Circumcision reduces HIV risk, according to new study.

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Lulu2
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Circumcision reduces HIV risk, according to new study.

Post by Lulu2 »

(The information below was cut/pasted from two articles today)



Circumcision appears to reduce a man’s risk of contracting AIDS from heterosexual sex by half, United States government health officials said yesterday, and the directors of the two largest funds for fighting the disease said they would consider paying for circumcisions in high-risk countries.

The announcement was made by officials of the National Institutes of Health as they halted two clinical trials, in Kenya and Uganda, on the ground that not offering circumcision to all the men taking part would be unethical. The success of the trials confirmed a study done last year in South Africa.

AIDS experts immediately hailed the finding. “This is very exciting news,” said Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development, who has argued that circumcision slows the spread of AIDS in the parts of Africa where it is common.

In an interview from Zimbabwe, he added, “I have no doubt that as word of this gets around, millions of African men will want to get circumcised, and that will save many lives.”

Uncircumcised men are thought to be more susceptible because the underside of the foreskin is rich in Langerhans cells, sentinel cells of the immune system, which attach easily to the human immunodeficiency virus, which causes AIDS. The foreskin also often suffers small tears during intercourse.

But experts also cautioned that circumcision is no cure-all. It only lessens the chances that a man will catch the virus; it is expensive compared to condoms, abstinence or other methods; and the surgery has serious risks if performed by folk healers using dirty blades, as often happens in rural Africa.

Circumcision is “not a magic bullet, but a potentially important intervention,” said Dr. Kevin M. De ****, director of H.I.V./AIDS for the World Health Organization.

Sex education messages for young men need to make it clear that “this does not mean that you have an absolute protection,” said Dr. Anthony S. Fauci, an AIDS researcher and director of the National Institute of Allergy and Infectious Diseases.

Circumcision should be used with other prevention methods, he said, and it does nothing to prevent spread by anal sex or drug injection, ways in which the virus commonly spreads in the United States.

The two trials, conducted by researchers from universities in Illinois, Maryland, Canada, Uganda and Kenya, involved nearly 3,000 heterosexual men in Kisumu, Kenya, and nearly 5,000 in Rakai, Uganda. None were infected with H.I.V. They were divided into circumcised and uncircumcised groups, given safe sex advice (although many presumably did not take it), and retested regularly.

The trials were stopped this week by the N.I.H. Data Safety and Monitoring Board after data showed that the Kenyan men had a 53 percent reduction in new H.I.V. infection. Twenty-two of the 1,393 circumcised men in that study caught the disease, compared with 47 of the 1,391 uncircumcised men.

In Uganda, the reduction was 48 percent.

Those results echo the finding of a trial completed last year in Orange Farm, a township in South Africa, financed by the French government, which demonstrated a reduction of 60 percent among circumcised men.

The two largest agencies dedicated to fighting AIDS said they would now be willing to pay for circumcisions, which they have not before because there was too little evidence that it worked.

Dr. Richard G. A. Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has almost $5 billion in pledges, said in a television interview that if a country submitted plans to conduct sterile circumcisions, “I think it’s very likely that our technical panel would approve it.”

Dr. Mark Dybul, executive director of President Bush’s $15 billion Emergency Plan for AIDS Relief, said in a statement that his agency “will support implementation of safe medical male circumcision for H.I.V./AIDS prevention” if world health agencies recommend it.

He also warned that it was only one new weapon in the fight, adding, “Prevention efforts must reinforce the A.B.C. approach — abstain, be faithful, and correct and consistent use of condoms.”

Researchers have long noted that parts of Africa where circumcision is common — particularly the Muslim countries of West Africa — have much lower AIDS rates, while those in southern Africa, where circumcision is rare, have the highest.

But drawing conclusions was always confounded by other regional factors, like strict Shariah law in some Muslim areas, rape and genocide in East Africa, polygamy, rites that require widows to have sex with a relative, patronage of prostitutes by miners, and men’s insistence on dangerous “dry sex” — with the woman’s vaginal walls robbed of secretions with desiccating herbs.

