...

[Poll_Blind]

15. Honey, ignorance is hyping circumcision over condoms as you do.

And your argument is a dangerous one, Fredda. If you want to insist that circumcision is somehow superior to condoms well, I can't change your "mind". Myths like the ones you spread are causing huge problems in AIDS-ridden African nations. Educate yourself on the harm it does: Myths blunt Africa’s fight against AIDS

Do you really think that if African nations have problems getting men to wear condoms that it's going to be easier to convince them to get circumcised? And if they do, are they more likely or less likely to wear condoms, which they should be doing in the first place?

PB

[Fredda Weinberg]

32. Enjoy your strawman

I never argued that circumcision is superior to condoms - I'm rebutting an ignorant charge that circumcision is useless to slow the spread of the disease.

If you can't imagine the difference between sex with a condom and without, I can't help you. But in a country where you don't have a drug store on every corner, anything that reduces the chance of transmission is a good thing.

[OneBlueSky]

11. no links to the "studies," no mention of who conducted them . . .

or how they were conducted . . . until I see it in JAMA and/or the New England Journal of Medicine, I'd be very skeptical . . .

[Poll_Blind]

17. I was kind of wondering that myself.

PB

[pnwmom]

20. The article says that the World Health Organization will be releasing

results of two large scale studies in Africa in late June that, so far, look "tantalizing." But at this point, the WHO is holding back on making a recommendation.

[subterranean]

12. The U.S. has one of the world's highest circumcision rates

It doesn't seem to have done much to prevent AIDS here.
I think it would be dangerous to lead people to believe that merely getting circumcised will make unprotected sex safer.

[Poll_Blind]

16. Indeed, but some people in this thread are curiously ignorant of that.

PB

[pnwmom]

21. And we might have had a higher HIV transmission rate if we did not.

[Poll_Blind]

25. "Might"...What does that mean? Does "might" have any empirical weight?

They might also have a lower transmission rate if they copulated with a clove of garlic in their left ear. Might means nothing- condoms are proven to reduce the spread of diseases and unwanted pregnancies. Proven. There's a big difference...

PB

[pnwmom]

27. Condoms are the best. But the data on circumcision, which are

still coming in, appear very promising. Why can't both be used? Here's another link.

http://72.14.203.104/search?q=cache:q8y7i0JCNiYJ:www.wws.princeton.edu/pai/Circumcision2.pdf+%22World+Health+Organization%22+%2BAIDS+%2Bcircumcision+%2Bstudies&hl=en&gl=us&ct=clnk&cd=10

One of the studies it mentions is a randomized controlled study that was discontinued prematurely because the benefit of circumcision was shown to be so high that it was unethical to withhold it from half the study's subjects.

[Demeter]

13. I Suspect Castration Would Work Better.....

or as a last resort, amputation. But seriously, folks....

This sounds like another grasping-at-straws, faith-based, no supporting evidence PR campaign.

[pnwmom]

22. What if the World Health Organization comes out with a recommendation

this summer based on its 8,000 subject studies. Could that change your mind?

[Demeter]

38. If Bush and the Neocons had NOTHING to Do With It.....

[PublicWrath]

14. Here is further info on medical research on circumcision:

http://www.circlist.com/considering/medicalben.html

[pnwmom]

19. I hope everybody reads this. Thanks.

Here's a sample:

From the British Journal of Urology:
http://www.circlist.com/considering/medicalben.html#bjusupp

"At the meeting of the International Society for STD Research (ISSTDR) in Denver in July, Richard Hayes from the London School of Hygiene and Tropical Medicine presented the results of a properly conducted meta-analysis on this issue which he and colleagues have recently undertaken. It showed a strong and statistically significant protective effect of circumcision with respect to HIV infection. This meta-analyis will hopefully be published soon. As I recall, the protective effect without adjusting for confounders was about 0.5 (i.e. a two-fold reduction in risk). This became stronger, to about 0.4 I believe, when analyzing results from studies which controlled for potential confounders. The protective effect was stronger still when analysis was restricted to high risk groups."

And from the Sunday Times, London (same link as above):

"'The presence of an intact foreskin,'says the Short-Szabo paper, 'has consistently been shown to be the single most significant factor associated with the much higher prevalence of HIV in countries of the Aids belt.'

"The link is stronger than with more familiar indicators such as promiscuity, other sexually transmitted diseases and multiple marriage.

"Even more startling evidence came from a recent study in Uganda, reported in February. This showed that among a large group of 'discordant couples' - where one is infected and one not - no circumcised males became infected over 30 months, even though their wives were HIV-positive. Short describes these results as 'staggeringly significant'.

Outside Africa there is the same pattern. Countries with low circumcision rates, such as Thailand, India and Cambodia, have between 10 and 50 times the rates of infection compared with countries with high circumcision rates, such as the Philippines, Bangladesh and Indonesia."

[BadgerKid]

34. "Postpubertal circumcision not protective against HIV"

From the text you linked.

"To further investigate whether later circumcision confers the same level of HIV protection as early circumcision, Dr. Gray's group conducted a cross-sectional study of 6,821 Ugandan men between the ages of 15 and 59 years. The subjects were grouped by age of circumcision: before or after the age of 12 years. In addition, the older subjects were divided into younger (13 to 20 years) or older (21 years or older) age groups.

