This amazing headline -- "South Africa to Circumcise Two Million Men" -- must drive the anti-circumcision fanatics crazy. After all, their goal is to keep the foreskin just where it is, thank you, free to infect the sad guy (or his partner) unfortunate to have one with STDs, HIV, and other diseases, to say nothing of his bad genital odor.
But this headline was prominent this past week as the South African government in one of its provinces committed to increase the health of its nation through the removal of that useless piece of ugly skin that has caused so much harm over the years.
Circumcising two million men sounds daunting, and would have never been necessary had routine neonatal circumcision been practiced throughout South Africa. It is so much better to snip a baby than to subject an adult male to a healthy circumcision. But it may take a generation or two before South Africa joins America in leaving the foreskin behind at the maternity hospital.
In the meantime, congrats to South Africa for setting an ambitious goal. You have a lot of fans in the USA rooting you on.
Here's the whole newspaper article:
"South Africa to circumcise two million men
Durban: In an effort to combat the scourge of HIV and Aids, over two million men will be circumcised in South Africa's eastern KwaZulu-Natal province, BuaNews reported on Friday.
The premier of KwaZulu-Natal province, Zweli Mkhize, said on Thursday this initiative had received overwhelming support from HIV activists and the medical fraternity.
The process will begin on April 11.
In late 2006, two randomised controlled trials on whether male circumcision reduces HIV transmission were halted because interim results showed an overwhelming protective effect, validating the results from an earlier South African trial conducted in Orange Farm.
Based on the weight of the evidence from both observational studies and randomised trials, public health leaders have concluded that male circumcision when performed by well-trained and well-equipped health professionals can significantly reduce the risk of HIV infection among adult men.
"We now have our task cut out for us to circumcise over two million males using the safety of professional techniques and encourage HIV pre-testing," he said.
Showing posts with label HIV. Show all posts
Showing posts with label HIV. Show all posts
Sunday, April 11, 2010
Saturday, January 23, 2010
Circumcise Newborns is Most Effective Strategy
Sometimes it just takes a little common sense to do what is right. But it never hurts to have an academic study back up your point of view. Common sense dictates that circumcising baby boys is the most cost-effective way to achieve the benefits of circumcision even if that boy is not likely to engage in sexually risky behavior until later in life. The anti-circ fanatics often rail against newborn circumcision, saying "baby boys don't have sex, don't circumcise them until later in life." Now comes still another study that establishes the obvious -- newborn circumcision is cheaper and safer and less complicated than adult circumcision. So let's do the obvious -- every baby boy should leave that foreskin behind when he comes home with mommy!
Check out this story below, and share your comments.
ScienceDaily (Jan. 21, 2010) — Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study in PLoS Medicine.
It has already been conclusively shown, from three randomized clinical trials in Uganda, Kenya, and South Africa, that adult male circumcision (MC) roughly halves the HIV transmission rate from women to men. Many African countries hit hard by HIV are therefore offering men the procedure as way to control the epidemic. Rwanda is one such country -- about 3% of adults in Rwanda are infected with HIV but only 15% of men are currently circumcised.
But performing the operation in adolescents and adults is linked with a higher risk of complications than circumcising newborns. And the operation is quicker and simpler to perform in newborns. The new study, by Agnes Binagwaho (Rwanda Ministry of Health) and colleagues, therefore set out to compare three different strategies as applied to Rwanda: circumcising newborns (neonates), adolescents, or adults.
The researchers used a technique called "cost-effective analysis," which looks at the balance between the costs of a medical intervention and its benefits. They estimated that each neonatal MC would cost just US$15 whereas each adolescent or adult MC would cost US$59. They found that neonatal MC would in fact save more money than it costs, because the operation is cheap to perform and would prevent HIV infections that are expensive to treat.
The study findings, say the authors, "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young."
In an expert commentary on the new study, Seth Kalichman (University of Connecticut) says: "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa."
Check out this story below, and share your comments.
ScienceDaily (Jan. 21, 2010) — Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study in PLoS Medicine.
It has already been conclusively shown, from three randomized clinical trials in Uganda, Kenya, and South Africa, that adult male circumcision (MC) roughly halves the HIV transmission rate from women to men. Many African countries hit hard by HIV are therefore offering men the procedure as way to control the epidemic. Rwanda is one such country -- about 3% of adults in Rwanda are infected with HIV but only 15% of men are currently circumcised.
But performing the operation in adolescents and adults is linked with a higher risk of complications than circumcising newborns. And the operation is quicker and simpler to perform in newborns. The new study, by Agnes Binagwaho (Rwanda Ministry of Health) and colleagues, therefore set out to compare three different strategies as applied to Rwanda: circumcising newborns (neonates), adolescents, or adults.
The researchers used a technique called "cost-effective analysis," which looks at the balance between the costs of a medical intervention and its benefits. They estimated that each neonatal MC would cost just US$15 whereas each adolescent or adult MC would cost US$59. They found that neonatal MC would in fact save more money than it costs, because the operation is cheap to perform and would prevent HIV infections that are expensive to treat.
The study findings, say the authors, "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young."
In an expert commentary on the new study, Seth Kalichman (University of Connecticut) says: "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa."
Saturday, January 9, 2010
Removal of Foreskin Rids Penis of Bad Bacteria, Study Shows
In another exciting study just released, medical researchers have confirmed that the removal of the foreskin allows the clean-cut penis to shed bad bacteria that can harm both the male and his female partners.
Here's the article from New Scientist
"A flap of foreskin isn't the only thing missing after a circumcision. Microbes that call the penis home disappear, too, which could explain why the procedure reduces a man's chance of contracting HIV.
"The microbes change dramatically," says Lance Price, a microbiologist at the Translational Genomics Research Institute in Flagstaff, Arizona, whose team identified thousands of microbes on the penises of 12 HIV-negative men. All had participated in a clinical study in Uganda which showed that circumcision halves the chances of getting the virus.
"The team discovered a total of 38 families of bacteria on the men's penises before circumcision, and 36 a year after. But the make-up of these communities had swung. Gone were a diverse population of bacteria intolerant of oxygen and linked with vaginal infection; now there was a more homogenous air-loving lot, more typical of other patches of skin.
"Price thinks that some of the expelled bacteria provoke an immune reaction on an uncircumcised penis, causing specialised immune cells to shuttle HIV throughout the body.
Residents of the penis
"Even where religion, culture or costs prevent widespread circumcision, Price says the work could be a first step in delivering the benefits of the procedure without surgery. "The really interesting thing about this study is the potential to modify somebody's risk for HIV."
"His team next plans to determine which microbes are most common on the penises of men who go onto to acquire HIV. Targeting these bacteria with antibiotics – while leaving harmless or even helpful residents of the penis alone – could stem the spread of HIV, he says.
"Martin Blaser, a microbiologist at New York University, says the new study is the most comprehensive look yet at the microbes living on the penis. But given that microbial populations on other parts of the body shift over time, he wonders whether the pre-circumcision bacteria will return. "I expect it will stay changed," he says.
Here's the article from New Scientist
"A flap of foreskin isn't the only thing missing after a circumcision. Microbes that call the penis home disappear, too, which could explain why the procedure reduces a man's chance of contracting HIV.
"The microbes change dramatically," says Lance Price, a microbiologist at the Translational Genomics Research Institute in Flagstaff, Arizona, whose team identified thousands of microbes on the penises of 12 HIV-negative men. All had participated in a clinical study in Uganda which showed that circumcision halves the chances of getting the virus.
"The team discovered a total of 38 families of bacteria on the men's penises before circumcision, and 36 a year after. But the make-up of these communities had swung. Gone were a diverse population of bacteria intolerant of oxygen and linked with vaginal infection; now there was a more homogenous air-loving lot, more typical of other patches of skin.
"Price thinks that some of the expelled bacteria provoke an immune reaction on an uncircumcised penis, causing specialised immune cells to shuttle HIV throughout the body.
Residents of the penis
"Even where religion, culture or costs prevent widespread circumcision, Price says the work could be a first step in delivering the benefits of the procedure without surgery. "The really interesting thing about this study is the potential to modify somebody's risk for HIV."
"His team next plans to determine which microbes are most common on the penises of men who go onto to acquire HIV. Targeting these bacteria with antibiotics – while leaving harmless or even helpful residents of the penis alone – could stem the spread of HIV, he says.
"Martin Blaser, a microbiologist at New York University, says the new study is the most comprehensive look yet at the microbes living on the penis. But given that microbial populations on other parts of the body shift over time, he wonders whether the pre-circumcision bacteria will return. "I expect it will stay changed," he says.