Outside Muslim regions, circumcision is spotty. In South Africa, for example, the Xhosa people circumcise teenage boys, while Zulus do not. AIDS is common in both tribes.

Nelson Mandela’s autobiography, “Long Walk to Freedom,” contains an unnerving but hilarious account of his own Xhosa circumcision, by spear blade, as a teenager. Although he was supposed to shout, “I am a man!” he grimaced in pain, he wrote.

But not all initiation ceremonies are laughing matters. Every year, some South African teenagers die from infections, and the use of one blade on many young men may help spread AIDS.

In recent years, as word has spread that circumcision might be protective, many southern African men have sought it out. A Zambian hospital offered $3 circumcisions last year, and Swaziland trained 60 doctors to do them for $40 after waiting lists at its national hospital grew.

“Private practitioners also do it,” Dr. Halperin said. “In some places, it’s $20; in others, much more. Lots of the wealthy elite have already done it. It prevents S.T.D.’s, it’s seen as cleaner, sex is better, women like it. I predict that a lot of men who can’t afford private clinics will start clamoring for it.” (S.T.D.’s are sexually transmitted diseases.)

Male circumcision also benefits women. For example, a study of the medical records of 300 Ugandan couples last year estimated that circumcised men infected with H.I.V. were about 30 percent less likely to transmit it to their female partners.

Earlier studies on Western men have shown that circumcision significantly reduces the rate at which men infect women with the virus that causes cervical cancer. A study published in 2002 in The New England Journal of Medicine found that uncircumcised men were about three times as likely as circumcised ones with a similar number of sexual partners to carry the human papillomavirus.

The suspected mechanism was the same — cells on the inside of the foreskin were also more susceptible to that virus, which is not closely related to H.I.V.
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tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

I think this does need thinking through somewhat.

There is a difference between reducing the rate of infection and prevention.

If we give people the idea that sex with a circumcised male is less risky than with an intact male there is the chance that a good many couples will take that as meaning they don't have to wear a condom.

It may well be the case that increasing the number of circumcised males simply reduces condom use and the same incidence rates will re-occur eventually.

Circumcision Issues and Circumcision Information presents the reasons why some monogamous couples may prefer not to become circumcised.

I am not against monogamous sex but I feel promiscuous unprotected sex is responsible for the increase in SDT's in the UK. Anything which encourages folk to think that the risks of unprotected sex are reduced may also encourage more risk taking activity.
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Lulu2
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Circumcision reduces HIV risk, according to new study.

Post by Lulu2 »

EDUCATION is obviously needed, along with any possible method to reduce risk.
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cherandbuster
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Circumcision reduces HIV risk, according to new study.

Post by cherandbuster »

Lulu2;495977 wrote: EDUCATION is obviously needed, along with any possible method to reduce risk.


Plus

They just look better to me :p :)
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Lulu2
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Circumcision reduces HIV risk, according to new study.

Post by Lulu2 »

:wah: THANKS, CHER! My sentiments, exactly....more fun to play with, too.;)
My candle's burning at both ends, it will not last the night. But ah, my foes, and oh, my friends--It gives a lovely light!--Edna St. Vincent Millay
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cherandbuster
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Circumcision reduces HIV risk, according to new study.

Post by cherandbuster »

Lulu2;495984 wrote: :wah: THANKS, CHER! My sentiments, exactly....more fun to play with, too.;)


Pammy

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Lulu2
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Circumcision reduces HIV risk, according to new study.

Post by Lulu2 »

Why not, Sweets? We see so many compatible friends!
My candle's burning at both ends, it will not last the night. But ah, my foes, and oh, my friends--It gives a lovely light!--Edna St. Vincent Millay
tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

cherandbuster;495980 wrote: Plus

They just look better to me :p :)Looks ain't everything, if you click the links I've provided you will see and learn why what looks good doesn't always provide the same satisfaction.
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Lulu2
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Circumcision reduces HIV risk, according to new study.