"Overall, the "...men who were circumcised before puberty had a much reduced risk of prevalent HIV infection than men who were uncircumcised," they report in the February 25th issue of AIDS. "

[LeftyMom]

26. Circlist is a pro-circumcision group run by fetishists nt

[pnwmom]

28. Fetishists with data from the British Journal of Urology?

[LeftyMom]

29. Sure, fetishists can google the same as everbody else. nt

[pnwmom]

30. So, do you dismiss the research or just the fetishists?

[LeftyMom]

31. I'm saying that anybody who would cite circlist either has suspect motives

or doesn't review thier sources very well.

[pnwmom]

33. I think the tide has begun to turn on the issue of HIV transmission.

Here's another link, in which a speaker for the World Health Organization describes as "very promising" the results of a circumcision study conducted for Frances National AIDS Research Agency, which were announced at the Third International AIDS Society Conference on HIV Pathogenesis and Treatment in Rio de Janeiro last July,

http://health.dailynewscentral.com/content/view/0001361/49/

We should know more by early next year when the WHO releases the final results of its research, if not by this summer, when the preliminary results will be announced.

[LeftyMom]

35. The research on that is still sketchy at best

but I see little talk of the ethical considerations and I believe they should be brought to the fore.

For that matter, considering the lack of hygenic medical care in most of sub-saharan africa, I think more research into the potential disease transmission risks caused by widespread genital surgery needs to be done before any recomendation can be safely made.

[pnwmom]

36. Actually, the article I just cited does address ethical considerations,

for example, Gilks, of the World Health Organization,

"said he was concerned that the results of the study would lead many circumcised men to think they were protected from AIDS and fail to take adequate precautions.

He also worried that it would lead many men to rush to get circumcised, and said the World Health Organization was racing to set guidelines for safe and hygienic circumcision.

Gilks said his main concern was that traditional healers might try to provide circumcision without adequate training and without providing counseling on how to prevent AIDS."

[LeftyMom]

37. Those are practical considerations, really

The ethical considerations have more to do with surgery without informed consent, IMO.

[pnwmom]

39. Are you saying that the people in the studies aren't giving informed

consent? Or are you talking about the issue of parents giving consent for the children's treatment? I'm not sure which issue you're concerned about.

[LeftyMom]

40. Two issues

One, minors can't give informed consent.

Two, in many parts of africa (and in many parts of the US sadly) there really isn't sufficient science or health education for many adult men to understand the science involved and give informed consent. In some communities in the US independent patient advocates help in these cases, but I can't see how that could be applied on a large scale.

[pnwmom]

41. Both of these issues would apply to any treatment given to children

or to people lacking in science education. That doesn't mean we withhold treatment, once it has been proven to work.

Every day, parents consent to treatment for minors, for procedures far more risky than circumcision.

[LeftyMom]

42. But those are procedures with proven benefits

Circumcision is a solution in search of a cause.

So far science has found a whole lot of risks ranging from pain and infection on up to loss of the penis and death and only one proven benefit- a decrease in a very rare cancer found almost exclusively in very old men.

[pnwmom]

43. As I said, we'll know more when the World Health Organization makes

its recommendation, based on the results of its large scale studies.

[PublicWrath]

45. One reason penile cancer is rare in this country is

because the majority of our males are circumcised.

[laundry_queen]

46. So

If I cut off my ear lobe, does that mean I don't have to worry about ear lobe cancer? Maybe everybody should cut off their ear lobes. Then we'll have the lowest rate of ear lobe cancer in the world! :silly:

[PublicWrath]

49. Please don't cut off your earlobe!

Unless you hear differently. (Please imagine a smiley here, I can't get the damn thing to go to the right line of text.)

However, it is worthwhile to review some of the statistics on venereal disease and the uncircumcised male. The inner surface of the foreskin is a very fragile mucous membrane, somewhat like the flesh inside the mouth. Because it is easily abraded, it is easily infected. Also of interest are the stories of men circumcised in their adult years. It really does provide a variety of advantages.

The current movement against circumcision began when insurance companies decided to cut costs instead of foreskins. Many companies quit paying for circumcision realizing that most parents would have it done at their own expense, saving the company both the cost of the procedure and the cost of treating the infections which are so common in uncircumcised boys; they also calculated that some of the other problems associated with intact foreskins might occur years down the road on someone else's dime.

[LeftyMom]

50. That's simply not true

The current movement against circumcision was initiated by parents, doctors and nurses who did not wish to subject infants to unneeded surgery or harm thier genitals without consent.

Many insurers stopped covering routine infant circumcision (RIC) because it is a cultural practice and not a medical one. Circumcisions indicated by phimosis and other conditions are still covered.

[pnwmom]

53. I saw the "state of the science" change over the 10 years when my children

were born. When my first was born, the well-educated parents I knew, based on their research, decided not to have their sons circumcised. At that time, according to the Academy of Pediatricians, the risks exceeded the benefits. By the time my second child was born, the Academy had changed their policy to take a neutral stance on circumcisions -- the risks and benefits (including, most significantly, the reduced risk of urinary tract infections) balanced each other out. By the time my third child was born, there was more and more evidence accruing of positive health benefits to circumcision outweighing the risks. At the same time, doctors finally began to use local anesthesia.