Monday, November 30, 2009
Are Uncircumcised Fathers Most Likely to Circumcise -- or Not?
Here's a question worth pondering. Are uncircumcised fathers more likely to circumcise their sons than circumcised fathers are to leave their sons uncircumcised?
My gut says that, as the medical evidence grows on the health value of circumcision, more and more uncircumcised dads are saying, hey, I want what's best for my son -- and that means a healthy, clean-cut penis from the start of life.
Is there any empirical evidence for this supposition?
I have blogged earlier that there is nothing more admirable -- and no one more deserving the title of FATHER -- than an uncircumcised dad who gives his newborn the gift of circumcision. There is a special place in Heaven for these men who recognize that just because they have a foreskin is no reason for their sons to be so afflicted, especially when the chances are much greater in the 21st century that a foreskin will increase a male's chance of HIV, STD, HPV, and other diseases.
Are there circumcised men who leave their sons with a foreskin prone to disease? Of course, there must be some who are taken in by the anti-circ propaganda and a few who have developed a psychological problem over being clean-cut. But, once again, my gut says that most circumcised dads want their sons to enjoy the healthy penises that they have -- to say nothing of the aesthetic and social reasons to circumcise.
In my view, circumcising your son to "look like" you is no more valid than leaving your son uncircumcised to "look like" you. The best reason for all fathers, regardless of their own circumcision status, to circumcise their sons is that it is in the child's best health interests. That's all you need to do the right thing!
My gut says that, as the medical evidence grows on the health value of circumcision, more and more uncircumcised dads are saying, hey, I want what's best for my son -- and that means a healthy, clean-cut penis from the start of life.
Is there any empirical evidence for this supposition?
I have blogged earlier that there is nothing more admirable -- and no one more deserving the title of FATHER -- than an uncircumcised dad who gives his newborn the gift of circumcision. There is a special place in Heaven for these men who recognize that just because they have a foreskin is no reason for their sons to be so afflicted, especially when the chances are much greater in the 21st century that a foreskin will increase a male's chance of HIV, STD, HPV, and other diseases.
Are there circumcised men who leave their sons with a foreskin prone to disease? Of course, there must be some who are taken in by the anti-circ propaganda and a few who have developed a psychological problem over being clean-cut. But, once again, my gut says that most circumcised dads want their sons to enjoy the healthy penises that they have -- to say nothing of the aesthetic and social reasons to circumcise.
In my view, circumcising your son to "look like" you is no more valid than leaving your son uncircumcised to "look like" you. The best reason for all fathers, regardless of their own circumcision status, to circumcise their sons is that it is in the child's best health interests. That's all you need to do the right thing!
Thursday, November 5, 2009
New Study: Circumcision Reduces Herpes & HPV in Males
How long must we wait for the Centers for Disease Control and the American Academy of Pediatrics to take account of the growing body of medical evidence that points in only one direction -- every boy should be circumcised to protect himself, his partners, and society as a whole.
This week, still another study in the New England Journal of Medicine confirms that male circumcision reduces a male's chance of getting genital herpes and HPV.
After years of such evidence, it's amazing that the CDC and AAP feel so threatened by a small group of anti-circumcision fanatics that they appear to be back-pedaling on doing what is medically right. I will never understand why the foreskin fetishists go to such extremes, but eventually even the docs at the CDC and AAP will yield to medical science and declare what most of us know is true: circumcision is good for every boy!
For more evidence of that, read the full Reuters story, as reported in the Vancouver Times Colonist:
Circumcision protects men from genital herpes and a virus that causes genital warts and cancer but it does not appear to guard against syphilis, U.S. and Ugandan researchers said on Wednesday.
The report in the New England Journal of Medicine adds to the debate over whether men — and newborn boys — should be circumcised to protect their health and perhaps the health of their future sexual partners.
The findings from two trials in Uganda build on related research showing that circumcision cuts a man's risk of HIV infection through heterosexual intercourse by more than 50 per cent, said Anthony Fauci of the National Institutes of Health in the United States, which funded the study.
They also come at a time when circumcision rates are declining in places like the United States even as evidence mounts that the practice can provide important health benefits.
"Medically supervised adult male circumcision is a scientifically proven method for reducing a man's risk of acquiring HIV infection through heterosexual intercourse," he said.
"This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well."
The human papillomavirus, or HPV, is the most common sexually transmitted infection in the world. It causes cervical cancer, which kills 300,000 women globally every year.
The team, which also included researchers from Johns Hopkins University in the United States and Makerere University in Uganda, conducted two parallel clinical trials to analyse the impact of male circumcision as a public health tool.
The combined results of the studies looking at more than 3,000 men showed circumcision reduced the risk of herpes by 25 per cent and of HPV by one third. HPV also causes anal and penile cancers.
Circumcision also appeared to reduce the odds of genital warts but had no effect on the incidence of syphilis, the researchers added.
The study highlights the potential of using circumcision to protect people most at risk of the infections in the developing world, especially Africa, where HIV and HPV are widespread.
"Efforts to scale-up male circumcision could have tremendous benefit," said David Serwadda of Makerere University in Uganda, who worked on the study.
Since 2007, circumcision has been promoted by the World Health Organization and the United Nations Program on HIV/AIDS as a way to reduce the risk of AIDS in areas where heterosexual transmission is high.
When done in children, the operation reduces the chance of urinary tract infections and phimosis, a problem with the foreskin.
This week, still another study in the New England Journal of Medicine confirms that male circumcision reduces a male's chance of getting genital herpes and HPV.
After years of such evidence, it's amazing that the CDC and AAP feel so threatened by a small group of anti-circumcision fanatics that they appear to be back-pedaling on doing what is medically right. I will never understand why the foreskin fetishists go to such extremes, but eventually even the docs at the CDC and AAP will yield to medical science and declare what most of us know is true: circumcision is good for every boy!
For more evidence of that, read the full Reuters story, as reported in the Vancouver Times Colonist:
Circumcision protects men from genital herpes and a virus that causes genital warts and cancer but it does not appear to guard against syphilis, U.S. and Ugandan researchers said on Wednesday.
The report in the New England Journal of Medicine adds to the debate over whether men — and newborn boys — should be circumcised to protect their health and perhaps the health of their future sexual partners.
The findings from two trials in Uganda build on related research showing that circumcision cuts a man's risk of HIV infection through heterosexual intercourse by more than 50 per cent, said Anthony Fauci of the National Institutes of Health in the United States, which funded the study.
They also come at a time when circumcision rates are declining in places like the United States even as evidence mounts that the practice can provide important health benefits.
"Medically supervised adult male circumcision is a scientifically proven method for reducing a man's risk of acquiring HIV infection through heterosexual intercourse," he said.
"This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well."
The human papillomavirus, or HPV, is the most common sexually transmitted infection in the world. It causes cervical cancer, which kills 300,000 women globally every year.
The team, which also included researchers from Johns Hopkins University in the United States and Makerere University in Uganda, conducted two parallel clinical trials to analyse the impact of male circumcision as a public health tool.
The combined results of the studies looking at more than 3,000 men showed circumcision reduced the risk of herpes by 25 per cent and of HPV by one third. HPV also causes anal and penile cancers.
Circumcision also appeared to reduce the odds of genital warts but had no effect on the incidence of syphilis, the researchers added.
The study highlights the potential of using circumcision to protect people most at risk of the infections in the developing world, especially Africa, where HIV and HPV are widespread.
"Efforts to scale-up male circumcision could have tremendous benefit," said David Serwadda of Makerere University in Uganda, who worked on the study.
Since 2007, circumcision has been promoted by the World Health Organization and the United Nations Program on HIV/AIDS as a way to reduce the risk of AIDS in areas where heterosexual transmission is high.
When done in children, the operation reduces the chance of urinary tract infections and phimosis, a problem with the foreskin.
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.
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.
Saturday, September 26, 2009
Operation Abraham Coming to USA
Three cheers for Dr. Inon Schenker! A couple weeks ago, Ha'aretz News, an Israeli paper, published a story about Dr. Schenker and something called Operation Abraham. The good doctor was at the recent CDC meeting in Atlanta and proposed bringing his Operation Abraham to America. As described in the newspaper, "Operation Abraham [is] a group of Israeli doctors who gained expertise in circumcision by performing the procedure thousands of times, quickly and safely, on Russian-Jewish men who were raised outside Jewish tradition and immigrated to Israel in the 1990s. "
Knowing that America has a growing foreskin problem, not only because too many boys are left uncircumcised, but also because our fast growing immigrant population is largely foreskin afflicted, Dr. Schenker suggests: "Why not bring mass adult male circumcision to the Hispanic and African-American communities of America?" Indeed, to all Americans, I would add, because we have many whites and asians here who still are at risk to themselves and their partners because of their uncircumcised status.