Post by Lulu2 »

Ted, I don't know any adult who has made the decision to be circumcised AS an adult. If I were to have a son born today, I'd seriously consider ANYTHING which is likely to reduce HIV risk.
My candle's burning at both ends, it will not last the night. But ah, my foes, and oh, my friends--It gives a lovely light!--Edna St. Vincent Millay
tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

Lulu2;496009 wrote: Ted, I don't know any adult who has made the decision to be circumcised AS an adult. If I were to have a son born today, I'd seriously consider ANYTHING which is likely to reduce HIV risk.Even if it reduces his and his partners enjoyment of sexual intercourse?

I suppose you'd approve of genital mutilation on the same grounds?
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Lulu2
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Circumcision reduces HIV risk, according to new study.

Post by Lulu2 »

Oh, good grief! I've known circumcised men and UNcircumcised men and they've reported little dissatisfaction. GENITAL MUTILATION is what's done to little girls in many parts of the world...it hardly compares with removal of a foreskin!

I'm done with this, Ted.
My candle's burning at both ends, it will not last the night. But ah, my foes, and oh, my friends--It gives a lovely light!--Edna St. Vincent Millay
tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

Lulu2;496119 wrote: Oh, good grief! I've known circumcised men and UNcircumcised men and they've reported little dissatisfaction. GENITAL MUTILATION is what's done to little girls in many parts of the world...it hardly compares with removal of a foreskin!While the intention of Circumcision is not to remove erogenous tissue in practice it does. See The prepuce:

Specialized mucosa of the penis and its loss to circumcision so the effect may, in practice, be similar.

My partner has experienced sex with both circumcised and uncircumcised men and prefers an intact penis.

I was simply trying to draw attention to the counter arguments to circumcision for all. The point that male behavior may alter should they consider their risk is lower is valid as is the consideration that with less erogenous tissue available they may also be even more reluctant to tolerate condom use.

If you wouldn't tolerate genital mutilation on little girls why are you prepared to condone a lesser form of this practice on little boys?
RedGlitter
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Circumcision reduces HIV risk, according to new study.

Post by RedGlitter »

I must agree with that last question.

Whatever my preferences as a woman may be, if I were a boy's mother, I would not have that surgery performed. That is the boy's decision and although painful if he decided later on to do it, it is also painful to a screaming, strapped down, usually unanesthetized infant. There is theory that the body "remembers" pain inflicted on it. Regardless, that is one decision I feel should be left to the boy or man. It's his body.



Mutilating a girl is despicable for all reasons although done for different reasons than removing foreskin, and I don't feel one is more acceptable than the other just because one is a "simple" snip and the other is scraping away every shred of flesh. It would seem to me that common sense and empathy would recognize that.



I personally don't buy that circumcision reduces HIV/aids. They say it prevents uterine cancer too and to the best of my knowledge that hasn't been proven either.
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

RedGlitter;496509 wrote: I personally don't buy that circumcision reduces HIV/aids. They say it prevents uterine cancer too and to the best of my knowledge that hasn't been proven either.male circumcision was also strongly associated with lower HIV prevalence among countries with primarily heterosexual HIV transmission, but not among countries with primarily homosexual or injection drug use HIV transmission. I think the evidence that male circumcision is linked to lower rates of HIV and Male circumcision status has been shown to reduce the risk not only of acquiring and transmitting genital Human Papillomaviruses but also of cervical cancer in their female partners. is sufficiently strong to claim the matter is proven.

So the dilemma is "Do you circumcise you baby boy to reduce the risks associated with promiscuity in later life" or do you leave him intact and educate him about the risks associated with promiscuity. A similar dilemma is, but without as far as I know any risk factors, do we vaccinate prepubescent girls so their risks of cervical cancer are reduced should they wish to become promiscuous when they mature?