So it is not merely a cultural practice any longer, according to the Academy of Pediatricians. There are some good medical arguments that can support the decision, particularly since the incidence of urinary tract infections in boys has increased with the decrease in circumcisions.

I'm sure the issue of HIV transmission, IF it is accepted by the broad community of AIDS researchers, will cause the Academy to take up the matter again.

[LeftyMom]

55. The UTI study was flawed

It compared a coterie of mostly premature intact boys (who were at risk for UTI due to thier premature birth) with term boys who were circumcised. The data were useless and any review of unbiased literature will reveal as much.

In any case girls have a much higher UTI rate and nobody cuts thier genitals to prevent it. We just treat the UTIs when they happen and there's no reason not to do the same in boys.

[pnwmom]

59. There have been many UTI studies. Interestingly, however, the Academy

made another change in position several years ago, this time swinging back in your direction. However, according to this article in the Journal of the American Academy of Pediatrics, the new policy is not backed up by the research.

http://pediatrics.aappublications.org/cgi/content/full/105/3/620

New Policy on CircumcisionCause for Concern

Edgar J. Schoen, MD*, Thomas E. Wiswell, MD, and Stephen Moses, MD§

From the Departments of * Pediatrics and Genetics, Kaiser Permanente Medical Center, Oakland, California; Departments of Pediatrics and Neonatology, Thomas Jefferson University, Philadelphia, Pennsylvania; and Department of § Medical Microbiology, Community Health Sciences and Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

(Note that one of the authors is at an HMO, which has a vested interest in good preventative medicine.)


"The negative conclusions on newborn circumcision drawn by the recent American Academy of Pediatrics (AAP) Task Force on Circumcision are misleading and contrary to the current medical evidence, including data in the body of the report itself1 and in the references cited therein. As professionals closely involved with clinical investigations on newborn circumcision,2-7 we are compelled to express our concern about this report. The Task Force states that newborn circumcision is not recommended and that the procedure is "not essential to the child's current well-being."1 The media and the public are now understandably convinced that the AAP has adopted an anticircumcision stance compared with its previous neutral position on newborn circumcision.2 This attitude has not only been taken by the activist anticircumcision forces but also by the respected media: eg, "Circumcision Loses a Key Endorsement" (Washington Post),8 "Circumcision Benefits Disputed" (Chicago Sun-Times),9 "Pediatricians Turn Away From Circumcision" (CNN),10 and "Circumcision Opponents Energized by About-Face of Academy of Pediatrics" (Forward).11 One would assume that in the decade since the 1989 report,2 new evidence must have appeared demonstrating substantial disadvantage of newborn circumcision. However, the opposite is true.

"Considerable published data from the past 10 years (much of it cited in the current report) confirm and reinforce previous evidence on the medical benefits of newborn circumcision, particularly in protecting against urinary tract infection (UTI) and human immunodeficiency virus (HIV) infection. Pain a major disadvantage of the procedure has been shown to be safely and effectively controlled by local anesthesia. With more proven advantages and fewer disadvantages, how could the Task Force issue a statement that could only be interpreted as reversing previous policy and discouraging newborn circumcision?

"The report of the 1989 Task Force, for which 1 of the authors (E.J.S.) was Chair,2 listed definitive benefits of newborn circumcision: prevention of 3 specific conditions (penile cancer, local infection, and phimosis) and facilitation of good genital hygiene. In addition, we found credible evidence that newborn circumcision prevents UTI in the first year of life.4 Published articles describing a preventive effect on HIV acquisition12,13 were considered preliminary and not included in the report. Disadvantages listed were pain and possible infection and bleeding. In the ensuing 10 years, the protective effect of newborn circumcision on UTI in infants has been repeatedly confirmed,5 and worldwide epidemiologic studies have presented compelling evidence of the protective effect against HIV acquisition.6

"Multiple studies14 comparing the prevalence of UTI in uncircumcised and circumcised male infants have shown a preponderance of UTI in uncircumcised infants. While a meta-analysis described a 12-fold increase for UTIs,14 the 1999 Task Force statement suggests the protective effect of circumcision is less (3- to 7-fold), inappropriately citing among others, the works of Shaw et al,15 Herzog,16 and Fussell et al.17 In reality, the study by Shaw et al yielded an 8-fold increased risk, the Herzog investigation demonstrated a greater than 50-fold increased risk, and the Fussell report did not even address the issue. It seems likely that the prevalence of UTI is higher than reported because it will be underdiagnosed unless urine cultures are routinely taken in evaluating febrile infants. Newman et al,18 reporting for the Pediatric Research in an Office Setting network, concluded that fewer than 50% of pediatricians performed urine culture in evaluating febrile infants <3 months old, despite the high incidence of UTI (>10%) in these infants. In a population-based study of 14 893 males born in 1996 in a closed-panel, nonprofit health maintenance organization with an effective tracking system, 2.5% (1 in 40) of uncircumcised infants developed UTI within the first year of life, most before 6 months old, and were 11 times more likely to develop UTI and 18 times more likely to be hospitalized with UTI than were circumcised infants.19 The subsequent development of renal scarring indicates that UTI in infancy may not be benign.20 As stated in "Information for Parents,"21 evidence indicates that in the first year of life uncircumcised infants have at least a 10-fold increased risk of UTI; a circumcised infant has approximately a 1 in 1000 chance of having UTI in the first year of life, whereas an uncircumcised infant has a 1 in 100 chance. In clinical terms, given that ~2 million boys are born each year in the United States, this 10-fold risk of UTI translates into 20 000 UTIs annually in the United States if all newborn boys are uncircumcised but only 2000 UTIs annually if all the boys are circumcised. Otherwise stated, newborn circumcision is >90% effective for preventing UTI, a preventive health benefit equivalent to the protective rate of many vaccines given to children.22 Despite this implication, however, the 10-fold relative risk for UTI in uncircumcised:circumcised is referred to as a "slightly lower risk."1"

