Tuesday, October 27, 2009

The Greater the Foreskin, the Higher the HIV Risk

This study did not get quite the play in the media that other health-related circumcision studies have attracted, but it deserves mention on this blog. Still another African study has found that the more foreskin an individual has, the greater his risk of getting HIV.

Perhaps the media didn't report this widely because it's so obvious. The foreskin is a "portal of entry" for deadly diseases, so obviously the more foreskin you have the more portals and the greater the risk. Pretty simple.

As reported in "AIDS Map," here's the gist of the study: "Larger foreskin size is associated with an increased risk of becoming infected with HIV, investigators from the Rakai circumcision study report in the October edition of AIDS. “Larger foreskin size is a risk factor for HIV acquisition in uncircumcised men,” comment the investigators."

"Investigators from the Rakai circumcision study hypothesised that the size of an individual's foreskin may be associated with an increased risk of HIV infection, due to the larger surface area containing cells vulnerable to HIV infection. They therefore analysed men in the clinical trial who had previously taken part in a cohort study to see if they could find an association between the size of the foreskin measured at the time of circumcision and the risk of HIV acquisition in uncircumcised men prior to the removal of their foreskin. They conducted the retrospective analysis in men who had initially been recruited to the Rakai community cohort study, tested for HIV at baseline and followed for a median of four years prior to enrolling in the clinical trial and undergoing medical circumcision. A total of 965 men were included in the study."

"There were 48 new HIV infections. The median foreskin area was larger in those who became infected with HIV compared with those who did not (41.5 vs 35 cm2). Furthermore, the mean foreskin area was significantly higher among those who seroconverted than those who did not (43.3 vs 36.8 cm2). . . . HIV incidence was lowest amongst men with foreskin surface areas in the lowest quartile (0.8 per 100 person years), and incidence increased with foreskin surface area, being 2.48 per 100 person years amongst individuals in the upper quartile (p < 0.01 for the trend). After adjustment for possible confounding factors, the investigators found that individuals with a foreskin area above 45.6 cm2 had a significantly increased risk of becoming infected with HIV compared to men with the smallest foreskin surface area."

The obvious thing about this study is that it confirms that the presence of ANY foreskin carries a risk, but the risk increases as the foreskin grows larger. To me, it suggests that the removal of all foreskin as quickly as possible after birth is most desirable. Why should anyone run the risk of growing a large foreskin later in life? Most importantly, it once again links the foreskin to HIV risk, clarifying that the more you have of a bad thing the greater your chances of getting hurt.

Friday, October 16, 2009

Anti Circumcision Radicals to Protest AAP Docs

You want to know why so many people dismiss the ravings of the anti circumcision fanatics? Just read their latest press release, announcing their intent to demonstrate at this weekend's conference of the American Academy of Pediatrics.

"Intactivists will be protesting what they believe to be an unethical and sexist practice—infant circumcision—at the American Academy of Pediatrics National Conference and Exhibition (AAP NCE, 2009), Washington Convention Center, Washington, DC, October 17-20. . . . Intactivist Dan Strandjord, Chicago, says, “Cutting off the end of a boy’s penis is not what a medical “hero” should do. It is a "villainous" practice, there is no medical reason for it. . . . Demonstrators will be carrying placards satirizing the conference’s cartoon characters of pediatricians as flying super-heroes. It depicts a super-hero protecting a baby boy with the comment: “Real heroes don’t cut babies.” Girls are protected from genital cutting, even a pinprick, by federal law, but boys have no protection. Circumcision is a multi-million dollar income stream for doctors, a source of revenue that is almost doubled in order to repair poorly performed circumcisions."

Well, it will be interesting to see what kind of national news coverage these antics get. The media generally ignores the couple dozen nutcases who show up for their annual penis walk on the U.S. Capitol.

It's pretty much a waste of time to rebut all the lies in this typical anti-circ press release. Circumcision is hardly "villainous" because there are so many medical reasons to do it. And the typical foreskin lover tactic of equating female genital mutilation with male circumcision is getting rather boring. As for docs making money off circs, at $50 or $100 a clip, it's not exactly a money winner.

So let the fanatics march on. It only makes their "cause" seem sillier and sillier.

Tuesday, October 13, 2009

Why Are Anti-Circumcision People so Fanatic?

I admit there's a whole lot more to my life than circumcision -- which explains why I don't post something on my blog every day. But I have been increasingly struck by how -- for the anti-circumcision crowd -- the only thing in life that's important to them is "Saving the Foreskin."