Operation Abraham is not something new and novel. The altruistic doctor and his team have already perfected it in African countries. Here's what Ha'aretz reported: "The resulting abstract, which Dr. Schenker presented in Atlanta, proposes to help train American doctors in much the same way as was effective in Swaziland: by working side by side and showing them how to circumcise efficiently. The innovation creates what Schenker called an "assembly line" technique, working in a team, using only local anesthesia and perfecting a "clamp" method of foreskin removal that uses forceps. The Israeli doctors boast that they are able to perform 30 or 40 circumcisions a day."
The link between HIV, STDs, HPV, cancer, and all sorts of other pernicious diseases and the foreskin is now conclusive. Operation Abraham is a humanitarian effort to save the lives of millions of uncircumcised Americans who, through no fault of their own, were not circumcised at birth like most Americans.
So far, the U.S. government has not embraced Dr. Schenker's proposal. They should do so immediately. After all, U.S. taxpayers spend millions to circumcise Africans. Why not spend a little of that money on our own people? Readers of my blog know that I think it is hypocritical for us to circumcise the rest of the world and ignore our own. Dr. Schenker is offering a great public service.
The Ha'aretz article notes that some of the anti-circumcision foreskin lovers are trying to portray the Israeli docs as some sort of proselytizers for Judaism. That strikes me as anti-semitic. No, these docs are not mohels. No, they are not looking for Jewish converts. But, yes, they want to help restore America to its clean-cut status of the 1960s & 1970s. After all the money and support America has given Israel over the decades, I can't think of a better way for Israel to return the favor than to let its docs eliminate the foreskin from our continent.
Obviously, the expected recommendation from the Centers for Disease Control and the American Academy of Pediatrics that all newborn boys be circumcised will help in the future, but Operation Abraham could be just what the doctor ordered for American males who were not so fortunate at birth. Dr. Schenker, we need you and want you!
Knowing that America has a growing foreskin problem, not only because too many boys are left uncircumcised, but also because our fast growing immigrant population is largely foreskin afflicted, Dr. Schenker suggests: "Why not bring mass adult male circumcision to the Hispanic and African-American communities of America?" Indeed, to all Americans, I would add, because we have many whites and asians here who still are at risk to themselves and their partners because of their uncircumcised status.
Operation Abraham is not something new and novel. The altruistic doctor and his team have already perfected it in African countries. Here's what Ha'aretz reported: "The resulting abstract, which Dr. Schenker presented in Atlanta, proposes to help train American doctors in much the same way as was effective in Swaziland: by working side by side and showing them how to circumcise efficiently. The innovation creates what Schenker called an "assembly line" technique, working in a team, using only local anesthesia and perfecting a "clamp" method of foreskin removal that uses forceps. The Israeli doctors boast that they are able to perform 30 or 40 circumcisions a day."
The link between HIV, STDs, HPV, cancer, and all sorts of other pernicious diseases and the foreskin is now conclusive. Operation Abraham is a humanitarian effort to save the lives of millions of uncircumcised Americans who, through no fault of their own, were not circumcised at birth like most Americans.
So far, the U.S. government has not embraced Dr. Schenker's proposal. They should do so immediately. After all, U.S. taxpayers spend millions to circumcise Africans. Why not spend a little of that money on our own people? Readers of my blog know that I think it is hypocritical for us to circumcise the rest of the world and ignore our own. Dr. Schenker is offering a great public service.
The Ha'aretz article notes that some of the anti-circumcision foreskin lovers are trying to portray the Israeli docs as some sort of proselytizers for Judaism. That strikes me as anti-semitic. No, these docs are not mohels. No, they are not looking for Jewish converts. But, yes, they want to help restore America to its clean-cut status of the 1960s & 1970s. After all the money and support America has given Israel over the decades, I can't think of a better way for Israel to return the favor than to let its docs eliminate the foreskin from our continent.
Obviously, the expected recommendation from the Centers for Disease Control and the American Academy of Pediatrics that all newborn boys be circumcised will help in the future, but Operation Abraham could be just what the doctor ordered for American males who were not so fortunate at birth. Dr. Schenker, we need you and want you!
Sunday, August 30, 2009
San Francisco Chronicle Joins Boston Globe: Circumcise All Newborns
In a Sunday editorial, the San Francisco Chronicle has joined the Boston Globe in urging the Centers for Disease Control to stick to its original position that now is the time for all American newborns to be circumcised. It comes at a time when the anti-circumcision fanatics have become almost hysterical about the medical science that points to universal male circumcision. The editorial addresses the fanatics calling them what they are -- "hysterical intactivists." The editorial is so good that I am repeating it word for word:
The Centers for Disease Control and Prevention are weighing a proposal to recommend routine circumcision for all baby boys born in the United States to curb the spread of HIV and other infections. The CDC should ignore the cries of outrage from so-called "intactivists" and recommend the procedure. The evidence shows that the benefits of circumcision outweigh the risks.
This shouldn't even be controversial. Nearly 80 percent of adult American men are already circumcised, and they seem to be getting through life just fine. Studies have shown that circumcision can reduce HIV infection rates for heterosexual men by half. Observational studies have also shown that circumcised men have lower rates of other sexually transmitted diseases (like herpes and syphilis), cancer of the penis and urinary tract infections. What's the problem, again?
Well, the problem centers on the hysterical intactivists, who believe that: A. circumcision is "mutilation"; and that B. baby boys should be able to "decide for themselves," as though families have no right to make decisions about their children's health, treatment and culture. (Not to mention the health and safety of the larger society.)
The CDC should recommend routine circumcision.
CDC should recommend routine circumcision
Sunday, August 30, 2009
Sunday, August 30, 2009
The Centers for Disease Control and Prevention are weighing a proposal to recommend routine circumcision for all baby boys born in the United States to curb the spread of HIV and other infections. The CDC should ignore the cries of outrage from so-called "intactivists" and recommend the procedure. The evidence shows that the benefits of circumcision outweigh the risks.
This shouldn't even be controversial. Nearly 80 percent of adult American men are already circumcised, and they seem to be getting through life just fine. Studies have shown that circumcision can reduce HIV infection rates for heterosexual men by half. Observational studies have also shown that circumcised men have lower rates of other sexually transmitted diseases (like herpes and syphilis), cancer of the penis and urinary tract infections. What's the problem, again?
Well, the problem centers on the hysterical intactivists, who believe that: A. circumcision is "mutilation"; and that B. baby boys should be able to "decide for themselves," as though families have no right to make decisions about their children's health, treatment and culture. (Not to mention the health and safety of the larger society.)
The CDC should recommend routine circumcision.
Thursday, August 27, 2009
Boston Globe Endorses Newborn Circumcision for all Males
In another dramatic sign that America may be returning to its clean-cut, foreskin-free tradition, the Boston Globe has editorialized its view that all American boys should be circumcised at birth.
Entitled "Circumcision: A Cut against HIV," the Globe hailed the Centers for Disease Control's call to circumcise all American infant boys. "Such a tactic makes sense against a virus that infects more than 50,000 Americans each year," the editors wrote.
The editorial marks another sign that the anti-circ fanatics are losing the battle because the medical evidence is just so strong in favor of universal mandatory circumcision. The hope is that more major newspapers and media organizations will follow the Globe's example and encourage the CDC. The anti-circ foreskin lovers have mounted a strong PR campaign to dissuade the CDC from its sound science approach, but most Americans dismiss the foreskin lovers as whackos.
As I have repeatedly noted, the current "neutral" government policy hurts minorities, African Americans, and Hispanics because many have been denied health coverage for newborn circumcisions. The Globe notes that rates of HIV are higher among these groups because many more of them are uncircumcised.
While the overall tone of the editorial is quite positive, the Globe's editors can't quite say what we all know is obvious. It's not enough to call for universal male circumcision -- it should be mandatory. The editorial writers stop short of that, saying, "No one should be forced to circumcise a son. But where the health benefits are clear, the CDC should be equally clear in its recommendations. Circumcision is no panacea, but it deserves the CDC’s support."
In my view, if circumcision has clear health benefits that protect the male, his partners, and society, then it ought to be required for all. That's the editorial I really want to read. But the truth is that American parents are smart enough to follow the medical advice of the CDC, so the practical impact of promoting universal newborn circumcision will be to rid the filthy foreskin from the shores of this country.