SNIP

Renal scarring is a serious issue. So is invasive penile cancer, which, according to this article, would triple to more than 3,000 cases per year in the event that circumcision were completely eliminated. The article talks about other research in detail. You might want to read it.

[subterranean]

58. Urinary tract infections are much more common in girls

but I have yet to hear anyone advocate preemptive genital surgery for them.

[pnwmom]

61. My daughter has renal scarring based on a symptomless kidney

infection and if there had been a simple surgical procedure to prevent it, you bet I would have consented to it.

[Name removed]

81. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[LeftyMom]

47. Penile cancer is rare everywhere

Including places like Scandanavia where circumcision is nearly unheard of.

Even the American Cancer Society has stated that circumsionion is not indicated to prevent penile cancer. A main risk factor for penile cancer is HPV infection.

http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_Can_penile_cancer_be_prevented_35.asp

[pnwmom]

69. A different point of view, from a pro-condom website

According to this article, circumcision offers even greater protection than condoms against infection.

http://www.condomdepot.com/learn/2004/10/circumcision-condoms-reduce-risk-of.cfm

10/8/2004

"Circumcision, Condoms Reduce Risk of Genital Warts

Associated Press 10-08-04

NEW YORK (Reuters Health) - Human papillomavirus (HPV) is the cause of genital warts, and some subtypes of the virus can cause cancer. Now, researchers report that circumcision and regular condom use seem to reduce the risk of penile HPV infection."

SNIP

"As noted, circumcision and regular condom use seemed to protect against penile HPV. Circumcised men were one-third as likely as uncircumcised men to be infected, while always using a condom halved the risk compared with never using a condom.

"The increasing rate of HPV-related cancers in the US "attests to the importance of understanding HPV not only in women, but in men, who serve as vectors of this ubiquitous virus and potentially as reservoirs," the researchers conclude."

SOURCE: Sexually Transmitted Diseases, October 2004.

[ldf]

64. mastectomies have shown positive results

in the reduction of breast cancers.

so i can assume that you have already made your appointment, right?

keep your myths and prejudices off my dick!

:grr: (getting to be my favorite smiley)

[barb162]

103. I didn't even know there was such a thong as penile cancer n/t

[PublicWrath]

44. It was chosen for the immediate need of getting a lot of info on medical

research on circumcision and disease. There are other linked sites with forums, most are not fetishists, only men who were circumcised later in life and want to share their stories. (A great many men who have lived as sexually active adults, choose circumcision later and are delighted with the results.)

Sometimes it's because of a health issue, such as chronic infection or odor (which is sometimes quite resistant to even the most heroic hygiene) or incomplete retraction, causing pain during sex. Sometimes it's done for other reasons, many men find sensation during sex greatly enhanced without the foreskin sliding forward and shielding the glans.

Others do it for the obvious advantages to their female partners; few women are eager for certain intimacies with an uncircumcised male; even the usual can sometimes feel to both partners like the penis is sliding in its own tube, rather than in the vagina. Some men have it done for sheer aesthetics: the glans of an uncircumcised male is significantly smaller; a circumcised male has a larger and more emphatic crown. This blooming effect develops fairly rapidly, even if a male is circumcised quite late in life.

[laundry_queen]

48. I find this hard to believe.

Sometimes it's done for other reasons, many men find sensation during sex greatly enhanced without the foreskin sliding forward and shielding the glans.

Until, without their foreskin shielding their glans, it loses sensation from being dry all the time and rubbing against clothes. How about mentioning the other side of the coin, hey?
I don't know who all these males who wish they were circumsised are, but can't say I've heard about them. Then again, I'm in Canada where our circ rate is 20% and dropping.

As for this bullshit:
few women are eager for certain intimacies with an uncircumcised male; even the usual can sometimes feel to both partners like the penis is sliding in its own tube, rather than in the vagina.

I've had both types. Let's just say I call BS on that little 'fact'. I haven't met a woman yet who's been with an uncircumcised male who has a complaint. And us women do talk. A lot.

I have heard plenty of complaints from women about their husbands having circ scars or really tight skin around the glans, so tight a large erection hurts. But you didn't mention that.

[PublicWrath]

54. If you haven't heard any complaints you aren't talking to women who

are very active sexually, or very experienced.