Why is that so? What drives the foreskin lovers into such rage that they surf the internet to post mind-numbing repetitive comments on every reference to circumcision? Have you noticed that, too? What is their deep-set psychological problem that life for them begins and ends with the foreskin?

I was reminded about that when I noticed that almost all the "blogs" called up by Google when you type in "circumcision" are authored by anti-circs. This blog is one of the few mainstream blogs out there that espouse normal American behavior, the circumcision of male newborns. It got me wondering if I was really all alone out there -- or whether the anti-circs are just so angry that everyone of them needs to hyperventilate on the internet.

For most Americans at least, circumcision is hardly ever thought of. When our sons are born, we circumcise them for all the right reasons, then move on. It's a topic that never really comes up again. At some point -- for me it was health class in school -- we learn that we were circumcised, told it was the healthy thing to do (that's what my health teacher said), and then again move on. The next time it comes up is when we have a son and, once again, we do the right thing and have the kid circumcised just like us. That pretty much ends the circumcision discussion in the average American household!

But for the anti-circ fanatics, every day begins and ends with the foreskin. I don't know how they carry on a normal life being so obsessed with this useless piece of skin. But guess is that the whackiness of it all comes through to the vast majority of Americans -- which is why we so easily dismiss them when they march on the Capitol, demand "genital integrity," and deride our medical institutions when they seek to follow the medical evidence towards universal circumcision.

I'll leave it to commenters to deduce the psychological hang-ups of the anti-circumcision crowd. Those of us who favor a clean foreskin-free society don't need to get rabid about it. We'll just go about our daily business, knowing that sound science is our side.

Saturday, October 3, 2009

Tattoos and Circumcision

An Associated Press story the other day caught my eye, and I thought I would share it with you for your comments because the defense attorney raised the issue of circumcision.

Turns out that Enrique Gonzalez from Fresno, California, wanted his 7-year old son to have a small paw print tattoo on his hip. The dad has a lot of those tatts cuz it's like a tattoo for a gang called the Bulldogs. The boy, too, wanted the tattoo to be like his dad, although a 7-year in most states is not considered old enough under the law to know what he wants. Still, in many states, it's perfectly legal for parents to have their kids tattooed, but in California apparently nobody under 18 is allowed to get a tatt.

Anyways, Enrique and his buddies either didn't know the law or didn't care because they went ahead and put a small, quarter size paw tatt on this kid. Now Fresno is throwing the book at Enrique saying he has maimed (bodily mayhem) and disfigured his son against the law, charging him with crimes that could jail him for life.

The judge is not so sure. Here's part of the AP story:

"But testimony at the preliminary hearing this week to establish which charges the evidence supports gave pause to Fresno County Superior Court Judge Hillary Chittick.

"A defense attorney, seeking to undermine the potential mayhem charge, raised the issue of a painful, irreversible, and increasingly controversial medical procedure with the boy's pediatrician, a witness for the prosecution.

"Which is more painful, circumcision or a tattoo?" asked public defender Manuel Nieto about the practice performed on a decreasing number of newborn boys.

"I would guess the circumcision," Dr. Carmela Sosa responded. . . .

"It seems to the court," Judge Chittick said as she asked Monday for a few days to think, "that mayhem requires a certain level of bodily injury, and I'm not sure a quarter-sized tattoo meets that."

What I find interesting about this story is the smart defense attorney's linking of circumcision with the tattoo. Now first off, I have no problems with tatts on little kids if small and not in an inappropriate place (like a face). Nowadays, most kids get 'em in college anyways. But tattoos are different from removing the filthy foreskin from a kid. While both tatts and circs "beautify" part of the body, readers of this blog know that my big push for universal circumcision is the health benefits it confers. I don't think tattoos have a health benefit!

The anti-circumcision fanatics want everyone to believe that circumcising a kid is mutilation and a crime. They even have lawyers who go around trying to sue doctors and parents on behalf of circumcised kids. Fortunately, these cases are losers. Why? Because not only is the kid not harmed by circumcision, there is sound medical evidence that it protects the male from HIV, STDs, HPV, cancer, etc. And, so far, no court has denied a parent the right to do what is in the best medical interest of the child -- circumcise him!

The Gonzalez lawyer knows this, so he is cleverly linking tattoos with circumcision. Will it work? I don't know. Let's hear what you think!