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The snip that could save his life

STEPHANIE NOLEN

From Thursday's Globe and Mail

Latest comment posted at 8:31 AM EDT 27/03/08

Circumcision has become a booming business in Africa as more men learn of its protective effect in the fight against HIV and AIDS ...Read the full article

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  1. Mark Lyndon from NY, United States writes: Circumcision can only possibly help men who have unsafe sex with HIV partners, so why this bizarre obsession with genital surgery when we know that ABC works better than circumcision ever could? (ABC=Abstinence, Being Faithful, Condoms). The studies which allegedly show a reduction in HIV among circumcised men are highly questionable. Not one of them was finished, despite the protective affect appearing to decline well below the oft-reported 65%, and several of the subjects disappeared. The fact that one study described circumcision as 'comparable to a vaccine of high efficacy' seems to show clear bias. They appear to have been seeking a certain result. The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circed men than intact men, yet they've just started a nationwide circumcision campaign. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes, anything but condoms), and their actions will cost lives rather than saving them. Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that. Circumcised male virgins are more likely to be HIV than intact male virgins, as the operation sometimes infects men. The latest news is that circumcised HIV men are more likely to transmit the virus to women than intact HIV men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised.
  2. ROBERT DE KRIEGER from France writes: A dink? That is being very polite!!
  3. S Dewar from Ottawa, Canada writes: It does baffle me that a man would rather cut off a part of his penis than wear a condom.
  4. Arn N from Kitchener, Canada writes: Sue Hickey, male circumcision IS male genital mutilation. You need to wrap your brain cells around that concept! The only people who say it isn't are people who don't have an intact penise - i.e. circumcised men and some women. But then again, knowing what it's like to have your own foreskin is beyond the scope of these people's understanding.
  5. Akbar M from Regina, Canada writes: The article did mention getting something cut off of a part of your body that people are emotional about is controversial. The science isn't controversial its just the follow through that's controversial. While the ABC method is excellent it just isn't practical in Africa. Circumcision is a very safe procedure that actually has an effect on HIV rates. Obviously the anti-circumcision crowd are going to be angry about it but they are almost exclusively found in wealthy nations that have no conception of the fear and real danger of HIV to sub-Saharan Africa. Being circumcised does no long term harm to a man no matter what the hysterical ravings of certain groups say. This is in no way comparative to the so-called female circumcision (genital mutilation is the correct term) which does long term, permanent and irreparable harm to women.
  6. Mark Lyndon from NY, United States writes: Removing the clitoris is undoubtedly worse than male circumcision, but some forms of female circumcision do less damage than male circumcision, and one is the exact equivalent. Only north Americans seem to see a fundamental difference - Africans certainly don't.

    The fastest way to end female circumcision will be to end male circumcision at the same time.
  7. Diane Ly-Grech from Toronto, Canada writes: Whether it has been accepted in Africa or not, the best prevention of AIDS transmission is the use of a condom.

    Male Genital Mutilation (circumcision) should not be promoted anywhere in the world to help prevent the spread of STDs. My concern is for the expectant parents who read this article in the Globe who may be influenced to circumcise based on this 'research'. No one has the right to authorize the removal of an otherwise healthy part of a baby boy's genitals. The foreskin has many practical roles (protection, added sensitivity, sexual function). While the world cries out against Female Genital Mutilation, Africans are just waiting for enough doctors to begin their mass campaign to clean up male foreskin?
  8. guy tozer from Saskatoon, Canada writes: The foreskin is only a remote unused section of mans brain.... so no loss in circumcision.
  9. web warlock from Canada writes: I don't understand how it's possible to convince a man to cut off their foreskin, but not possible to convince them to wear a condom. If they went to the doctor to get circumsized, and the doctor took a minute to educate the patient on their options, which are A. cut it off, still probably get AIDS or B. wear a condom, probably don't get AIDS, what man in their right mind wouldn't choose option B?

    The result of this policy: lots of guys with no foreskins who think they're invincible; rate of AIDS infections continues to climb.
  10. RD Lone from Vancouver, Canada writes: I'm with Sue Hickey. This isn't as rational as some people make it sound like. ABC doesn't work anywhere, not in the US, not and certainly not in Africa. Even in developed countries how many people risk infection despite vastly superior affordability and accessibility in protection? If sex was rational there wouldn't be rampant affairs and Spitzer-gate. Some protection is always better than no protection.
  11. GlynnMhor of Skywall from Canada writes: Saying that circumscision reduces the probability of infection by 69% compared to the non-circumscised does not address what the probability of infection is for either.