As for men, on the backstroke the glans is usually covered by the foreskin, many men are unable to retract the foreskin at all. Being able to feel more of the woman's inner texture is a delight often reported by men who have been circumcised after adulthood. Ask a few men about the importance of the withdrawing stroke and you'll easily understand why many men prefer the glans without a cover. While results can vary, a tight circumcision generally enhances orgasm, at least according to many men who've had it both ways. You are interested in men's opinions, aren't you? Or are you defending a cosmic male baby?

But then you really don't want to consider any of this; you've already decided you're the vanguard against what you consider surgical child abuse. If you could consider the pros and cons a little more dispassionately, particularly medical research, you'd make a better advocate for your cause.

[laundry_queen]

63. ROTFL!

Aren't very active or sexually experienced?
Moms with multiple children and a period of partying and casual sex before that? I'm talking HUNDREDS of women over the last 9 years I've been online. We've all BTDT and discussed it.
LOL.

Not to mention you must not know much about it since when an uncircumsized male is erect, the glans is NOT COVERED. And it doesn't slide back over the glans on the backstroke. I don't know who these 'many men' who can't retract their foreskin are, since that is usually taken care of in childhood, but you seem to know all of them, so who am I to argue.

[LeftyMom]

51. "few women are eager for certain intimacies with an uncircumcised male"

Back that little factoid up, would you?

Bear in mind that most of the world's men are intact.

For that matter, there's a whole lot of "some people say" in that post. I can find similar stories stating the exact opposite on intactivist sites. Try linking to some facts rather than making nebulous comments about percieved aesthetic advantages.

[PublicWrath]

57. translation:

many women would rather not fellate an uncircumcised male, for reasons that I hesitated, and still hesitate, to point out on a public forum, but which will be perfectly clear to many others here.

As far as the difference in the size and shape of the glans, that is quite simply a medical fact, even if you haven't noticed. Whether or not you think an uncircumcised male is more beautiful, you will discover that some have a different preference. You will note, or could have, that I said many men (not all) prefer the look of a circumcised phallus; it is a matter of personal tastes.

If you want to hear the opinions of men who've known life both with, and without foreskins, you might do well to look on some of the forums on Circlist and elsewhere. As I said, men choose circumcision for a variety of reasons. Thousands of purely elective adult circumcisions are done every year. (Men undergoing surgery on the penis to fulfill a fetish are usually looking for results rather more dramatic than foreskin removal.) Surely you don't object to hearing the opinions of a few men on a subject directly touching their own lives?

Unless, of course, you feel qualified to answer on behalf of all males.

[LeftyMom]

60. Of course the men on circlist prefer circumcision,-it's circlist

If they didn't like it, they'd not be posting on a circumfetishist site!

Post some *data* rather than hearsay and unfounded assertions.

For that matter, you still haven't said why intact men have a hard time getting oral or posted any facts to back up that assertion.

[laundry_queen]

62. I'm sure there are an equal amount of men

who wish they weren't circumsised and try to restore their foreskin. There are forums online for them too. Maybe you should check THEM out.

Anyhow, if it's so important for some guys to get circumsised as adults, shouldn't it be for them to decide AS AN ADULT? Not his parents???

[ldf]

65. women would rather not fellate an uncircumcised male?????

and obviously, most men hate performing cunnilingus for EXACTLY the same reasons.

so men have to put up with it, but women are too good for it? what a crock of shit!

i HATE these threads. WHY do i ever click on them. the ignorance displayed is absolutely breathtaking. (much like cunnilingus, huh???)

stupid biases works both ways.

sex is a primal urge, and some of you people want to sanitize it.

disgusting. our sex organs evolved into what they are. i'm sure it happened that way for advantageous reasons. otherwise, all us guys would all have little bald heads down there. naturally.

edit for spelling. what do I know about muff diving???

[Kailassa]

77. I'm not surprised you hate these threads.

The implication that an uncircumcised male is not going to wash is stupid and insulting.
My uncut male keeps clean and yummy, and washing each other is part of the fun anyway.

I could no more have agreed to my sons having their foreskins hacked off that I could have agreed to removing their eyelids, despite me never having slept with an uncircumcised male at that stage.

It took me till I was nearly 50 to find the right guy, and whether or not he was circumcised was not an issue to me, at first. But now we've been together a while, I've found I really appreciate everything about him. It's never been this fun much before.

I'm skeptical about it affecting "crown-size," and I wouldn't want my guy to be any larger than he is. When a body-part does start growing larger like that, it's usually through irritation or the development of scar-tissue, and I'd rather he had the natural protection that keeps the area ultra sensitive.

I'm so glad to hear from a guy who enjoys being the way nature made him, and knows how to make a woman happy. And you won't be wanting to mutilate any babies in that way, either.

:toast:

[QC]

102. As a gay man, I think that women's genitals would look much nicer

if they didn't have all those little flaps and folds and bumps and hair. Just a nice, smooth little hole, like on a Barbie doll! And we won't even get into the smell issue--women formerly had their own sanitary issues, but not under my new régime!

Do you think that this is sufficient reason for women to mutilate their genitals?

