Comments on: Size and Religion Matter for HIV Prevention

By: peripheries

peripheries — Tue, 20 Oct 2009 07:48:00 +0000

There are inaccuracies and misconceptions in the above comment hinting that the author has limited knowledge of how research works or what is needed and how clinical trials are conducted. The first being that research should be judged on the who is conducting it rather than on the quality of the data. If this were true, most of modern mechanics would have to be ignored on the ground it was the work of one man in the 18th Century!

I will address the above comments in a specific post. But it worth notind that today, at the AIDS vaccine Conference in Paris, another study conducted by a different group confirmed the role and importance of circumcision in preventing HIV infection. This is the STEP trial that tested a vaccine strategy.

By: Hugh7

Hugh7 — Fri, 16 Oct 2009 21:36:09 +0000

There have only been three clinical trials, circumcising a total of 5,400 men and delaying HIV transmission for less than two years in no more than 73 men. One trial (Rakai) used the sleeve method, which removes more of the inner mucosa than the forceps-guided method of the other two trials, yet the "protective" effect was the same.

Country-against-country comparisons are very weak because they are so seriously confounded by demographics, different strains of the virus and different means of transmission. Against the countries you cite, you can put the US (high circumcision and high HIV) against Europe (low circumcision and low HIV), for example. But the National Health and Demographic Surveys compare man against man – a much more powerful comparison, and found more of the circumcised men have HIV than the non-circumcised, in at least six countries. If circumcision has a protective effect, that needs some explaining.

Your last point means that it will be very hard to find the truth about circumcision from now on, because it will be combined with intensive counselling that non-circumcised men won't get (and this was a fault of the clinical trials, too). The malecircumcision.org website was set up to promote circumcision and it is completely biased, referring only to those studies that support its claims. If you look at the studies, they may have a variety of names (especially African names) at the beginning, but the last author is usually Gray, Bailey, Aubert, Klausner, Halperin, Weiss or one of handful of others. Halperin is on record as saying his descent from a ritual circumcisor may have made it his destiny to promote circumcision, and there is every reason to suppose the motives of the others are similarly mixed.

By: peripheries

peripheries — Fri, 16 Oct 2009 09:31:06 +0000

More than a few scientists are making more than a claim. The benefit of circumcision has been clearly demonstrated both through clinical trials and empirical research(Compare West to East Africa, Thailand and The Philippines). Of course, cicrcumcision alone is not enough and never will be enough to prevent HIV or to explain differences. But the sceintific evidences are there and for an overview of these see http://www.malecircumcision.org/

By: KOTFrank

KOTFrank — Fri, 16 Oct 2009 01:09:32 +0000

The demonstrated benefit (as yet only a known short term benefit) has
no known reason at to why, only conjecture. This is not science at its
best. And is called "The Pony Express" & "Cargo Cult Science". They
demonize the penis and introduce colonial memes to a scared people.

The African circumcision studies authors offer up the Langerhans cells
in the mucosa as the entry points of HIV infection when in absolute
scientific fact Langerhans cell secrete Langerin which has been shown
to immobilize and kill HIV.

In this Rakai study, they left only 1 cm = 3/8 inch residual mucoas,
this is greatly less than the typical US circumcision of 1/2 -1 inch
mucosal remnant cuff. This leaves even less feeling than American
circumcisions. It is a scientific fact that US circumcisions cut off
65% – 85% (with frenulum removal) of the sexual receptors. (Taylor's
The Frenulum Delta and it's loss to circumcision) And still, this
report would have all of the mucosa removed. A cut known in the US as
the "Marine Cut" that leaves absolutely only 15% of the sexual
receptors at the glands corona embedded in mucosa that has hardly any
fine touch receptors that are found in abundance in the shaft mucosa.
The glands is the least sensitive of all, detecting mostly hot and
cold. (Sorrells et al.) If the study author were truly bent on
removing mucosa then the glans mucosa should also be removed. After
all, even with all the sexual receptors removed, erection is still
possible and so is masturbation and intercourse. It just takes a lot
of mindful effort to orgasm, a lot more work than fun. (as told by a
botched circumcised blogger) Bottom line here then is of course it
will reduce HIV infection along with other STDs and pregnancies. By
mindful that circumcision has also been used in eugenics and for
reason.

Thanks for stating my thoughts connecting the Pope saying condoms will
increase HIV infection and it's dangerous thought played out in
Africa.

By: Hugh7

Hugh7 — Thu, 15 Oct 2009 22:08:11 +0000

A remarkably small number of researchers are making most of the running in the lemming-like rush to promote circumcision. This study comes out of the same group of men that was used to promote the original claim about HIV, that circumcision is also good against HPV, that it doesn't hurt female sexual satisfaction and the one that began to show that circumcision increased the rate of HIV transmission to women (18% percent of the women with circumcised partners had HIV compared to only 12% of those with intact men) but they cut it short before it reached statistical significance.

One factor they haven't counted is that men with bigger foreskins probably have bigger penises. This would give them more confidence, so they'd have more opportunities to have sex. That might be fanciful, but there are so many such unmeasured variables in these studies that it's not funny. Humans are not lab rats – you can't control the amount of sex they have or with whom, but they publish studies as though they had.