Entitled "Circumcision: A Cut against HIV," the Globe hailed the Centers for Disease Control's call to circumcise all American infant boys. "Such a tactic makes sense against a virus that infects more than 50,000 Americans each year," the editors wrote.
The editorial marks another sign that the anti-circ fanatics are losing the battle because the medical evidence is just so strong in favor of universal mandatory circumcision. The hope is that more major newspapers and media organizations will follow the Globe's example and encourage the CDC. The anti-circ foreskin lovers have mounted a strong PR campaign to dissuade the CDC from its sound science approach, but most Americans dismiss the foreskin lovers as whackos.
As I have repeatedly noted, the current "neutral" government policy hurts minorities, African Americans, and Hispanics because many have been denied health coverage for newborn circumcisions. The Globe notes that rates of HIV are higher among these groups because many more of them are uncircumcised.
While the overall tone of the editorial is quite positive, the Globe's editors can't quite say what we all know is obvious. It's not enough to call for universal male circumcision -- it should be mandatory. The editorial writers stop short of that, saying, "No one should be forced to circumcise a son. But where the health benefits are clear, the CDC should be equally clear in its recommendations. Circumcision is no panacea, but it deserves the CDC’s support."
In my view, if circumcision has clear health benefits that protect the male, his partners, and society, then it ought to be required for all. That's the editorial I really want to read. But the truth is that American parents are smart enough to follow the medical advice of the CDC, so the practical impact of promoting universal newborn circumcision will be to rid the filthy foreskin from the shores of this country.
Saturday, July 25, 2009
Circumcision Improves Women's Sex Life
"Male circumcision perks up women's sex life" was the headline the other day in The Money Times (of all places). Of course, it's true as we all know. Most women prefer a circumcised male once they've experienced that pleasure. [This is where the foreskin lovers will chime in about most women have sex with uncircumcised males -- but that's only because these poor women don't have any other options].
No surprise, this is still another study that proves the benefits of getting rid of that ugly, disease-ridden foreskin.
"Researchers studied 455 female partners of circumcised men in Uganda. The research team studied the sexual satisfaction of circumcised men’s partners as part of the initial trials to test the efficacy of male circumcision."
"In the study women, between the ages of 15 and 49, reported their sexual satisfaction before and after their partners were circumcised. Around 57 percent of the women reported no change in sexual satisfaction while 39 percent said sex was more satisfying post-circumcision, and mere 3 percent reported less satisfaction after their male partner’s circumcision."
Let's emphasize that. The anti-circ fanatics say that circumcision hurts sex. You know the standard bullshit -- "it takes away thousands of nerve endings" blah blah blah. In this study, a slight majority of women reported no difference -- and 39% said circumcision improved sex. No surprise, only 3% were unhappy. So much for those "nerve endings."
"According to Dr. Godfrey Kigozi, MD, of the Rakai Health Sciences Program in Kalisizo, Uganda, the handful of women who reported reduced sexual satisfaction blamed either lower levels of desire or their partner’s struggle to achieve an erection." Yah, it wasn't the circumcision anyways.
"On the other hand, those women who reported improved sexual satisfaction said improved hygiene (cited by 51 of 177 women) and the fact that their partner took longer to achieve an orgasm (45 of the 177 women) resulting in longer sex, perked up their sex life."
"Kigozi and colleagues reported their findings at the fifth annual International AIDS Society conference on pathogenesis, treatment, and prevention of HIV."
Readers of my blog know that I believe the best reason to circumcise is good public health. But, hey, it can't hurt when that little snip improves your sex life!
No surprise, this is still another study that proves the benefits of getting rid of that ugly, disease-ridden foreskin.
"Researchers studied 455 female partners of circumcised men in Uganda. The research team studied the sexual satisfaction of circumcised men’s partners as part of the initial trials to test the efficacy of male circumcision."
"In the study women, between the ages of 15 and 49, reported their sexual satisfaction before and after their partners were circumcised. Around 57 percent of the women reported no change in sexual satisfaction while 39 percent said sex was more satisfying post-circumcision, and mere 3 percent reported less satisfaction after their male partner’s circumcision."
Let's emphasize that. The anti-circ fanatics say that circumcision hurts sex. You know the standard bullshit -- "it takes away thousands of nerve endings" blah blah blah. In this study, a slight majority of women reported no difference -- and 39% said circumcision improved sex. No surprise, only 3% were unhappy. So much for those "nerve endings."
"According to Dr. Godfrey Kigozi, MD, of the Rakai Health Sciences Program in Kalisizo, Uganda, the handful of women who reported reduced sexual satisfaction blamed either lower levels of desire or their partner’s struggle to achieve an erection." Yah, it wasn't the circumcision anyways.
"On the other hand, those women who reported improved sexual satisfaction said improved hygiene (cited by 51 of 177 women) and the fact that their partner took longer to achieve an orgasm (45 of the 177 women) resulting in longer sex, perked up their sex life."
"Kigozi and colleagues reported their findings at the fifth annual International AIDS Society conference on pathogenesis, treatment, and prevention of HIV."
Readers of my blog know that I believe the best reason to circumcise is good public health. But, hey, it can't hurt when that little snip improves your sex life!
Tuesday, July 7, 2009
Failure to Circumcise Cost Millions of Deaths
Sometimes it takes awhile for medical scientists to understand the importance of the discoveries made by fellow researchers. Such was the case of the link between the foreskin and HIV/AIDs, a discovery first made nearly 25 years ago.
Alex Renton, a reporter for The Observer, wrote this over the weekend:
"In 1985 researchers discovered that circumcised men who visited prostitutes in Kenya were much less likely to contract HIV. Some 30 studies on the issue were done during the 1990s, but it was not until 2004 that formal double-blind trials were commissioned by international Aids agencies. As a result of "overwhelming results" from these, pilot programmes for mass circumcision of men began in a number of African countries late last year. "
"It is now accepted by the World Health Organisation and other bodies that circumcision reduces chances of HIV infection by about 60%, and that up to 3 million deaths and 5.7 million infections could be prevented over the next 20 years. About 30 million people are thought to have died from Aids-related illnesses since 1981."
Dr Catherine Hankins, the chief scientific adviser to UNAids, the United Nations special agency for the epidemic, said that the failure to test the findings in the 1990s was "hard to explain".
"There's a good question to be asked of the research agencies: why they did not start the trials earlier," said Hankins. "We had 20 years of observational data on circumcision. I can't think of another product, or a technique, that waited for so long before trials." Circumcision has now been proved a very cost-effective way of reducing the rate of HIV infection, she said.
"Professor Francis Plummer, who led the University of Nairobi research team that first discovered the circumcision-HIV link in Kenya in the 1980s, said millions of lives might have been saved if his research had been acted upon sooner.
"There's been a failure of global public health institutions. We haven't done it very well. It's a frustration I've lived with for a very long time," Plummer said.
The failure of public health organizations to act has been deadly, not just in Africa but all over the world. In 2009, there is absolutely no reason for any male to have a disease-causing filthy foreskin. How long must we wait until the American Academy of Pediatrics and the U.S. Centers for Disease Control, to say nothing of their counterparts in other countries, wake up? It's time for the AAP and CDC to state clearly: the circumcision of every boy is a must to protect not only their own health, but also the health of their partners and society as a whole.
Alex Renton, a reporter for The Observer, wrote this over the weekend:
"In 1985 researchers discovered that circumcised men who visited prostitutes in Kenya were much less likely to contract HIV. Some 30 studies on the issue were done during the 1990s, but it was not until 2004 that formal double-blind trials were commissioned by international Aids agencies. As a result of "overwhelming results" from these, pilot programmes for mass circumcision of men began in a number of African countries late last year. "
"It is now accepted by the World Health Organisation and other bodies that circumcision reduces chances of HIV infection by about 60%, and that up to 3 million deaths and 5.7 million infections could be prevented over the next 20 years. About 30 million people are thought to have died from Aids-related illnesses since 1981."
Dr Catherine Hankins, the chief scientific adviser to UNAids, the United Nations special agency for the epidemic, said that the failure to test the findings in the 1990s was "hard to explain".
"There's a good question to be asked of the research agencies: why they did not start the trials earlier," said Hankins. "We had 20 years of observational data on circumcision. I can't think of another product, or a technique, that waited for so long before trials." Circumcision has now been proved a very cost-effective way of reducing the rate of HIV infection, she said.
