Does circumcision prevent HIV in women?
No, but it does seem to prevent proper brain functioning.
In what I can only describe as an act of pure desparate idiocy, Diane Cole tries to launch a "rebuttal" to the proposed ban on male circumcision that will be on the San Francisco ballot this November, shooting her own self in the foot.
http://online.wsj.com/article/SB10001424052702304066504576343492869888506.html
And then our very own HIV test results—his and hers—arrived. Peter was positive. I was negative. How had it happened that I never became HIV-positive myself?
It wasn't until recently that we knew: He was circumcised.
The claim is that circumcision is supposed to prevent HIV transmission in MEN, but this seems to escape her...
Poor circumcision advocates. So desperately they want to find some pseudo-scientific alibi for deliberate child abuse that they forget to switch their brains on.
Here's Cole's attempt to sound intelligent:
"...here is the reason I am alive today: In the same way that circumcision vastly diminishes the chance of infecting women with the human papillomavirus that causes cervical cancer, studies suggest that circumcision also helps guard against the transmission of the HIV virus. In both cases, cells on the inside of the male foreskin are implicated in spreading the virus. But if the foreskin is removed, a source of infection is also removed."
Actually, it has never been proven that circumcision reduces HPV, nor HIV for that matter. Few people know this, but the HIV "studies" are nothing but statistical analyses of data hand-picked by circumcision advocates that call themselves "scientists."
It's true. Ask a circumcision advocate to tell you how exactly circumcision prevents anything, and all they can do is point to three so-called "randomized controll trials" in Africa and give you that magical 60% figure we've all heard. But they can never, nor will they ever tell you with 100% certainty how exactly this happens. They cannot furnish a causal link, only ad-hoc/post-hoc explanations that they can't demonstrably prove. They may as well be trying to explain the existence of god.
Not even Cole could tell you. She mentions that cells inside the foreskin are implicated, but did she actually even bother to check which ones?
The cells she refers to are the Langerhans cells, and they were implicated in the spread of HIV, not HPV.
Actually, the Langerhans cells hypothesis was blown out of the water a long time ago.
Studies found that not only are Langerhans cells found all over the body and that their complete removal is virtually impossible, it was also found that Langerhans cells that are present in the foreskin produce Langerin, a substance that has been proven to kill the HIV virus on contact, acting as a natural barrier to HIV-1.
http://www.circumcisionandhiv.com/files/de_Witte_2007.pdf
To date, there is no working hypothesis behind any of the so-called "studies" in Africa. It's all pure assertion based on skewed, carefully selected data. Entire "mass circumcision campaigns" are being carried out in Africa based on "studies" that don't even have a working hypothesis.
http://joseph4gi.blogspot.com/2011/05/soka-uncobe-our-us-tax-dollars-at-work.html
In fact, recent reports are showing that the promotion of circumcision in Africa is actually confusing Africans, giving them a false sense of security, encouraging complacency in the use of condoms, making the situation WORSE.
http://joseph4gi.blogspot.com/2011/05/male-circumcision-and-hiv-in-africa.html
Americans have a cultural bias in favor of circumcision that will only allow them to see "studies" and "evidence" in favor of circumcision, and none that contradict it. The following information is found in many other of my posts regarding circumcision and the assertion that it prevents HIV:
Countries in Africa where HIV was found to be more prevalent among the circumcised:
Cameroon table 16.9, p17 (4.1% v 1.1%)
http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf
Ghana table 13.9 (1.6% v 1.4%)
http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf
Lesotho table 12.9 (22.8% v 15.2%)
http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf
Malawi table 12.6, p257 (13.2% v 9.5%)
http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf
Rwanda , table 15.11 (3.5% v 2.1%)
http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf
Swaziland table 14.10 (21.8% v 19.5%)
http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf
Studies that found contradicting data:
According to USAID, "There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf
"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."
http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431
"Results: ...No consistent relationship between male circumcision and HIV risk was observed in most countries."
http://apha.confex.com/apha/134am/techprogram/paper_136814.htm
Other countries where both HIV and circumcision are prevalent:
According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia the majority of the males in the Muslim population are circumcised, whereas circumcision is uncommon in the non-Muslim community. This means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.
http://www.mmail.com.my/content/39272-72-percent-aidshiv-sufferers-malaysia-are-muslims-says-council
In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.
http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN
Despite circumcision being near-universal, it hasn't stopped HIV transmission in Israel.
