SAN FRANCISCO BAY TIMES: Dr. Fallon responds to my critique

I would like to thank Dr. Fallon, whose article in the San Francisco Bay Times was critiqued in an earlier post, for responding. This is his response.

Good morning:

I just found your counterpoint to my column in San Francisco Bay Times.

You did correctly find a typo, re: Israel.  The original draft of the article was supposed to say that:

The 1999 study had reported countries with high rates of uncircumcised guys (including Germany, Mexico, and Finland) all had much lower rates of HIV than the U.S.  But the same study notes in its tables that the country with the highest rate of circumcised guys, Israel, has an HIV infection rate 1/32nd of the U.S.’s, proving that circumcision is not the cause of higher HIV rates among circumcised men in the U.S.”

In editing the column down, this is where I mistyped the countries.  Good catch!

Regarding our other point of difference, I do hold that from a point of viral uptake, it doesn’t “matter” to HIV whether a penetrating partner encounters blood in a rectum or in a vagina.  There’s no reason to expect that penetrating gay males would not benefit the same as penetrating heterosexual males had in the the Africa studies.  You’re right, though, that the WHO has not studied MSM specifically in this regard.

Last small item, NYC has indicated that it likely would not fund circumcision.  However, the A.P. story, when I drafted the column, quoted them as saying they were considering it the week before.

Thanks, and happy reading.

Best regards,

Steve

Stephen J. Fallon, Ph.D.

President
Skills4, Inc.
sfallon@skills4.org
htttp://www.skills4.org

My response to his response is that I would only further suggest that it is inadvisable in my view to speculate without evidence that circumcision would have a prophylactic effect in anal sex. Better to stick to encouraging condom use where the evidence of effectiveness is overwhelming. I also take exception to the failure to mention the cost of circumcision. And I’m not talking about the cost in dollars and cents. See the posts of the last few days on this point.

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