"Professor Francis Plummer, who led the University of Nairobi research team that first discovered the circumcision-HIV link in Kenya in the 1980s, said millions of lives might have been saved if his research had been acted upon sooner.
"There's been a failure of global public health institutions. We haven't done it very well. It's a frustration I've lived with for a very long time," Plummer said.
The failure of public health organizations to act has been deadly, not just in Africa but all over the world. In 2009, there is absolutely no reason for any male to have a disease-causing filthy foreskin. How long must we wait until the American Academy of Pediatrics and the U.S. Centers for Disease Control, to say nothing of their counterparts in other countries, wake up? It's time for the AAP and CDC to state clearly: the circumcision of every boy is a must to protect not only their own health, but also the health of their partners and society as a whole.
Thursday, June 18, 2009
Mandatory Circumcision for Zambia Police Recruits
The Zambia National Broadcasting Company is reporting a new policy in that country: the mandatory circumcision of all male police recruits. Congratulations! I wonder if all policemen in America are circumcised? How ironic that American government officials are pushing for male circumcision in Africa but are strangely quiet here at home. Shouldn't we have a policy that all police and, frankly, U.S. military be circumcised? What's good in Africa is good at home.
"Recruits to be circumcised"
"The Zambia Police Service says plans are underway to introduce a mandatory circumcision policy for all male recruits. Kamfinsa Police training school commanding Officer, Malcom Mulenga, says male circumcision will help prevent HIV and AIDS cases in the Police service.
Mr. Mulenga, says the Zambia Police Service has continued to lose qualified manpower as a result HIV/AIDS. "
"He was speaking when the American government handed over a Voluntary Counselling and Testing centre to the Zambia Police Service. At the same function, Home Affairs deputy Minister, Misheck Bonshe, welcomed plans by the Zambia Police Service to circumcise male recruits. And the United States Charge d' Affairs for Zambia, Michael Koplovsky, said his government has set aside K1.5 billion for the construction of health centres for police officers."
"Recruits to be circumcised"
"The Zambia Police Service says plans are underway to introduce a mandatory circumcision policy for all male recruits. Kamfinsa Police training school commanding Officer, Malcom Mulenga, says male circumcision will help prevent HIV and AIDS cases in the Police service.
Mr. Mulenga, says the Zambia Police Service has continued to lose qualified manpower as a result HIV/AIDS. "
"He was speaking when the American government handed over a Voluntary Counselling and Testing centre to the Zambia Police Service. At the same function, Home Affairs deputy Minister, Misheck Bonshe, welcomed plans by the Zambia Police Service to circumcise male recruits. And the United States Charge d' Affairs for Zambia, Michael Koplovsky, said his government has set aside K1.5 billion for the construction of health centres for police officers."
Saturday, June 13, 2009
Americans Lead Way for Africa on Circumcision, But Don't Forget the Homefront
I have blogged about this before, but it's worth repeating. The United States is showing amazing leadership in circumcising African males, as the latest story below reports, and who can quarrel with doing that on that disease-infected, foreskin-afflicted continent. But I worry that the strong campaign to circumcise African males may blind the eye to what is happening here at home. Sadly, even if the anti-circs exaggerate the numbers, more American boys, especially Latinos and blacks, are going uncircumcised. In part, that's because the government Medicaid program no longer pays for this important procedure in about a dozen states. Poor blacks and Latinos are the first to suffer.
So while we can all applaud the Bill & Melinda Gates Foundation, the U.S. government through PEPFAR, and PSI -- let's not forget the boys at home who need to be circumcised, too.
Here's a June 11 press release from PSI:
"The Male Circumcision Partnership is launching a massive scale-up of voluntary male circumcision services in Swaziland and Zambia. The Partnership is supported by a five-year, US$50 million grant from the Bill & Melinda Gates Foundation to Population Services International (PSI). PSI and partners Marie Stopes International, Jhpiego, The Population Council and the governments of Swaziland and Zambia estimate that the project will provide voluntary male circumcision services to nearly 650,000 men."
"The Male Circumcision Partnership program in Swaziland and Zambia also builds upon the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) supported medical male circumcision activities in each country. This partnership is evidence of a strong and growing coordination among the Gates Foundation, PEPFAR and other partners under the leadership of host country governments to support evidence-based medical male circumcision for the purpose of HIV prevention."
"Cited by both the World Health Organization and UNAIDS as an "important intervention," male circumcision reduces HIV infections among men by 60%,according to scientific research -- more effective than any vaccine currently in development."
So while we can all applaud the Bill & Melinda Gates Foundation, the U.S. government through PEPFAR, and PSI -- let's not forget the boys at home who need to be circumcised, too.
Here's a June 11 press release from PSI:
"The Male Circumcision Partnership is launching a massive scale-up of voluntary male circumcision services in Swaziland and Zambia. The Partnership is supported by a five-year, US$50 million grant from the Bill & Melinda Gates Foundation to Population Services International (PSI). PSI and partners Marie Stopes International, Jhpiego, The Population Council and the governments of Swaziland and Zambia estimate that the project will provide voluntary male circumcision services to nearly 650,000 men."
"The Male Circumcision Partnership program in Swaziland and Zambia also builds upon the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) supported medical male circumcision activities in each country. This partnership is evidence of a strong and growing coordination among the Gates Foundation, PEPFAR and other partners under the leadership of host country governments to support evidence-based medical male circumcision for the purpose of HIV prevention."
"Cited by both the World Health Organization and UNAIDS as an "important intervention," male circumcision reduces HIV infections among men by 60%,according to scientific research -- more effective than any vaccine currently in development."
Tuesday, June 9, 2009
Aussie/NZ Doctors Cave to Anti-Circumcision Fanatics
According to The Age, a Melbourne newspaper, the Australia/New Zealand college of physicians is not yet ready to do the obvious -- recommend the circumcision of all baby boys. Anti-circumcision fanatics have been more successful on that continent than in the USA, dropping the number of healthy, clean-cut boys over the last twenty years.
Here's the article from its June 6 paper with my comments in boldface:
"THE Royal Australasian College of Physicians has flagged it will not change its policy against circumcision despite evidence the procedure can prevent the spread of HIV and other sexual diseases." [How much medical evidence do these docs need?]
"The college, which represents physicians and pediatricians in Australia and New Zealand, has adopted the position that "there is no medical indication for routine neonatal circumcision" since 2004." [A bad decision in 2004, but much worse in 2009.]
"But it has been reviewing this stance in part following recent scientific research suggesting that the risk of HIV infection could be dramatically reduced by the practice. Three trials conducted in South Africa, Kenya and Uganda between 2005 and 2007 showed conclusively, according to the World Health Organisation, "that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent". [Repeat, docs, circumcision cuts the risk of HIV by 60% -- what are you waiting for? 100%?].
"Further research, published this year in the New England Journal of Medicine, has found that circumcision can reduce the transfer of human papillomavirus — the chief cause of cervical cancer in women — by 35 per cent, and herpes simplex virus — the chief cause of herpes — by 25 per cent." [So, on top of the HIV reduction, it cuts cervical cancer in women by 35% and herpes by 25%, and you Aussie/NZ docs still won't acknowledge the obvious?]
"The journal said the findings underscored "the potential public health benefits of the procedure". The college, which began its review in 2006 and was supposed to come out with a revised policy at the end of 2007, will not do so until the end of this year, as it considers the new evidence." [Better late than never, but what are you waiting for?]
"It is estimated that 10 to 20 per cent of male infants are circumcised in Australia." [Ewww, the thought of so many filthy foreskins in Australia should make us all sick, especially their future female partners].
"The chairman of the college's panel considering the issue, David Forbes, of the University of Western Australia's school of pediatrics, said the African studies had delayed the new recommendation, but so too had the fact "it is a contentious and non-clear-cut issue". [It's only contentious for the foreskin lovers who won't recognize medical evidence.]
"It's quite clear that there's evidence that circumcision in adult males helps prevent HIV in Africa," said Professor Forbes. "It's not so clear that circumcision in Australia in infants is of benefit to the infants or the community. Policy is about getting the right message to health planners so that we have safe but cost-effective expenditure." [The best time to circumcise is at birth, folks. Safer, cheaper, faster, pain-free, cleaner. Everyone knows that.]
New concerns about the practice of circumcision in Australia were raised last week after the Tasmanian Law Reform Institute found that parental consent might not be enough to protect the circumcisers of baby boys from later legal action. [Another distraction by the foreskin lovers. Since when can parents not consent to life-saving medical procedures for their children?]