[depakid]

109. As a gay man, why would you even care?

:shrug:

[QC]

113. I don't actually.

The point was that aesthetics are not really a very good justification for cutting on people's genitals.

[depakid]

114. Doesn't seem to me the research is about aesthetics

It sounds more like startling results from science.

[QC]

115. No, but much of the discussion in this thread

and the other daily circumcision threads does tend to run along the lines of, "Oooo!! Icky!!" Kinda silly, don't you think?

[depakid]

116. agreed.

Unfortunately, I think it's part of a larger American trend in science and the public health.

[radfringe]

18. so when do the fundies come out

against circumcision claiming it will encourage sex among unmarried heterosexuals or some other blather?

[Opusnone]

23. self delete dupe

[Name removed]

24. Deleted message

Message removed by moderator. Click here to review the message board rules.

[JackBeck]

52. Yuck. What a stupid thing to say.

I think I need to shower.

:mad:

[Robb]

56. No kidding.

Love when liberals put the onus on the oppressed. Homeless? Go home. Unemployed? Get a job. :eyes:

[WindRavenX]

66. good. fucking. grief

:puke:

[Toucano]

67. And hysterectomies prevent ovarian cancer.

Line forms on the right.

[American Tragedy]

68. Interesting, but surely condoms are far more effective for that purpose

Furthermore, if men are unwilling or unable to even put on a condom, how the hell are they going to be motivated to let someone take a scalpel to their penis, for seemingly dubious benefit?

[pnwmom]

70. Actually, at least in the case of HPV transmission, circumcision appears

to offer more protection against infection than condoms (see my post 69 above -- from a condom website).

We'll know more about the results of large studies in HIV transmission when the World Health Organization releases its report.

The NY Times article says that African men are lining up to get circumcisions. Given the AIDS epidemic that exists there, is that really surprising?

In the US, infant circumcision, which is simpler, used to be the norm. It's possible that the pendulum has begun to swing back that way.

[depakid]

72. It's actually very impressive research

When you run the Pub Med searches.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed

[American Tragedy]

73. Circumcision may be better than nothing at all...

but it sounds distinctly inferior to condoms. A latex barrier blocking exchange of all bodily fluids (which has the obvious added benefit of highly effective contraception) is pretty damned reliable.

[pnwmom]

74. Condoms largely prevent male-to-female transmission, which circumcisions

do not do. But circumcisions appear to strongly reduce transmission of HIV from females to males, which of course should lower the amount in the whole population . . . unless males stopped using condoms as a result.

The best thing would probably be if circumcisions and condoms were recommended together . . . but health organizations are going to have a tough educational job. Plus, a circumcision is a one-time operation, while condoms must be used continuously.

With regard to HPV transmission (HPV being the cause of invasive penile cancer and cervical cancer), condoms don't help much. The transmission occurs by a different mechanism. But circumcision does appear to help, at least according to the research I've seen.

[Seabiscuit]

75. Designed for males who don't wash after sex.

[pnwmom]

76. Hygiene is more difficult in places without indoor plumbing or clean water

[Maine-ah]

79. it may help out in places like that, but here in the US in can

be a choice.

I know this will be considered a biased site, because it's called Mothers against circ. but it's pretty interesting none-the-less.

http://www.mothersagainstcirc.org/

[pnwmom]

80. Of course. But the article was about circumcision in Africa.

It is a choice anywhere. But even here, not everyone is middle class or even lower middle class, so good hygiene isn't always something to be taken for granted. People crammed into small apartments with one bathroom might not practice daily hygiene. People without hot water (believe it or not, this still exists in the U.S.) might not either.

[Maine-ah]

82. this article is from last year, but I think it's relavent.

http://www.news24.com/News24/South_Africa/Aids_Focus/0,,2-7-659_1809127,00.html

[pnwmom]

83. Interesting, but just assertions -- no hard data.

I'm waiting to see what the World Health Organization has to say after its large scale studies are completed.

[Maine-ah]

84. this is considered by many to be "mutilation"

a second study an assertion? (same article)

"A second study, unreported by the media, and performed by Stallings amongst African females in Tanzania, showed HIV transmission was also reduced among circumcised females."

http://www.news24.com/News24/South_Africa/Aids_Focus/0,,2-7-659_1809127,00.html

[pnwmom]

85. Since there's no link to that study, there's no way to evaluate it.

And female circumcision is not a consistent procedure -- if it includes infibulation it may as well be a chastity belt, which would certainly cut down on transmission.

[Maine-ah]

86. no, it was mostly unreported by anybody.

but google is your friend, and there is some info out there.

It's just not right to tell people that getting circ'd will prevent you from getting AIDS, because it won't. The only way not to get AIDS is, 1. don't have sex and 2. using a condom.

[Maine-ah]

87. in Africa FC is a consisitent procedure.

Circumcising young girls is a practice that dates back beyond anyone's memory in Kenya. Even though the Kenyan government recently banned the practice, parents are still risking jail terms and heavy fines to put their daughters through this rite of passage. More than a third of women in Kenya between the ages of 15 and 49 have been subjected to some form of genital circumcision. It is clear that the tradition will be difficult to eradicate.

