Circumcision Reduces Risk Of AIDS Infection, WHO Says
In a press release today, the World Health Organization has stated that there is strong evidence from three randomized controlled trials undertaken in Kenya, Uganda, and South Africa that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%.
This is suprising news, but my biggest question is how the trials were conducted. Did they take a bunch of guys, give half of them circumcisions, and then had them all have heterosexual intercourse with an HIV infected woman? How long did they wait to test them?
And if they didn't do that, if the process was somehow more ethical, how can they be sure they have accurate data about the impact of circumcision on the probability of AIDS infection?
Check out the press release here.
wow. i never have and probably for good reason seen what foreskin getting cut off looks like. you owe me breakfast.
I think the way they did it was that there is such a large percentage of the population there with AIDS, that they could just question men about their sexual habits, and figure it out from there. If you have a one in ten chance of getting HIV from unprotected sex (or whatever the odds are), and you have sex with twenty women and still don't have it....
Anyway, just and idea.
I'm still against circumcision though. In this country at least.
sorry for the long comment.
So, in this particular trial, they got a bunch of guys, made sure they weren't circumcised and didn't have HIV, circumcised half of them and let all of them go back to their normal lives (the circumcised group had to wait 30 days before having sex to heal up - two did not, and both got HIV). They did offer everybody free condoms. Only a small percentage of the men were married and living with a spouse. The only baseline characteristic that seemed to be associated with HIV was infection with herpes simplex 2, which was fairly evenly distributed between groups.
Both groups exhibited safer (but similar) sexual behaviors during the study as compared to baseline. Probably partly because they got free condoms and partly because they got some learning. The study was stopped short after two years by one of the review boards, because the protective effect was considered strong enough that it was unethical to continue.
An earlier study in Uganda followed sexual partners where the woman was HIV positive and the man was not. They didn't cut anybody up for this one, just compared men who were already circumcised to those who weren't. 37 of 134 uncircumcised men versus none of 50 circumcised men became seropositive after two years.
One proposed mechanism (noted in the article): The inside of the foreskin (mucosal surface), which is exposed on erection, has lots of HIV target cells (Langerhans' cells, CD4+ T cells, and macrophages). The target cells on the outer surface of the foreskin and on the glans are protected by epithelial (skin) cells. In culture, HIV is taken up by target cells in inner (mucosal) foreskin (much more so than in cervical tissue, interestingly), but not by outer (epithelial) foreskin.
My sister is a fucking DOCTOR(-to-be).
Thanks for that rather comprehensive and very interesting response!
Wow, the wiki page for 'Circumcision and HIV' has been taken over by militant anti-circumcision activists!
Steve, you are the Inigo Montoya of Foreskins.
I still like my HIV magnet part that I was born with, thanks bye!