No specific laws regulate the removal of the foreskin. [The biggest improvement would be a law to require circumcision before entering school, as a public safety measure like vaccinations.]
Professor Forbes said he wanted to have the college's position "finalised by the end of this year, hopefully before". [Again, better late than never].
"He said the benefit of reducing human papillomavirus "appears not to be such an issue in Australia" because a vaccine was being produced. And there were important differences between the HIV situation in Africa and Australia: HIV rates in Australia were far lower and condom use was much higher." [HIV rates are lower in Australia because the previous generation, now sexually active, were circumcised at birth. With so many young boys now afflicted with a foreskin, those rates will change by 2020].
"He said while there was clear evidence that circumcision reduced the rate of urinary tract infection, this alone did not justify routine use of the procedure as the infection rate was so small.
He said the 10-strong panel consisted of pediatricians, surgeons and policy and public health experts. "There are extremely strong views at both ends of the spectrum for those who promote circumcision and those who oppose it," he said." [Yes, another benefit of circumcision, the reduction of UTI. The list of benefits goes on and on and on, but Aussie docs ignore them].
"Undertaking elective surgery of minors who are not able to consent is for many pediatricians an even bigger issue, especially when there are examples of (Muslim) societies who elect to have it at puberty when people can choose." [This 'consent' issue is another red herring raised by the anti-circ fanatics. What about parental rights and responsibilities to keep their children healthy?]
"Dr Forbes declined to preview what the college's recommendation would be. "Policy change tends to be evolutionary, not revolutionary, and given that there are no trials of neonatal circumcision for prevention of HIV, I wouldn't expect revolutionary change. I would expect evolutionary change." [Just follow the science, dudes].
"Roger Short, from Melbourne University's department of obstetrics and gynaecology, hopes the college will view circumcision in a more favourable light. "It would be exciting to see the Royal College come forward with a slightly more progressive attitude than its previous pronouncements," he said. "The evidence is coming in, and it is irrefutable, that there are major benefits." [Thank you, Dr. Short. You're a doc who speaks the truth on the science].
"Professor Short said there were no grounds for making circumcision mandatory." [Well, I disagree about this. Circumcision should be required for all boys, with exceptions for the obvious conscientious religious objection].
Instead, the college should change its recommendation. "I think we should go from saying 'when in doubt, don't circumcise' to 'when in doubt, do'." [Absolutely. So Aussie/NZ docs, just do it].
Here's the article from its June 6 paper with my comments in boldface:
"THE Royal Australasian College of Physicians has flagged it will not change its policy against circumcision despite evidence the procedure can prevent the spread of HIV and other sexual diseases." [How much medical evidence do these docs need?]
"The college, which represents physicians and pediatricians in Australia and New Zealand, has adopted the position that "there is no medical indication for routine neonatal circumcision" since 2004." [A bad decision in 2004, but much worse in 2009.]
"But it has been reviewing this stance in part following recent scientific research suggesting that the risk of HIV infection could be dramatically reduced by the practice. Three trials conducted in South Africa, Kenya and Uganda between 2005 and 2007 showed conclusively, according to the World Health Organisation, "that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent". [Repeat, docs, circumcision cuts the risk of HIV by 60% -- what are you waiting for? 100%?].
"Further research, published this year in the New England Journal of Medicine, has found that circumcision can reduce the transfer of human papillomavirus — the chief cause of cervical cancer in women — by 35 per cent, and herpes simplex virus — the chief cause of herpes — by 25 per cent." [So, on top of the HIV reduction, it cuts cervical cancer in women by 35% and herpes by 25%, and you Aussie/NZ docs still won't acknowledge the obvious?]
"The journal said the findings underscored "the potential public health benefits of the procedure". The college, which began its review in 2006 and was supposed to come out with a revised policy at the end of 2007, will not do so until the end of this year, as it considers the new evidence." [Better late than never, but what are you waiting for?]
"It is estimated that 10 to 20 per cent of male infants are circumcised in Australia." [Ewww, the thought of so many filthy foreskins in Australia should make us all sick, especially their future female partners].
"The chairman of the college's panel considering the issue, David Forbes, of the University of Western Australia's school of pediatrics, said the African studies had delayed the new recommendation, but so too had the fact "it is a contentious and non-clear-cut issue". [It's only contentious for the foreskin lovers who won't recognize medical evidence.]
"It's quite clear that there's evidence that circumcision in adult males helps prevent HIV in Africa," said Professor Forbes. "It's not so clear that circumcision in Australia in infants is of benefit to the infants or the community. Policy is about getting the right message to health planners so that we have safe but cost-effective expenditure." [The best time to circumcise is at birth, folks. Safer, cheaper, faster, pain-free, cleaner. Everyone knows that.]
New concerns about the practice of circumcision in Australia were raised last week after the Tasmanian Law Reform Institute found that parental consent might not be enough to protect the circumcisers of baby boys from later legal action. [Another distraction by the foreskin lovers. Since when can parents not consent to life-saving medical procedures for their children?]
No specific laws regulate the removal of the foreskin. [The biggest improvement would be a law to require circumcision before entering school, as a public safety measure like vaccinations.]
Professor Forbes said he wanted to have the college's position "finalised by the end of this year, hopefully before". [Again, better late than never].
"He said the benefit of reducing human papillomavirus "appears not to be such an issue in Australia" because a vaccine was being produced. And there were important differences between the HIV situation in Africa and Australia: HIV rates in Australia were far lower and condom use was much higher." [HIV rates are lower in Australia because the previous generation, now sexually active, were circumcised at birth. With so many young boys now afflicted with a foreskin, those rates will change by 2020].
"He said while there was clear evidence that circumcision reduced the rate of urinary tract infection, this alone did not justify routine use of the procedure as the infection rate was so small.
He said the 10-strong panel consisted of pediatricians, surgeons and policy and public health experts. "There are extremely strong views at both ends of the spectrum for those who promote circumcision and those who oppose it," he said." [Yes, another benefit of circumcision, the reduction of UTI. The list of benefits goes on and on and on, but Aussie docs ignore them].
"Undertaking elective surgery of minors who are not able to consent is for many pediatricians an even bigger issue, especially when there are examples of (Muslim) societies who elect to have it at puberty when people can choose." [This 'consent' issue is another red herring raised by the anti-circ fanatics. What about parental rights and responsibilities to keep their children healthy?]
"Dr Forbes declined to preview what the college's recommendation would be. "Policy change tends to be evolutionary, not revolutionary, and given that there are no trials of neonatal circumcision for prevention of HIV, I wouldn't expect revolutionary change. I would expect evolutionary change." [Just follow the science, dudes].
"Roger Short, from Melbourne University's department of obstetrics and gynaecology, hopes the college will view circumcision in a more favourable light. "It would be exciting to see the Royal College come forward with a slightly more progressive attitude than its previous pronouncements," he said. "The evidence is coming in, and it is irrefutable, that there are major benefits." [Thank you, Dr. Short. You're a doc who speaks the truth on the science].
"Professor Short said there were no grounds for making circumcision mandatory." [Well, I disagree about this. Circumcision should be required for all boys, with exceptions for the obvious conscientious religious objection].
Instead, the college should change its recommendation. "I think we should go from saying 'when in doubt, don't circumcise' to 'when in doubt, do'." [Absolutely. So Aussie/NZ docs, just do it].
Monday, May 25, 2009
TSA Full Body Scanners Can See Circumcisions
We all know the stories about uncircumcised males being embarrassed about their foreskins, at least in circumcised countries like America. Turns out the new full body imaging scanners being put in place by the TSA at airports across the country are so detailed that TSA will soon know the circumcision status of every dude who gets scanned. I haven't yet heard if the anti-circumcision groups are up-in-foreskins, oops, I mean up-in-arms about this, but it wouldn't surprise me. Keeping track of the nation's uncircumcised males is one way to know who is the most likely threat to public health, I suppose. The TSA is obviously looking for objects and devices that can blow up planes, but I dare say that more people have died from foreskins infecting a male or his partners (especially female) with HIV, HPV, STDs, and other ailments than from a bomb on board an American plane.
Anybody think the day will come when the TSA will haul aside uncircumcised dudes and send them off to a doctor? I admit, that's extreme. But you do wonder whether knowledge that a man's circumcision status will be checked every time he goes through an airport has any impact on circumcision rates in the USA.
Anybody think the day will come when the TSA will haul aside uncircumcised dudes and send them off to a doctor? I admit, that's extreme. But you do wonder whether knowledge that a man's circumcision status will be checked every time he goes through an airport has any impact on circumcision rates in the USA.