http://www.haaretz.com/print-edition/opinion/failing-the-aids-test-1.249088
http://www.haaretz.com/print-edition/features/israeli-gays-shun-condoms-despite-worrying-rise-in-aids-1.249372
http://www.haaretz.com/news/has-the-aids-cocktail-worked-too-well-in-israel-1.258520
http://www.haaretz.com/print-edition/news/hiv-diagnoses-in-israel-climb-new-cases-among-gays-up-sharply-1.248651
The most obvious smoking gun: The United States of America
Circumcision hasn't stopped HIV in our own country.
http://data.unaids.org/pub/Report/1998/19981125_global_epidemic_report_en.pdf
And, it hasn't stopped other STDs either.
http://www.reuters.com/article/2009/01/13/us-infections-usa-idUSTRE50C5XV20090113?pageNumber=1&virtualBrandChannel=0
In America, the majority of the male population is circumcised, approximately 80%, while in most countries in Europe, circumcision is uncommon. Despite these facts, our country does poorly.
http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=419&Itemid=177
"So there you have it: My husband's circumcision saved my life."
Oblivious to her is the fact that it was her HUSBAND whom circumcision was supposed to benefit.
In fact, "studies show" that women are 50% more likely to acquire HIV from circumcised men.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2960998-3/fulltext
Cole is luckier than she cares to realize.
"If the San Francisco initiative passes, and encourages other communities to do the same, who knows whose lives won't be saved."
The lives of circumcised men, that's for sure.
The "studies" that say circumcision might "reduce the risk of HIV" have serious flaws. They lack working hypotheses and their conclusions don't correlate with real world data.
But even assuming that they were 100% accurate, the reduction in HIV transmission would still only be 60% over a period of 1.5 years (the short duration of the studies), and only in female to male transmission. In light of the fact that condoms reduce the risk of HIV transmission, not to mention the transmission of other STDs, by over 90%, in BOTH partners, but most of all, in light of the fact that babies are at absolute zero risk for sexually transmitted HIV, or any other STDs for that matter, these "studies" would still be a moot point.
But we must ask ourselves, how much do we actually care about so-called "medical benefits?"
Do we? Really?
What if there were "studies" that showed that female circumcision offered "potential medical benefits" for girls? Would we allow, request it for our daughters? What if there were "studies" that said female circumcision "reduced" the likelihood of some disease? What if "studies showed"that female circumcision "reduced the risk of HIV transmission?" Because there are few studies that show precisely this:
http://www.ncbi.nlm.nih.gov/pubmed/1442755
http://www.thebody.com/content/art12238.html
http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138
Additionally:
"Female circumcision results in a reduction of infections resulting from microbes gathering under the hood of the clitoris"
"Attacks of herpes and genital ulcers are less severe and less harmful with women who have been circumcised"
http://www.themuslimwoman.com/hygiene/femalecircumcision.htm
http://www.islamictreasures.com/manners-of-welcoming-the-new-born-child-in-islam-sku16723.html
How interested would we be in the "potential medical benefits" for girls? Would we support further "research" into the matter? Would we allow the National Institutes of Health, Johns Hopkins etc., to fund "research" in Africa? Well what about countries where female circumcision isn't as "severe?"
But let's ask a different question, would we support "research" in finding alternative ways to provide the same "medical benefits" as male circumcision? If doctors came into your child's birthing room and said "We have great news! This new vaccine offers the same protections as circumcision and more! Now we don't have to circumcise your child anymore!" How would American parents react?
As always, the bottom line...
The foreskin is not a birth defect. Nor is it a congenital deformity or a genetic anomaly akin to a 6th finger or a cleft. The foreskin is normal, healthy tissue found in all males at birth.
Circumcision in healthy boys is the destruction of normal, healthy tissue. It permanently alters the appearance and mechanics of the penis, and it puts a child at risk of infection, disfigurment, complete ablation and even death.
Thanks to research and modern medicine, we now have better, more effective, less-invasive ways to prevent disease, so that circumcision is not needed anymore (actually, it was never needed).
Unless there is a medical or clinical indication, the circumcision of healthy, non-consenting individuals is by very definition infant genital mutilation. It is child abuse and a violation of basic human rights, and doctors have no business performing it in healthy, non-consenting individuals, much less giving his parents any kind of "choice."
Wow, brilliant post Joseph! If logic and reason could convince those who are willfully ignorant on this subject you would end forced genital mutilation today.
ReplyDeleteThe rush to embrace the "African studies" and the magical 60% figure show us the irrationality of those who promote and condone genital mutilation of children.
