AUSTRALIA: Neonatal circumcision rejected

From a small LGBT news magazine [link, below, now dead], we have this sober gem from down under. Repetitive of the HIV/circumcision news releases of the time (Aug. ’06), the article generally states that gay men would receive no benefit from circumcision as the research did not include unprotected anal intercourse. It proposes an unfounded and questionable suggestion that maybe the Australian aborigines could benefit from it. Whaaa??

NOTE, 8/13/2013: It’s interesting that this 2006 article was backed up with multiple studies subsequent that showed gay men get no protection from circumcision and women may be at greater risk for HIV from circumcised men. Additionally, we now know that outside the clinical setting, there is no clear marker between circumcised and intact men in regards to levels of HIV. It all depends on what country you are examining, which suggests unexamined confounding factors.

Cautions on male circumcision and the spread of HIV

How much truth is there, let alone evidence, about whether infant male circumcision is of any benefit in stopping the spread of the HIV infection?

by Editor-in-Chief on 2006-08-25.

How much truth is there, let alone evidence, about whether infant male circumcision is of any benefit in stopping the spread of the HIV infection?

Australian AIDS groups have urged caution over calls for a review of Australian circumcision policy, saying there is no evidence the procedure would benefit gay men.

David Cooper, director of the National Centre in HIV Epidemiology and Clinical Research, told the XVI International AIDS Conference in Toronto last week Australia should consider more infant circumcision.

He made the recommendation because trials among heterosexual communities in Africa have shown circumcision could lower HIV transmission risk, The Sydney Morning Herald reported.

Cooper said circumcision could provide protection from HIV infection because it took away the sensitive lining of the foreskin.

Despite the promising African research, there is no evidence increasing infant circumcision in Australia would reduce the risk of HIV infection among gay men, according to local AIDS organisations.

John Kaldor, the National Centre in HIV Epidemiology and Clinical Research’s deputy director, said circumcision had little relevance to gay infection rates because many gay men practised both insertive and receptive anal sex. It’s quite clear that most of the transmission that occurs among gay men is the receptive partner [being infected],
Kaldor recently told Sydney Star Observer.

Whether a receptive partner was circumcised or not would have no bearing on his risk of being infected.

And Kaldor said it was speculation to say gay men practising insertive anal sex had less risk of contracting HIV if they were circumcised.

Australian Federation of AIDS Organisations executive director Don Baxter told the Star the African research might be worth thinking about in relation to some Australian populations, such as Aborigines.

But circumcision was not relevant to gay men’s HIV infection risk.

“We don’t have any evidence that circumcision would be valuable or of benefit to reduce the risk for gay men,” Baxter said.

“And certainly gay men who think that having circumcision will be a significant reduction of risk, if they have unprotected anal sex, is actually a nonsense, I think.”

So thats in Australia, how about other areas of the world?

Circumcision could have a “staggering” effect on the control of HIV worldwide, but the challenge will be convincing men to have it done, former U.S. president Bill Clinton said last Tuesday.

Scientists at the world’s largest AIDS gathering in Toronto reported more evidence that
removing the male foreskin appears to dramatically reduce the risk of HIV infection.

An ongoing study of tea plantation residents in Kericho, Kenya, found dramatically lower HIV rates among circumcised men versus uncircumcised men after two years of followup. Despite serious concerns that men who are circumcised would adopt more risky sexual behaviours, a study of 324 recently circumcised men in Kenya found no excess of reported risky sex. “We should all be prepared for a green light that could have a staggering effect on the male population.”

In the ongoing study in Kenya, the HIV infection rate after 24 months of followup was 0.78 per 100 person-years in the circumcised men, versus 2.48 in uncircumcised men.

That means that, for example, if 100 men were followed for one year, there would be 2.48 infections in the uncircumcised group.

The cells in the foreskin are thought to be more susceptible to HIV infection. But critics wonder how men who refuse to wear condoms will be convinced to undergo a circumcision.
Mr. Clinton told delegates that, if it works, circumcision could be a powerful means to reduce the devastating global burden of HIV.

In addition, studies to date show removing the foreskin doesn’t provide complete protection and there are fears a massive scale-up of circumcision programs could lead to diminished condom use.

Meanwhile, 25 years into the epidemic, there are 11,000 new HIV infections every day.

“Adult male circumcision is available now and is relatively affordable, safe and acceptable. It is also highly effective,” said Kyeen Mesesan of the Yale University School of Medicine.

Reference

Editor-in-Chief. Cautions on Male Circumcision and the Spread of HIV. Generation Q. August 25, 2006.

http://www.generationq.net/articles/Cautions-on-male-circumcision-and-the-spread-of-HIV-00001.html

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