Friday, May 15, 2009
Pro-Circ Doc to Head Centers for Disease Control
Good news for the circumcision movement! President Obama has named Thomas Frieden, MD, to be the new Director of the Centers for Disease Control. Dr. Frieden has been the New York City Health Commissioner. He drove the anti-circs crazy when the New York Times reported that NYC would recommend that all males be circumcised to prevent the spread of HIV. Frieden apparently backed away, or claimed that was never the original intent, but in a letter to the NYT on April 9, 2007, he encouraged discussion of this issue, saying he awaited "stronger evidence." His letter is below, but NOTE that it was written two years ago. In those two years, we now have incredibly strong evidence of the value of circumcision in reducing not only HIV but HPV and STDs in both men and women. Dr. Frieden's appointment is a significant blow to the anti-circumcision fanatics, as he appears to be a man who wants to follow the science.
Old Letter to NYT from new CDC Director:
"The New York City Health Department has not planned, developed or announced a campaign to encourage at-risk men to get circumcised. Like other domestic health agencies, we are encouraging people to discuss and study this issue."
"Because circumcision has the potential to decrease H.I.V. transmission by more than half, we hope that men who choose the procedure will have access to it. A campaign to promote circumcision in this country would be premature without stronger evidence, but the time is right for a communitywide dialogue."
Thomas R. Frieden, M.D. New York City Health Commissioner New York, April 9, 2007
Old Letter to NYT from new CDC Director:
"The New York City Health Department has not planned, developed or announced a campaign to encourage at-risk men to get circumcised. Like other domestic health agencies, we are encouraging people to discuss and study this issue."
"Because circumcision has the potential to decrease H.I.V. transmission by more than half, we hope that men who choose the procedure will have access to it. A campaign to promote circumcision in this country would be premature without stronger evidence, but the time is right for a communitywide dialogue."
Thomas R. Frieden, M.D. New York City Health Commissioner New York, April 9, 2007
Friday, May 8, 2009
Taking Lessons from Botswana on Universal Circumcision
The United States government should take a page or two out of Botswana's commitment to universal circumcision. It's downright embarrassing that we send millions of dollars overseas to circumcise Africans but can't get our act together here at home. Maybe one of these days we can follow Botswana's lead. See story below.
Botswana plans to circumcise nearly half a million
GABORONE (AFP) — Botswana, which has one of the world's highest HIV infection rates, has launched a scheme to circumcise nearly half a million men to curb the spread the disease, the health ministry said Thursday.
The country hopes to circumcise 460,000 men over the next five years, after a series of studies found that circumcised men were two to three times less likely to contract HIV, said Janet Mwambona, a public health specialist in charge of the project.
"For the public health benefits of the preventive effect of circumcision to be realised, the Ministry of Health is supposed to cover 80 percent of eligible males in Botswana," she said.
Government is running television and radio campaigns to encourage men to visit clinics for safe circumcision procedures.
"All primary and district hospitals are currently booking clients and performing the procedure," added Mwambona.
About 50 healthcare providers, including 27 doctors have undergone training on surgical circumcision.
The rapid spread of HIV and AIDS once threatened the survival of the approximately two million people of the land-locked southern African country, until the introduction of antiretroviral drugs in 2003.
According to a 2005 UNAIDS report, Botswana's HIV prevalence among pregnant women between the ages of 15 and 24 has stayed between 35 and 37 percent since 2001.
The rate among the older pregnant women was last measured at 43 percent in 2003.
Botswana plans to circumcise nearly half a million
GABORONE (AFP) — Botswana, which has one of the world's highest HIV infection rates, has launched a scheme to circumcise nearly half a million men to curb the spread the disease, the health ministry said Thursday.
The country hopes to circumcise 460,000 men over the next five years, after a series of studies found that circumcised men were two to three times less likely to contract HIV, said Janet Mwambona, a public health specialist in charge of the project.
"For the public health benefits of the preventive effect of circumcision to be realised, the Ministry of Health is supposed to cover 80 percent of eligible males in Botswana," she said.
Government is running television and radio campaigns to encourage men to visit clinics for safe circumcision procedures.
"All primary and district hospitals are currently booking clients and performing the procedure," added Mwambona.
About 50 healthcare providers, including 27 doctors have undergone training on surgical circumcision.
The rapid spread of HIV and AIDS once threatened the survival of the approximately two million people of the land-locked southern African country, until the introduction of antiretroviral drugs in 2003.
According to a 2005 UNAIDS report, Botswana's HIV prevalence among pregnant women between the ages of 15 and 24 has stayed between 35 and 37 percent since 2001.
The rate among the older pregnant women was last measured at 43 percent in 2003.
Wednesday, May 6, 2009
Listen to the Medical Doctors: Circumcise Now!
Below are just a couple of quotations from some noted medical doctors that I think we all should respect. Of course, the FLs ("foreskin lovers") will disparage these docs in the misguided, ongoing anti-circ effort to protect their beloved foreskin. But with a respected doctor like Anthony Fauci says, "Circumcise!" maybe the American Academy of Pediatrics will listen.
“Medically supervised adult male circumcision is a scientifically proven method for reducing a man’s risk of acquiring HIV infection through heterosexual intercourse,” says NIAID Director Anthony S. Fauci, M.D. “This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well.”
“The cumulative scientific evidence supporting the public health value of medically supervised male circumcision is now overwhelming,” says Thomas C. Quinn, M.D., study co-investigator, chief of the International HIV/STD Section in NIAID’s Laboratory of Immunoregulation and co-author of the study. “This new research confirms the substantial health benefits of male circumcision, including reduced acquisition of HIV, genital herpes, HPV and genital ulcer disease.”
"These findings have significant public health implications for the control of HIV, genital herpes and HPV in areas of high prevalence, such as Africa, and further suggest that efforts to scale-up male circumcision could have tremendous benefit,” said Dr. David Serwadda, co-principal investigator and dean of Makerere University’s School of Public Health.
In the eyes of the anti-circumcision fanatics, these doctors must just be looney.
“Medically supervised adult male circumcision is a scientifically proven method for reducing a man’s risk of acquiring HIV infection through heterosexual intercourse,” says NIAID Director Anthony S. Fauci, M.D. “This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well.”
“The cumulative scientific evidence supporting the public health value of medically supervised male circumcision is now overwhelming,” says Thomas C. Quinn, M.D., study co-investigator, chief of the International HIV/STD Section in NIAID’s Laboratory of Immunoregulation and co-author of the study. “This new research confirms the substantial health benefits of male circumcision, including reduced acquisition of HIV, genital herpes, HPV and genital ulcer disease.”
"These findings have significant public health implications for the control of HIV, genital herpes and HPV in areas of high prevalence, such as Africa, and further suggest that efforts to scale-up male circumcision could have tremendous benefit,” said Dr. David Serwadda, co-principal investigator and dean of Makerere University’s School of Public Health.
In the eyes of the anti-circumcision fanatics, these doctors must just be looney.
Saturday, April 25, 2009
American Academy of Pediatrics Statement on Circumcision We Hope to See
Somewhere circulating within the emails of the American Academy of Pediatrics' Task Force on Circumcision, there is a draft proposal updating the AAP's 1999 "neutral" stance on circumcision in light of the growing medical evidence in favor of male circumcision. You can call this a fictional wish-list, but we hope the AAP has the guts to issue a report something like this:
After a comprehensive review of the latest medical and scientific evidence, the American Academy of Pediatrics concludes that all males should be circumcised, preferably at birth, as a matter of both personal medical well-being and general public health to protect themselves, their future sexual partners, and society as a whole from a number of debilitating, life-threatening, and costly diseases.
In 1999, the AAP declared that “scientific evidence demonstrates potential medical benefits of newborn male circumcision,” but we cautioned that “these data are not sufficient to recommend routine neonatal circumcision.” This position, reaffirmed in 2005, understandably left parents of newborn males in a quandary. While the medical benefits of circumcision were established, such as a substantial reduction in urinary tract infection, the evidence was not then compelling to recommend that every male be circumcised. Parents were left to draw their own conclusions, which meant that social, familial, and other non-medical concerns often took priority over health care in the decision-making process.
With substantial new scientific evidence over the last four years, the AAP now recommends that all newborn males be circumcised, and we encourage all public and private health insurers and medical providers to cover, promote, and establish efficacious ways to achieve universal male circumcision. We endorse routine neonatal circumcision, with all the appropriate analgesics to alleviate pain, and we recommend that all males, regardless of age, be circumcised. Circumcision not only confers life-long benefits on the male, but it also protects his female partners and society as a whole.
