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The kindest cut

Did you hear this, men? Losing a little bit of your skin could cut your risk -- and perhaps ours -- of getting AIDS. The NIH reported yesterday that circumcision halves the risk of HIV infection. This is such good news that the agency decided to stop two trials early so they could offer circumcision even to men in the control arm.

The result isn't entirely a surprise. A previous study had pegged the protection at 60% and ever since then, some experts -- especially in Africa -- have been clamoring for circumcision to be implemented.

And rightly so. In many parts of the world where AIDS is a problem, circumcision could save millions of lives.

But is it really so simple as all that?

For instance, in India, where I'm from, whether a man is circumcised is not an idle preference -- it's a matter of cultural and religious identity. As war movies have brutally shown, in a conflict between Hindu and Muslim, Jew and non-Jew, that is sometimes the only way to distinguish friend and foe.

It's not going to be easy to convince these groups to give up their beliefs. Here's hoping they understand that in the war against AIDS too, that little piece of skin could mean the difference between life and death.


Comments

In a world where it is difiicult to persuade what is supposed to be the world's most prominent secular government to fund anti-AIDs programs that involve the use of condoms, it seems unlikely that nations more overtly affected by the nuance of its constituents' religous mores

Yeah, I think condoms are the most effective thing besides abstinence for blocking out diseases.

Circumcision, on the other hand, is very questionable in terms of being a prophylactic.

As for the term 'a little bit of skin'. The foreskin makes up from about 1/3 to 1/2 the skin on the penis, and it is very sensitive. Plus, removing it causes the glans to crust over, blocking a good deal of stimulation to the nerve endings.

That's not trivial.

And when a child is circumcised for supposed prophylactic benefits, I find it an insult to injury. As many have said; "You don't expect me to use condoms or be sexually responsible?"

That just plain hurts.

I know many people say it doesn't reduce sensation (many girls say the same for female circumcision), but if it doesn't always, it's apparently in the majority.
` I have interviewed a young man who was circumcised as a sexually-active teenager. It was quite devastating and debilitating for a while, and though he eventually learned to derive pleasure, he cannot have as much as he once did.
He also prefers the sex he had with his former genital injury to sex without a foreskin, even though it was painful and bled a lot.

Most guys probably don't take it as hard as he did, though keep in mind that's why they started circumcision in Victorian America - sex was bad for the health, people thought.

For more information, I found a good summary.

And, you might also want to check out the comments in this nature newsblog post.
Apparently female circumcision is good for getting rid of AIDS, too. Yeah, even if it is, who would do that here?

And, if anyone has any doubts that medical organizations do not approve of just circumcising newborn babies for no reason (which goes on around me here in America) this one to be fairly good. It's very short and to the point.
Oh, heck, I just found a shortcut of all these policy statements on Google - it's this page on the NOCIRC website.
` If you were wondering, the reason for English-Speaking nations to be the ones to practice neonatal circumcision is (apparently!) because of the doctor who started it all in Victorian America, who was English-speaking of course.
America is the only one that really still does it, as you will see if you keep reading these things I've linked to.

In a world where it is difiicult to persuade what is supposed to be the world's most prominent secular government to fund anti-AIDs programs that involve the use of condoms, it seems unlikely that nations more overtly affected by the nuance of its constituents' religous mores -- and differences in mores -- will be able to legislate any sort of effective policy covering (pardon the pun) circumcision.

In my personal opinion, there are 2 issues.

1 being, do you seriously expect people after reading this research finding just to get up and walk to their neighbourhood shrink and have themselves circumcized? I mean it's a very sensitive issue and unless you are used to having sex with multiple partners, which indirectly puts you at higher risk, you will not be inclined to do so.

2 being (and I am not a medical expert) what is the assurance that these tests are guaranteed? Like Raj mentioned, being circumcized does not mean you will not contract AIDS. It will probably only lower the risk.

So i believe that unless you are a high risk candidate, you will not be paying much attention to these findings.

That's an excellent point, Raj. I was saying that when condoms are not available, circumcision is a great alternative but you're absolutely right that they should not replace condoms. And that there is the risk of people becoming complacent--so education is essential.

Still interested in that religion question though...

I am sure circumcision really isn't an alternative to condoms...right? It may reduce the risk to an extent, but having sex with a stranger who may be infected is a risk whether or not you're circumcised. The point being this may actually be a non-issue if safe sex is advocated and condoms are made more accessible; and that in my opinion is much better than a bunch of guys walking around thinking they can do anything now just because they got circumcised. With this new concept will come a larger need for education, which is circumsision doesn't rule out the use of condoms. This, in fact, may get confusing to the point where people may wonder why advocate circumcision if you need condoms anyways. I hope that made sense :)

Hmm... Interesting perspective, Raj. What was this HBO commentary? And yes, of course, safe sex does prevent HIV infection, but many people at high risk don't have access to either condoms or to the knowledge that condoms protect or, in the case of sex workers, for example, don't have the choice to use condoms. A one-time circumcision is surely more cost-effective too?

I'm also fascinated by the religious angle-- who do you think is pushing this for religious reasons? And why?

I actually have seen a documentary on HBO which was related to this research and in fact a lot of people said the findings are very skewed purely because the risk lies mainly amongst people who do not have safe sex or have unhygienic environments where they may practice drug abuse or something similar. The point is, if one can just practice simple things like cleanliness and safe sex, the risk of HIV is practically eliminated. The drive for circumcision also has known to be very religiously motivated, I may be wrong....but who knows the entire truth anyways.

I already have done so when i was very young. But cannot imagine doing it now inspite of this research finding. God knows that in 3 years time this research finding will be proved wrong.

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