    In the absence of other diseases (particularly those involving festering open sores) even receptive anal sex has only about a 1 in 50 transmission rate.
  12. Globe Insider subscriber content
    A C from Canada writes: You know what else protects against AIDS and most other STDs?

    A CONDOM!

    Even if he cuts off a part of his penis, if he continues to have unprotected sex with HIV positive women, then he'll probably get HIV.
  13. Will Hoaccio from Toronto, Canada writes: This whole comparison to male and female circumcision is a bit wacky. Correct me if I am wrong here, but i was under the impression that the entire issue behind female genital mutilation was that it is quite often carried out without the approval of the woman. From this article, it would seem that men are more than willing to undergo the procedure. If men (or women) want to mutilate themselves in any manner possible it should be their right to do so.

    As for the ABC argument, i don't see how this contradicts ABC. It's unrealistic to assume that one policy or decision will eliminate AIDS. Any approach that relies solely on one technique or program is flawed from the start. If this does reduce HIV transmission rates in males (I must say, I am skeptical of that) I don't see the harm. It can't possibly make things worse, can it?
  14. Ron Low from Chicago, United States writes: This sloppy cut and paste article is almost as bad as the idea of amputation to fight disease. What is it trying to say with that list near the end? That "outer foreskin" is a disease? Silly!

    The cut men in the Africa trials CONTRACTED HIV at a rate 6 times higher than the rate of new infections for African-American men. That's success?

    The article mentions Rwanda adopting circumcision, which is absurd. The cut men there presently have roughly twice the AIDS rate that the intact men have. How will cutting more help?

    In the US, most of the dead male AIDS victims were cut at birth. Circumcision did not and does not prevent AIDS.
  15. GlynnMhor of Skywall from Canada writes: A C from Canada writes: "You know what else protects against AIDS and most other STDs? A CONDOM!"

    Even better is to use the DIY plan. You always know where your trusty right hand has been, after all.
  16. Hugh Young from Wellington, New Zealand writes: This article would have been more balanced if Stephanie Nolan had interviewed others than the world's two chief advocates of circumcision, who have almost single-handedly written the UN's policy.

    Some men who have lost their own foreskins have, almost literally, an axe to grind.

