I posted this here a while ago so people would have a understanding of the proposition. I'll repost it for everyone's benefit. The thing is the WHO recommendation applies only to countries with high prevalence and not to countries like the US. And let me just explain to you why especially in the US, and other first world countries, the HIV argument is pretty much BS. It's also a stupid policy in Africa and will almost certainly be a long term failure but for other reasons.
Anyway, to determine the probability of not becoming infected you can use the following formula:
(1 - [chance of transmission from sex])^[sexual encounters]
Now for the estimates, let's assume that there is a risk reduction of 50% for circumcised men. This is the number most often banted around by the popular media and those clowns at the UN and WHO in their reports from Africa. The probability of infection in any one encounter with an HIV positive partner varies depending on viral load, co-infection, and numerous other reasons. For example, people are most infectious soon after being infected. Infectiousness lessens after a few weeks which is one reason HIV spreads so fast in Africa, read The Invisible Cure: Africa, the West, and the Fight Against AIDS by Helen Epstein to find out why it's so infectious in Africa but not anywhere else. Anyway, I've seen numbers for women infecting men range from 1/700 - 1/2500 but we'll estimate that the chance of infection is 0.1%. That means a male having unprotected sex with an HIV positive women has about a 1 in 1000 chance of being infected. The number of sexual encounters is important too. If we assume 1000, then the probability of not being infected after 1000 encounters with an HIV positive woman would be:
Base line risk intact men vs circumcised men 1000 heterosexual contacts/HIV+ partner.
[1 - 0.001]**1000 ~= 36.76 ~= 63% ~= 3/5
[1 - 0.0005]**1000 ~= 60.64 ~= 40% ~= 2/5
But, the HIV distribution in the US population is 5 in 1000 or 1/200 so the odds when I add that wheel, the numbers are:
1/200 * 3/5 = 3/1000 = 1/333.3 ~= 1 - 0.003 ~= 99.7%
1/200 * 2/5 = 2/1000 = 1/500 ~= 1 - 0.002 ~= 99.8%
That's is what circumcision bought you, big deal. Of course there are some caveats to this. First, the 1/200 is quite high since 75% of the HIV positive population are men. Women only account for about 1/4 of the total which reduces that to between say 1/700 or 1/1000. And I am not even making any attempt to figure in regular condom use which essentially reduces your risk at least one but proabably two orders of magnitude. Also the probability of infection may be higher or lower depending on other factors. The bottom line is the numbers don't really make a good case for infant circumcision particularly in industrialized countries.
If a man finds himself in a higher risk group and think the incremental benefit is worth it then he is free to get circumcised. But for the vast majority of the population there is no practical benefit, a difference on the order of hundredths perhaps thousandths of a percent.
As an aside, keep in mind that the US does in fact have the highest prevalence rates of all STDs as compared to other industrialized countries (which don't circumcise their boys BTW). And not by a little, by a lot. Here is a sample from
Advocate for Youth.
Now it's time to read up.
I agree.
:
By Helen Epstein. Chapter three if you don't want to read the whole book, page 56