While I welcome anything which may reduce cancer/HIV rates I think we have to consider carefully the ultimate consequences of encouraging, facilitating and sanctioning ever increasing levels of promiscuity. There are always long term unintended consequences when we meddle in such matter.

Acceptability of Male Circumcision for Prevention of HIV/AIDS in Sub-Saharan Africa:
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valerie
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Circumcision reduces HIV risk, according to new study.

Post by valerie »

I think there is one good, clear reason for circumcision.



It being Chirstmas, I'll just say...





The "S" word.
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RedGlitter
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Circumcision reduces HIV risk, according to new study.

Post by RedGlitter »

valerie;496641 wrote: I think there is one good, clear reason for circumcision.



It being Chirstmas, I'll just say...





The "S" word.


Hmm...if you're talking about..."buildup"...women can get that too, it's just easier for us to wash it away. Men who have good hygiene shouldn't have this trouble I don't think. :o
tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

RedGlitter;496718 wrote: Hmm...if you're talking about..."buildup"...women can get that too, it's just easier for us to wash it away. Men who have good hygiene shouldn't have this trouble I don't think. :oBut that may be a problem in the less developed parts of the world where regular access to clean water and soap is a problem.

In a recent survey in a UK hospital experiencing MRSA/CDIFF/Winter Sickness virus problems a team of 3 experienced observers noted 140 missed handwashing opportunities in one day's monitoring of health professionals, who had agreed to be observed, and knew they were being watched. If experienced, well qualified, well trained, confident health professionals, can make regular lapses through the day, is it any wonder those without training, without knowledge or experience make a bigger hash of it.

I've been racking my brains to work out which S word Valerie is meaning but don't think any I can think of apply.
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

SnoozeControl;496738 wrote: (smegma)Well goes to show you can learn something new every day. Fancy getting to my age and not knowing about the existance of smegma.
RedGlitter
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Circumcision reduces HIV risk, according to new study.

Post by RedGlitter »

Does anyone know exactly *how* circumcision prevents uterine cancer? Since cancer is not caused by germs, I would like to know.I've never heard of the reason this is believed.
tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

RedGlitter;496764 wrote: Does anyone know exactly *how* circumcision prevents uterine cancer? Since cancer is not caused by germs, I would like to know.I've never heard of the reason this is believed.The carcinogenicity of smegma: debunking a myth.Smegma is widely believed to cause penile, cervical and prostate cancer. This nearly ubiquitous myth continues to permeate the medical literature despite a lack of valid supportive evidence. METHODS: A historical perspective of medical ideas pertaining to smegma is provided, and the original studies in both animals and humans are reanalysed using the appropriate statistical methods. RESULTS: Evidence supporting the role of smegma as a carcinogen is found wanting. CONCLUSIONS: Assertions that smegma is carcinogenic cannot be justified on scientific grounds.



Effects of hygiene among the uncircumcised.]Effects of hygiene among the uncircumcised.Recommendations against routine neonatal circumcision are based on the assumption that good penile hygiene can offer the same advantages as this procedure. The purpose of this study was to investigate hygienic practices of uncircumcised subjects and the relationship of these practices to the condition of the prepuce and glans. Outcome was related to hygiene: subjects who retracted the foreskin when bathing were less likely to have smegma accumulation, inflammation, phimosis, or adhesions than those who did not. Significant correlations were also found between early instructions concerning hygiene and the type of hygiene practiced. These results support the recommendation that good hygiene can offer many of the advantages of circumcision and highlight the need for clear, early instructions on hygiene to uncircumcised patients.

I have to admit to never having heard of smegma before tonight but as I now have to self catheterise every four hours and this entails washing before insertion it's not something that's going to have time to accumulate. I suppose I was taught to wash properly as a child. I can't get over the fact that this is something I didn't even know existed. I wonder what else I am totally ignorant of, but perhaps ignorance is bliss.
tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

SnoozeControl;496790 wrote: You didn't notice my bad joke about 'head cheese' did you. :lips:I've now read the Wiki definition of smegma and understand your reference, however, as an ignorant innocent I have to admit your reference was lost on me but the penny has now dropped.
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Circumcision reduces HIV risk, according to new study.