    Circumcision can certainly make things worse, Will Hoaccio, if it makes men think they are safe from HIV, and there is evidence it does. It can also divert valuable resources away from measures that would do some good. For example, as the article says, the Family Life Association of Swaziland is abandoning family planning in favour of circumcision - which will increase poverty and consequently AIDS.
  17. Hugh Young from Wellington, New Zealand writes: "Meanwhile, behaviour-change campaigns pushing abstinence, fidelity or condom use have limited impact." This is simply not true. A campaign called "Zero Grazing" in Uganda was so successful that after the trials, the rate of HIV infection among intact (and circumcised) men in Uganda was still lower than the rate among the circumcised men in Kenya. Clearly, that is the way to go.
  18. Brian Morris from Australia writes: This article shows clearly that once men (and their partners) are informed of the benefits of circumcision they want it! Condoms help only partially. Infection often occurs prior to application of this CONTRACEPTIVE device, and research shows little prevention of HIV and HPV infection. For the largest set (660 refs) and most accurate information on all matters related to circumcision go to http://www.circinfo.net This was compiled by an international authority on the topic who is a Professor of Medical Sciences. More than one in three males will suffer an adverse medical condition if they remain uncircumcised and many of them, and their partners, will die from a disease directly linked to the foreskin. Benefits exceed risks by over 100 to one. The benefits are enormous, whereas the risks are mostly trivial and easily treated. The greatest benefit, ease of circumcision, cosmetic result, greatest convenience and lowest cost applies when circumcision is performed in infancy ... using a local anesthetic. Research shows no adverse effect on sexual function, sensitivity or sensation during sex. Any thoughts to the contrary reflect psychological and associated sexual problems by men that have nothing to do with their circumcision, yet are used by the anti-circ movement in their devious recruitment of new members. Comments on this site from those who oppose circumcision are ill-informed and mostly erroneous, influenced as they are by propaganda generated by the anti-circumcision movement, whose cause is fast losing support as WHO, UNAIDS, medical and other authorities recognize the massive benefits and promote this simple, safe operation as a 'surgical vaccine' with a lifetime of benefits.
    See: http:www.circinfo.net.
  19. Joseph Lewis from Stockton, CA, United States writes: Yet another shrill article campaigning for circumcision using utter misinformation. It is based on a dubious assumption: that a person that gets it will indeed be part of that supposed "65%" that doesn't get HIV. The basis of these studies, that "the langerhans cells found in the foreskin are the prime point of entry for HIV" has been long rendered these studies moot, but this is continuously, conveniently ignored. http://www.cirp.org/news/healthday2007-03-05/ The article continues: "AIDS researchers often note that although hundreds of millions of dollars have been spent on research into vaccines and microbicides trying to figure out how to stop the virus, the condom remains the only successful piece of technology for blocking its spread." Is anybody listening? "...the procedure is not, in the words of researcher Robert Bailey of the University of Illinois, "just a shot in the arm," but rather surgery to chop something off, of a body part about which most people are emotional." Finally one of them comes out and says it. "It's like a mass vaccination campaign." There's that "V" word again. What good is a vaccine that works only 65% of the time? Would you trust a condom that only works 65% of the time? The results of these studies defy reality. First, America has been circumcising its males for close to a century now. When the AIDS epidemic hit in the early 1980s, 90% of US males were already circumcised. Circumcision did not work in the US, yet, somehow it is expected to work in Africa. It is important to scratch beneath the surface to see who exactly is behind these "studies" and campaign to circumcise the world. One would find it is none other than self-interested circumcised men who are more interested in normalizing a worthless cosmetic mutilation, who could care less whether or not it prevents HIV. http://www.doctorsopposingcircumcision.org/info/HIVStatement.html Beware the Fox with No Tail.
  20. Hugh Young from Wellington, New Zealand writes: Brian Morris from Australia is too modest. The author of "the largest set (660 refs) and most accurate information on all matters related to circumcision" "an international authority on the topic who is a Professor of Medical Sciences" is none other than - Brian Morris.

    It should be added, however, that he is a professor of molecular medical sciences, not anything remotely related to the foreskin or sexuality. Conspicuously lacking from his 660 references are any of the many that find that circumcision has no protective effect and actually causes harm.

    Among the good reasons Professor Morris claims for circumcision are that "the foreskin of uncircumcised boys can become accidentally entrapped in zippers" - unlike the glans of circumcised boys? (If this were a serious problem, Velcro [TM] offers a better solution than pre-emptive surgery.)

    He says "More than one in three males will suffer an adverse medical condition if they remain uncircumcised" - a figure that, if it is true, probably compares favourably with most other parts of the body over a lifetime - " and many of them, and their partners, will die from a disease directly linked to the foreskin", a claim of such stunning vagueness (how many?) that the term "shroud-waving" seems strangely inadequate.

    Professor Morris has also said "There are no deaths today from medical circumcisions in developed countries" - news to the bereaved parents of Ryleigh McWillis, Demetrius Manker, Dustin Evans Jr and others not named by the coroners.
  21. X MacDonald from Vancouver, Canada writes: No article I have ever read deserves the title 'Poppycock' more than this one. The African studies mentioned are for adult males and in most cases include safe sex information, but they do not include this fact in their results. This information will, I'm sure, continue to be used to advocate ritual genital mutilation of infant boys. More at : www.circumstitions.com
  22. Joseph Lewis from Stockton, United States writes: Why stop at the foreskin? If the recent "studies" are correct, and removing the foreskin reduces HIV transmission by 60%, then removing the whole shaft should take care of the remaining 40%.

    Circumcised or not, men contract the AIDS virus. This little fact seems to escape the recent circumcision promotion articles.

    And why stop at AIDS? Circumcised or not, men get penile cancer. Read the statement the American Cancer Society has released HERE:

    http://www.fathermag.com/health/circ/acs/

    The penile shaft as well as the testicles can develop cancer. Not to mention cancer of the prostate is the most common type of cancer afflicting the US today.

    So where does the prophylaxis stop?

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