SOUTH AFRICA: Are circumcised men safer sex partners?

Turns out the answer is no.

A new study published August 1, 2018 in PLoS One suggests that medically circumcised men over 40 carry higher rates of HIV than intact men or men circumcised as part of an initiation ritual earlier in life.

The authors conclude:

Medically circumcised older men in a rural South African community had higher HIV prevalence than uncircumcised men, suggesting that the effect of selection into circumcision may be stronger than the biological efficacy of circumcision in preventing HIV acquisition. The impression given from circumcision policy and dissemination of prior trial findings that those who are circumcised are safer sex partners may be incorrect in this age group and needs to be countered by interventions, such as educational campaigns.

The unstated fact is that men will not opt for circumcision unless it is protective standing alone. Those who do opt for it believe it is. And as such, these circumcised men generally cannot be counted on to adhere to all the other prevention practices and messages when they believe circumcision is protective by itself.

Evidence on the ground, and more formal research generally, will surely bear out the fact that circumcision as a risk reduction measure is incompatible with all the other risk reduction messages and practices, given the loss that circumcision necessarily entails.

And hence, you have the foundation for why infant circumcision is the new focus and emphasis of male circumcision campaigns in Africa. Infant circumcision is the antithesis of voluntary medical male circumcision or VMMC. The proponents of circumcision have shifted their focus. I expect this study will be leveraged in their argument to force circumcision on infants, a population without the capacity to consent or resist.

(As an aside, I would speculate that the reason circumcised men who participate in circumcision initiation rites have lower rates of HIV is because they also are part of a larger culture that reinforces other messages of sexual restraint.)

Citation:  Rosenberg MS, Gomez-Olive FX, Rohr JK, Kahn K, Barnighausen TW (2018) Are circumcised men safer sex partners? Findings from the HAALSI cohort in rural South Africa. PLoS ONE 13(8): e0201445.

https://doi.org/10.1371/journal.pone.0201445

Download PDF: Rosenberg et al Circumcised Men Have Higher HIV Rates – S. Africa – August 2018

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American Circumcision, the movie

Screening now at film festivals throughout the United States, winner of the Lone Star Film Festival best documentary category, an official selection of the Social Justice Film Festival, American Circumcision, a film by Brendon Marotta.

Links:

American Circumision

Lone Star Film Festival

Social Justice Film Festival

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Still here

While mostly dormant, MC_HIV is still here.

I’ll be publishing more old posts that sit in the draft folder (since the transition to WordPress from TypePad) over the coming days and weeks.

Surprisingly (to me), this blog still gets 5-10 visitors a day. Clearly, the subject matter covered here continues to have an audience.

Thanks to everyone who still checks in from time to time.

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COLLEGE HUMOR: The real reason you’re CIRCUMCISED!

Link: http://www.collegehumor.com/

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8 Reasons Vaccination is NOT like Circumcision

Eight reasons why vaccination is not like circumcision:

  1. Vaccination confers immunity against specific diseases; even if the extravagant claims of its advocates were correct, circumcision could do no more than reduce the risk (and not by much). Nobody will become immune to any disease by virtue of circumcision.
  2. Vaccination adds to the body’s natural immune system; circumcision amputates a large and visually prominent part of the penis.
  3. Vaccination provides protection against diseases to which children are at risk and which they may spread to others. Of the diseases to which circumcision is supposed to provide protection, only UTIs are found in children.
  4. Vaccination provides protection against diseases that are highly contagious. The diseases against which circumcision is supposed to provide protection are either non-contagious (UTIs, penile cancer) or of low virulence (STIs and HIV) – meaning that they are not easily communicated from one person to another.
  5. Vaccination leaves at most a small spot or lump; circumcision disfigures and scars a man in his most sensitive region for life.
  6. Vaccination is an injection; circumcision is major surgery, accurately described as pre-emptive amputation.
  7. Vaccination does not diminish the functionality of any body part; circumcision has documented adverse effects on the function of the genitals.
  8. Vaccination is scientific medicine, with proven protective value; circumcision is a relic of Victorian quackery.

Source: Call to Circumcise Ignores the Evidence, Online Opinion, http://www.onlineopinion.com.au/view.asp?article=16264&page=0

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