Diane Cole sounds more intelligent than she is, because her article was probably rewritten by the WSJ, which did not bother to do any fact checking.
ReplyDeleteA mechanism for the alleged prophylactic effect of routine circumcision has been proposed, BTW. Normal unprotected sex is supposed to result in micro fissures in the foreskin and frenulum, through which HIV gains access to the bloodstream. This hypothesis applies to all STDs, including HPV.
The fundamental problem with Cole's article is that the African clinical trials "concluded" that circumcision does not affect a clean woman's chances of catching HIV from an infected man. The CDC reached the same conclusion 20 years ago with respect to the AIDS epidemic then raging among North American gay men. Therefore Diane Cole is barking up the wrong tree.
Again, no one argues that circ makes gay sex any less dangerous. No one argues that a straight carrier of HIV is less likely to pass it on if he is circumcised. The claim is only that circumcised straight men are less likely to catch HIV from an infected woman than intact men are. That claim has no bearing on Diane Cole's tragic life story.
She is alive and AIDS-free mainly because she is lucky. She has no grounds for concluding that she would have AIDS "but for" her late husband's circ status.
For several reasons, the African clinical trials will be completely discredited one day. They are a scientific scandal waiting to explode. But that is another story, well documented in other blog posts.
"Normal unprotected sex is supposed to result in micro fissures in the foreskin and frenulum, through which HIV gains access to the bloodstream. This hypothesis applies to all STDs, including HPV."
ReplyDeleteAnd circumcision was supposed to toughen the outer skin with keratin layers, right? But according to recent studies:
"CONCLUSION: We found no difference between the keratinization of the inner and outer aspects of the adult male foreskin. Keratin layers alone are unlikely to explain why uncircumcised men are at higher risk for HIV infection."
http://www.ncbi.nlm.nih.gov/pubmed/20098294
STUDY: HIV-1 Interactions and Infection in Adult Male Foreskin Explant Cultures - "No difference can be clearly visualized between the inner and outer foreskin."
http://retroconference.org/2009/PDFs/502.pdf
"For several reasons, the African clinical trials will be completely discredited one day. They are a scientific scandal waiting to explode. But that is another story, well documented in other blog posts."
That promoting circumcision as HIV prevention could only result in disaster has been obvious to anyone with half a brain since the very beginning. I'm wondering what exactly bigwigs at the WHO, CDC, AAP etc. have been smoking...
When the circumcision/HIV hoax blows over, and it will, who's going to be responsible? Who's going to pay for all that medical treatment for all of those HIV infections circumcision was supposed to prevent?
Will circumcision "researchers" be brought to trial for conducting scientific experiments at the expense of Africans?
I love how she drags the San Fransisco Initiative to ban forced circumcision on minors into this. She's worried about public health and HIV? A. men can still opt for circumcision, B. babies and children aren't having sex so, won't be exposed.
ReplyDeleteIn a way I'm upset that such a 'reputable' news source is printing such obvious propaganda, but in a way it kind of shows their hand. Whether or not their educated readers will see it, or eat it is yet to be seen.
What I really love is how she honestly thinks she's making a case for circumcision.
ReplyDeleteIf she had been paying attention, she would have known that it was her HUSBAND who was supposed to benefit from circumcision.
Her husband succumbed to AIDS; mentioning the fact that he was circumcised doesn't do her or her cause any favors.
But now, millions across America think sex without condoms doesn't give a woman AIDS if her partner is circumcised.
This woman is idiotic, insulting and a danger to public health.
The WSJ ought to be ashamed.
Joseph, I haven't read all your splendid work and this was one until now. There's no conveying my admiration and appreciation I constantly feel when reading your blog. You search out the facts, forge them with logic, thus making tools anyone can use. All universal tools.
ReplyDeleteThank you.
May 2011 was very busy and emotionally draining. There's a lot that I missed like this post. I found myself fighting forced circumcision while awake but also when asleep. Especially when approaching the SF Ethics filing deadlines. I would have horrific dreams. I was fearful, with fears I had never known was inside me, a part of me.
But on that crisp clear morning after parking the car to turn in our valid signatures at the registrar's office, I felt a release of my genitals by an omnifarious hand. I hadn't realized before but now I was free. Like I use to feel back in grade school when it was the 60's and equality was THE THING. Bright, Crisp, Clear, FREEDOM.
Today I feel like more hands than ever are in my pants.
Ps.- I found the Wall Street Journal to be an instigator of circumutilation. Innocence doesn't recognize evil.