National Geographic Today traveled to Kenya in December because it is the traditional month for circumcision ceremonies. Our intention was to travel southwest of Nairobi to Kisii where we know the practice of these rites of passage still flourish. Although 38 percent of Kenyan women have been circumcised, in Kisii that figure rises to 97 percent.
http://news.nationalgeographic.com/news/2002/02/0220_020219_TVcircumcision.html


it's also pretty consistent in some parts of the Middle East as well.


Unless you're talking about how the procedure is actually done, as in how much is cut away from each patient. But not all male circ's are consistant in that manner either. Some have just enough removed, some have too much removed resulting in very painful erections,or just causing some strangly curved erections that aren't painful, some have so much removed that the penis ends up being damn near removed all together, some end up losing a lot of sensation. Granted, most circ's end up ok, but there are some major issues with them as well. Babies have died from it.



- now, if I could only get my thoughts into one posting.....lol

[pnwmom]

88. The procedure itself has many variations, from almost a token

cut of the tip of the clitoris to complete removal of clitoris and inner labia, followed by sewing the outer labia together leaving only a tiny opening for the passage of fluids. Then, on her wedding day, the bride is cut open. No one can reasonably compare infibulation/circumcision to male circumcision.

I'm saying we don't know what type of FC is practiced in that region, nor what other confounding factors there may be. If you feel like googling for the study, go ahead.

[Maine-ah]

89. If you read the article I posted, you'd know.

[pnwmom]

90. Neither of the articles you posted answers my question. So why don't

you just tell me? Why the guessing game?

[Maine-ah]

93. the National Geographic article describes the types of

FC that go on in this particular area of Africa, which you said that kind of data wasn't available. If you can't be bothered to read what other people have posted, then discussing this with you is useless. It would be like someone not fully reading the OP and just the few paragraphs that were posted.

[pnwmom]

91. Since there are virtually no cultures that practice female circumcision

without also practicing male circumcision, any result that seems to show reduced AIDS transmission with female circumcision may actually be showing the effect of male circumcision in that population.

The reverse is not true, i.e., there are significant populations that practice male circumcision and not female.

Edit to add:

But I did find more info about the Stallings study you mentioned, and the results are the OPPOSITE of the article you posted.

http://www.scidev.net/News/index.cfm?fuseaction=readnews&itemid=2261&language=1

"Also at the IAS conference, Rebecca Stallings, of the US Macro International Research Corporation Company, presented a study of female circumcision.

The trial involved 7,154 HIV positive women in Tanzania. According to Stallings, female circumcision appears to increase the risk of women being infected with HIV.

She says this is because the surgery itself increases the vulnerability of the genital skin.

In addition, says Stallings, circumcised women are more likely to have anal intercourse, which also increases the chances of infection."

Isn't that interesting that her results are being misreported?

[Maine-ah]

94. I had not come across that particular link yet

many links I had found say the opposite. So, yes it is interesting that her particular findings are being misreported, I have no issues with that.

The main issue I have had this whole time is telling people that circ's will stop the spread of AIDS which it won't. The USA is pretty big proof of that, and for some reason you don't seem to get it.

And also, that it is still genital mutilation regardless of gender.

[pnwmom]

96. I think it is up to Africans, in their different countries, to evaluate

the scientific evidence in the context of their societies; and it's presumptuous for us, as middle class Americans, to assume that what might be the best for us is also the best for them.

[Bigmack]

92. Important note....A more important factor in Aids spread....

in Africa than circumcision is the prevalence of "dry sex".

This thread has mostly been about pro & con circumcision - a worthy topic, certainly - but the original post centered around Aids prevention in Africa, I believe.

Nobody else mentioned what I think is the worst factor in Aids spread in Africa.... "dry sex". Neither condoms nor circumcision will slow the spread of Aids while "dry sex" is so popular.
- - -
"Dry, abrasive vaginas are seen as desirable in sexual intercourse in the vast majority of southern African cultures, notes an article in Tuesday's Village Voice. Aversion to moisture in penetration has inflamed the HIV/AIDS epidemic in this region.

Many men and women regard the smell of vaginal secretions as repulsive, the report says, plus they're embarrassed by the noise of wet sex. Dry vaginas that are swollen with friction are also tighter; this pleases the men because it makes them feel larger. One common belief holds that loose, slippery vaginas are evidence of infidelity.

Dry sex promulgates HIV/AIDS in three ways: The lack of lubricant results in lacerations in the delicate membrane tissue, making it easier for the lethal virus to enter. In addition, the natural antiseptic lactobacilli that vaginal moisture contains aren't available to combat sexually transmitted diseases. Finally, condoms break far more easily due to the increased friction.

Sub-Saharan women attain this dryness in various ways. Herbs from the mugugudhu tree are wrapped in a nylon stocking and inserted into the vagina for 10-15 minutes in a procedure that one woman described as "very painful." Mutendo wegudo (dry soil where a baboon has urinated) is a traditional Zimbabwean recipe. A crushed stone called "wankie" is also utilized, reports the Oct. 23, 1998, World African Network, as are potions called chimhandara ("like a virgin" in Shona) and zvanamina ("taste me only" in Ndebele). Shredded newspapers, cotton, salt and detergents are also used."