Among its other benefits, circumcision reduces a male’s chance of acquiring HIV by at least 50 percent, reduces his risk of acquiring HPV by 35 percent and spreading HPV to his female partners, reduces his chances of contracting Herpes Simplex Virus Type II by 28 percent, and reduces the likelihood of causing cervical cancer in his female partners. The AAP does not assert that circumcision eliminates these painful and costly medical scourges, but it will significantly reduce them. These health benefits to males and females far outweigh any risks posed by circumcision, and to suggest otherwise is to engage in a head-in-the-sand approach to science for political and non-medical reasons.
We recognize that the decision to circumcise children lies with the parent, so, consequently, just as with AAP-recommended vaccinations, an option not to circumcise must be made available. But the AAP concludes that sound science dictates the goal of universal male circumcision, regardless of the race, nationality, religion, age, or economic status of the male. A requirement by schools that all boys be circumcised before puberty is recommended, subject to exception for religious or deeply-held objection, or a rare medical necessity. But like the eradication of polio and measles through a policy of universal vaccination, the public health benefits of circumcision are best conferred when adopted by all.
This position in no way impugns the decision of many parents in recent years that left their sons uncircumcised. The decision not to circumcise was perfectly understandable, particularly in the context of the AAP’s former position. But medical science advances, and health care requirements must change with that evidence. Boys left uncircumcised, particularly as they become sexually active, increase their own risks and those with whom they are intimate. That is why the AAP encourages both public and private health insurers and health providers to establish cost-effective options to circumcise both young and older males. And we encourage parents of uncircumcised boys to take advantage of those options as quickly as possible.
Finally, we believe that the evidence for universal male circumcision is so compelling that the United States Government, through the Surgeon General, the Public Health Service, the Centers for Disease Control, Centers for Medicare & Medicaid Services, and all other relevant agencies, needs to engage in a public information campaign and improve affordable access to circumcision for all American males of every age. Under the leadership of the World Health Organization, many other governments have taken such a pro-active lead. The American Academy of Pediatrics urges the U.S. Government to do the same. A country with the greatest medical scientists, practitioners, and institutions should once again take the lead on this critical public health mission.
"DRAFT DRAFT DRAFT"
Task Force on Circumcision
American Academy of Pediatrics
Benefits of Male Circumcision Outweigh Risks
A Call to Universal Circumcision
Executive Summary
After a comprehensive review of the latest medical and scientific evidence, the American Academy of Pediatrics concludes that all males should be circumcised, preferably at birth, as a matter of both personal medical well-being and general public health to protect themselves, their future sexual partners, and society as a whole from a number of debilitating, life-threatening, and costly diseases.
In 1999, the AAP declared that “scientific evidence demonstrates potential medical benefits of newborn male circumcision,” but we cautioned that “these data are not sufficient to recommend routine neonatal circumcision.” This position, reaffirmed in 2005, understandably left parents of newborn males in a quandary. While the medical benefits of circumcision were established, such as a substantial reduction in urinary tract infection, the evidence was not then compelling to recommend that every male be circumcised. Parents were left to draw their own conclusions, which meant that social, familial, and other non-medical concerns often took priority over health care in the decision-making process.
With substantial new scientific evidence over the last four years, the AAP now recommends that all newborn males be circumcised, and we encourage all public and private health insurers and medical providers to cover, promote, and establish efficacious ways to achieve universal male circumcision. We endorse routine neonatal circumcision, with all the appropriate analgesics to alleviate pain, and we recommend that all males, regardless of age, be circumcised. Circumcision not only confers life-long benefits on the male, but it also protects his female partners and society as a whole.
Among its other benefits, circumcision reduces a male’s chance of acquiring HIV by at least 50 percent, reduces his risk of acquiring HPV by 35 percent and spreading HPV to his female partners, reduces his chances of contracting Herpes Simplex Virus Type II by 28 percent, and reduces the likelihood of causing cervical cancer in his female partners. The AAP does not assert that circumcision eliminates these painful and costly medical scourges, but it will significantly reduce them. These health benefits to males and females far outweigh any risks posed by circumcision, and to suggest otherwise is to engage in a head-in-the-sand approach to science for political and non-medical reasons.
We recognize that the decision to circumcise children lies with the parent, so, consequently, just as with AAP-recommended vaccinations, an option not to circumcise must be made available. But the AAP concludes that sound science dictates the goal of universal male circumcision, regardless of the race, nationality, religion, age, or economic status of the male. A requirement by schools that all boys be circumcised before puberty is recommended, subject to exception for religious or deeply-held objection, or a rare medical necessity. But like the eradication of polio and measles through a policy of universal vaccination, the public health benefits of circumcision are best conferred when adopted by all.
This position in no way impugns the decision of many parents in recent years that left their sons uncircumcised. The decision not to circumcise was perfectly understandable, particularly in the context of the AAP’s former position. But medical science advances, and health care requirements must change with that evidence. Boys left uncircumcised, particularly as they become sexually active, increase their own risks and those with whom they are intimate. That is why the AAP encourages both public and private health insurers and health providers to establish cost-effective options to circumcise both young and older males. And we encourage parents of uncircumcised boys to take advantage of those options as quickly as possible.
Finally, we believe that the evidence for universal male circumcision is so compelling that the United States Government, through the Surgeon General, the Public Health Service, the Centers for Disease Control, Centers for Medicare & Medicaid Services, and all other relevant agencies, needs to engage in a public information campaign and improve affordable access to circumcision for all American males of every age. Under the leadership of the World Health Organization, many other governments have taken such a pro-active lead. The American Academy of Pediatrics urges the U.S. Government to do the same. A country with the greatest medical scientists, practitioners, and institutions should once again take the lead on this critical public health mission.
Saturday, April 18, 2009
Anti Circumcision Fanatics Are Getting Hysterical
Have you noticed how the anti-circumcision crowd is getting more and more hysterical, as the prophylactic value of circumcision grows with each new medical study?
What is it with these people? Science is science, and to name-call those whose medical evidence reaches a conclusion you don't like is Luddite medicine at its worse. You remember the Luddites, don't you? Decent enough people, I suppose, who during the Industrial Revolution didn't like the marvelous new inventions of the era took it upon themselves to destroy the good that modern science was delivering.
Today's anti circ crowd is just like that. They cling to the foreskin like it was some Holy Grail, denouncing every new study that shows circumcision to reduce the incidence of HIV, HPV, STDs, and a host of other ailments. These socalled "intactivists" use trash talk and hyperbole to disparage those of us who want to follow medical science to its logical conclusion -- a foreskin-free society where all males are circumcised, not only for their own good health, but also for those of their partners and society as a whole.
Even on this page, the anti circ fanatics try to turn my logical and reasonable call for mandatory circumcision into a Nazi-like dragging of adult males into some hospital room. I have never ever suggested that. Universal circumcision will be achieved by custom, law, and the good sense of people, heeding the doctors and scientists of the 21st Century. It will happen over time, as every young boy is circumcised before school age, just as we innoculate children today. But such is the hysteria of the anti circ crowd that, rather than debate the science, they trash the scientists and those who follow the science to its logical conclusion.
The only good news about the growing anti circumcision hysteria is that it's a sure sign that they are losing!
What is it with these people? Science is science, and to name-call those whose medical evidence reaches a conclusion you don't like is Luddite medicine at its worse. You remember the Luddites, don't you? Decent enough people, I suppose, who during the Industrial Revolution didn't like the marvelous new inventions of the era took it upon themselves to destroy the good that modern science was delivering.
Today's anti circ crowd is just like that. They cling to the foreskin like it was some Holy Grail, denouncing every new study that shows circumcision to reduce the incidence of HIV, HPV, STDs, and a host of other ailments. These socalled "intactivists" use trash talk and hyperbole to disparage those of us who want to follow medical science to its logical conclusion -- a foreskin-free society where all males are circumcised, not only for their own good health, but also for those of their partners and society as a whole.
Even on this page, the anti circ fanatics try to turn my logical and reasonable call for mandatory circumcision into a Nazi-like dragging of adult males into some hospital room. I have never ever suggested that. Universal circumcision will be achieved by custom, law, and the good sense of people, heeding the doctors and scientists of the 21st Century. It will happen over time, as every young boy is circumcised before school age, just as we innoculate children today. But such is the hysteria of the anti circ crowd that, rather than debate the science, they trash the scientists and those who follow the science to its logical conclusion.
The only good news about the growing anti circumcision hysteria is that it's a sure sign that they are losing!
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