Post by joesoap »

Hi All,

I often wonder how my life would be now if I had been circumcised as a baby? You see I am a long-term sufferer of Lichen sclerosus et atrophicus and now have no useful penis at all.

For the benefit of those who have never heard of the above very rare condition it mainly affects females and the few men who do develop it are always un circumcised. I should point out that this condition is nothing to do with personal hygiene as it is considered to be genetic and as in males it almost always starts off in the foreskin.

Those who have the genetic predisposition for it and are without a foreskin seem to escape it.

I was mis diagnosed for two years from first discovering “scaly growths, at 45 years old and by the time it was correctly identified my penis was damaged beyond repair.

I guess I was just unlucky I drew a short straw.

It is believed I inherited the condition from my Great Grandfather who used to visit an herbalist to buy ointment for “something down his pants”. Since there was no NHS then and men did not discuss such topics with anyone I guess I will never know? But the only surviving photo of him has more than a passing resemblance to me!

Given the chance to go back would I opt for circumcision or to keep my foreskin in the knowledge that I would develop Lichen Sclerosus and be ruined in that department before my 50th birthday, I know which I would choose!

Paul.
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Circumcision reduces HIV risk, according to new study.

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joesoap;655014 wrote: Given the chance to go back would I opt for circumcision or to keep my foreskin in the knowledge that I would develop Lichen Sclerosus and be ruined in that department before my 50th birthday, I know which I would choose!That's a major event to spring on you out of the blue like that. I'm impressed that you can discuss it though. Are there other kin-family members who turned pale when you told them? What have they done about it?
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tedhutchinson
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Circumcision reduces HIV risk, according to new study.

Post by tedhutchinson »

I think if the condition LICHEN SCLEROSU were more common there would be incidence statistics that enabled us to make rational decisions, still if it was sufficiently common for statistics to be kept it would be more readily diagnosed and you may not have been in the situation you currently are.

While it is too late now to be of much use to you, other readers may be interested to know that Vitamin D3, which most people in the UK are short of, is a natural anti inflammatory agent, it also regulates the immune system, a condition such as this, which is both a chronic inflammatory skin disease and an auto-immune skin condition having strong links with other auto-immune related conditions such as thyroid, vitiligo and pernicious anaemia would be less likely to happen and would be better controlled in bodies with optimal Vitamin d status. (over 100nmol/L)
joesoap
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Circumcision reduces HIV risk, according to new study.

Post by joesoap »

spot;655042 wrote: That's a major event to spring on you out of the blue like that. I'm impressed that you can discuss it though. Are there other kin-family members who turned pale when you told them? What have they done about it?


Fortunately I am an only child and have no offspring so the condition dies out in my family with me. Reactions amongst what is left of my extended family have been very variable to say the least!

Funnyest response (from my point of view), was from the wifes sister in law who is a "nosey parker", and upon asking "Why we had not started a family yet"? was told by me in no uncertain terms the "why and wherefore". She promptly fainted in her bowl of soup and had to be rescued from drowning in it by her Husband:wah:

I am past worrying about what others may think of my condition. My attitude is to tell as many folks as possible so that anyone with similar syptoms can get checked out early and, hopefully NOT be mis diagnosed.

I was very depressed about it when first correctly diagnosed but I did eventually come to terms with it.

I also have diverticular disease (which may or may not be genetic). This severely limits what I can and cannot eat, without risking pooing my pants:( So I guess I must be one of lifes optimists to be as cheerfull as I am!

Paul.
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Circumcision reduces HIV risk, according to new study.

Post by spot »

joesoap;655258 wrote: I guess I must be one of lifes optimists to be as cheerfull as I am!Damn right too, mate. E L Wisty said much the same thing whenever he thought about Spotty Muldoon.
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