Information available lots of places, but this was from: http://www.salon.com/health/sex/urge/world/1999/12/10/drysex/

[pnwmom]

97. Thank you! I just read about this somewhere today, as a matter of

fact. But not in this kind of detail.

This kind of information is why it seems wrong for us, as Americans, to be making blanket statements about male circumcision in other cultures. Most of us have little understanding of the cultural context.

[Prisoner_Number_Six]

95. I'm circumcised. I don't have aids. I guess it must be true!

:shrug:

[QC]

98. Does this mean that if I get circ'ed I can get barebacked all I want

and not get AIDS!

Cool!

FUCKIN' A!!!

Um, no, of course not. But that won't stop the circumcision fetishists here from making a lot more of this study than it merits.

[QC]

99. pnwmom, please tell us about your penis.

I look forward to your response, because it will allow us to judge exactly how much your comments here are worth.

The only reason I even have to ask this is that you have carefully disabled your own profile. Please share a bit of personal info and then we can talk.

[sofa king]

100. What about my penis? Can we talk about my penis?

[QC]

101. Sure, tell us about it.

I'm always interested in a nice penis.

[pnwmom]

105. Some of us have brains instead.

[QC]

108. Yes, some, but not all. n/t

[pnwmom]

111. The jury's still out on me but not on anyone who says I'm hiding my gender

[QC]

112. I'm quite well aware of your gender.

That's my point. I was commenting on the utter presumption of your declaring what feels better for men, something you cannot possibly know.

What puzzles me about all this is your enthusiasm for surgically altering other people's genitals. It's very odd, and not a little creepy.

[pnwmom]

117. You're confusing me with someone else. I posted the article about

the issue of circumcisions being used to help in the AIDS crisis in Africa. I never got involved in any of the discussions about what circumcisions feel like. All I care about are the health issues, which I don't think are the same in the US as in countries where many people have poor access to clean water. And I'm not saying the choice is not complicated. Obviously, it won't help the situation if men have circumcisions out of a mistaken belief that they then won't need condoms.

But here's the bottom line: As of 2004, 43% of pregnant women in Swaziland have HIV. A number of other African countries face situations almost as desperate. ALL of us should be obsessing about that. Don't you think?

[davsand]

104. I have to wonder about affluence education and access to health care.

I am not minimizing this study in any way, however, I can't tell from that article if there was any adjustment for level of education and affluence in this study. My logic in saying this is as follows:

Access to health care in many places is controlled by either location or affluence. Frequently, access to education is also is also impacted by those same factors.

There are two things we do recognize that play a role in transmission of STDs--Education and access to health Care...

If they (or their families) had enough affluence and eduction to afford access to health care (to GET circumcised) then it might be that these circumcised males are better educated and in better overall health, generally, than the rest of that study sample.

I hope that this study is significant, and will reduce the transmission of AIDS and other STDs, however, I am reserving judgment yet on how significant the impact will ultimately be.


Laura

[pnwmom]

106. An article about the situation in Swaziland, which has the highest

AIDS rate, I understand. It is hard to overstate how desperate their situation is.

"Even now, with lifesaving retroviral drugs increasingly available, the AIDS rate in Swaziland remains extremely high. The United Nations estimates that two of every five working-age adults are infected with HIV. An estimated 20,000 people here last year died of complications caused by AIDS, and in the past decade the disease has lowered life expectancy from 57 years to 33. There is worry that AIDS could severely depopulate Swaziland, a tiny nation of 1.2 million people on the border between South Africa and Mozambique. "I worry that this younger generation will be wiped away," Dlamini said.

"As hospital wards overflow, avoiding HIV has become a consuming concern for Swazis. Since the South African report appeared saying that circumcised men are 60 percent less likely to contract HIV, the shift in Swazi attitudes toward circumcision -- once widely viewed as unmanly -- has been dramatic and swift.

"Hospitals that once rarely performed circumcisions have recently been doing 10 to 15 a week, with two-month waiting lists. A physician with a radio show has called on his listeners to have the surgery, which removes the foreskin and along with it the cells most vulnerable to HIV. A lawmaker has advocated the procedure in a speech to parliament and demanded that the government increase capacity and subsidies for it."

http://www.washingtonpost.com/wp-dyn/content/article/2005/12/25/AR2005122500749.html

[DemExpat]

107. This link's study seems to say adult circumcision won't help.....

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x2252758#2253329

http://www.circlist.com/considering/medicalben.html#bjusupp

Scroll down a bit for this study:

Postpubertal circumcision not protective against HIV

WESTPORT, Mar 25 (Reuters Health) - Circumcision performed before puberty appears to reduce the risk of HIV infection, according to a multicenter team. However, "...circumcision after age 20 years is not significantly protective against HIV-1 infection." ------------------------------------------------------------------------

Based on these findings, Dr. Gray's group concludes that circumcision before the age of 21 years is protective against HIV infection, but circumcision performed later in life is not.

[pnwmom]

110. I heard about that study. Hopefully the bigger ones being conducted

by the WHO will resolve the issue.

I just read that the HIV rate among pregnant women in Swaziland is 43%. Can you imagine that? No wonder they're willing to try anything.