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Monday, May 23, 2011

Circumcision in Africa: It ain't workin'...

We keep saying it, and we will continue to say it; nothing good can come of promoting circumcision over HIV. The promotion of circumcision is a disservice to the fight against HIV. It is already sending confusing messages and giving men a false sense of security. Promoting circumcision is going to HASTEN the spread of HIV, not reduce it.

I've already blogged about the ongoing circumcision disaster in Africa here:
http://joseph4gi.blogspot.com/2011/05/male-circumcision-and-hiv-in-africa.html

And here:
http://joseph4gi.blogspot.com/2011/05/soka-uncobe-our-us-tax-dollars-at-work.html

Here is yet another voice of reason. When are people going to snap out of the circumcision craze and listen?

http://www.monitor.co.ug/News/National/-/688334/1167560/-/c1fynnz/-/

Church heads criticise male circumcision
Posted Monday, May 23 2011 at 00:00

The launch of safe male circumcision in Bushenyi District has been met with stiff resistance from church leaders, who say the practice is against morals.

Religious leaders said the way the medical people have packaged messages about male circumcision encourages people to go on sex rampage after the exercise.

The Rev. Can. Norbert Tibikoma, the Archdeacon for All Saints Church Greater Bushenyi, said the church will not compromise its morality.

"Telling people that circumcision will prevent them from the risk of HIV is very unfortunate. We have buried circumcised people who died of the disease. The way they are putting across their message of circumcision is like giving a licence to commit adultery.

It is like saying now you are free go and sin," he said during the launch of the exercise last week.
He said the message from the church is that couples should remain faithful and those who are not yet married should abstain from premarital sex in order to avoid acquiring HIV.

The chaplain of Masheruka Girls SS, the Rev. Ananias Ntereyo, said the approach being used to promote male circumcision should be changed.

"Circumcision has been in existence for ages. Putting HIV/Aids at the fore will encourage people to have sex with multiple partners. We have seen those who are circumcised also getting the disease," he said.

And we are seeing the destruction the promotion of circumcision is causing all over Africa.
http://joseph4gi.blogspot.com/2011/05/male-circumcision-and-hiv-in-africa.html

The Soka Unkobe campaign is a sad example of how the circumcision/HIV message is going out of control.

I repost highlights of it here:
http://www.observer.org.sz/index.php?news=24311

May 04, 2011
THE public has received the Male Circumcision campaign "Soka Uncobe" with mixed feelings as some people have come out to say the message was not clear.

A concern has been raised that the kombis which had been branded with the advertisements promoting the campaign display four women, which is said to be confusing as to whether once a person is circumcised they got more women. The logo itself, “Soka Uncobe” has raised a lot of questions as people wonder if by being circumcised it means one “has conquered” and would not get HIV and AIDS.

"If it had been the picture of a family including the wife supporting her man, who goes to circumcise then that would be better, but in this case you see four beautiful women and it says they are going to support you, it is really confusing. Are they now promoting multiple partners?" said one of the people who raised a concern. (HELLO???)

Solomon Mndzebele, who is a caregiver under Red Cross, made a personal plea to the ministry of health to remove the message from the kombis stating that it was making his work difficult.

"When you tell people about condoms they would just tell you that they would circumcise and by then they would have conquered HIV AIDS.

The Swazi Ministry of Health tries to explain away the blunder.

We could see it coming a million miles away. Most people with half a brain could predict that circumcision would become an alternative to condoms.

The "protection" circumcision provides is dubious at best. Real-world data shows us that circumcision is irrelevant in the fight against HIV/AIDS.

Contradicting Statistical Data
In the following African countries, HIV was found to be more prevalent among the circumcised:

Cameroon table 16.9, p17 (4.1% v 1.1%)
http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf

Ghana table 13.9 (1.6% v 1.4%)
http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf

Lesotho table 12.9 (22.8% v 15.2%)
http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf

Malawi table 12.6, p257 (13.2% v 9.5%)
http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf

Rwanda , table 15.11 (3.5% v 2.1%)
http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf

Swaziland table 14.10 (21.8% v 19.5%)
http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf

According to USAID, "There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."
http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

"Results: ...No consistent relationship between male circumcision and HIV risk was observed in most countries."
http://apha.confex.com/apha/134am/techprogram/paper_136814.htm

According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia the majority of the males in the Muslim population are circumcised, whereas circumcision is uncommon in the non-Muslim community. This means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.
http://www.mmail.com.my/content/39272-72-percent-aidshiv-sufferers-malaysia-are-muslims-says-council

In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.
http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN

Despite circumcision being near-universal, it hasn't stopped HIV transmission in Israel.
http://www.haaretz.com/print-edition/opinion/failing-the-aids-test-1.249088
http://www.haaretz.com/print-edition/features/israeli-gays-shun-condoms-despite-worrying-rise-in-aids-1.249372
http://www.haaretz.com/news/has-the-aids-cocktail-worked-too-well-in-israel-1.258520
http://www.haaretz.com/print-edition/news/hiv-diagnoses-in-israel-climb-new-cases-among-gays-up-sharply-1.248651

Circumcision hasn't stopped HIV in our own country.
http://data.unaids.org/pub/Report/1998/19981125_global_epidemic_report_en.pdf

And, it hasn't stopped other STDs either.
http://www.reuters.com/article/2009/01/13/us-infections-usa-idUSTRE50C5XV20090113?pageNumber=1&virtualBrandChannel=0

In America, the majority of the male population is circumcised, approximately 80%, while in most countries in Europe, circumcision is uncommon. Despite these facts, our country does poorly.
http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=419&Itemid=177


But even if the "studies" were 100% accurate, circumcision would still be a moot point.

Even if...
At best, circumcision would "reduce the risk of HIV by a 60%" (over 1.5 years), while a condom conclusively reduces the risk of HIV by over 90%. Circumcision would still fail. Circumcision fails, which is why even the very authors of the African "studies" themselves cannot stress the use of condoms enough. At best, circumcision would be like a permanent condom that broke 40% of the time. If "researchers" were promoting a condom that broke over 40% of the time, they'd be laughed out of the room!

Squaring circles...
Circumcision promoters actually think that they can make it work. They actually think that they can get African men to get circumcised AND wear a condom. Only in a perfect world...

A Deadly Shortcut


One must seriously wonder. What on earth are they smoking up at the WHO? Are American leaders on crack? How on EARTH does it make sense to promote a dubious alternative to the most effective method of HIV prevention known to us?

When "scientists" and "researchers" are more concerned with validating a historically controversial and ethically problematic surgical procedure, rather than finding and promoting less expensive, less invasive, more effective ways to reduce HIV transmission, we've got a serious problem.

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