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Originally Posted by Claire and Boys  I've been having an argument with someone about this issue and pointed out the fact that Europe has lower circ rates + HIV prevalence and their argument was that in countries where circ is not practised there is a greater heterosexual risk and where circ is practised the biggest risk groups are MSM and drug users. Looking at the figures on Avert, this seems to be mostly true, I did uncover a few exceptions looking at other sites namely Japan and Ethiopia..Japan has a very low circ rate and low risk of heterosexual transmission and Ethiopia the opposite.
The other issue is they point out that the groups in the US with high HIV rates are blacks and hispanics who tend not to circ. I have said that they also have disproportionate rates of poverty which may affect sexual education etc. But it's a difficult argument to win.
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You have to be careful about how those figures are interpreted. There are always caveats aren't there?
We don't know how things are defined and they may be defined differently between countries. One of the terms used by Avert is 'high risk heterosexual sex' this is defined as having sex with someone who is or is at a high probability of infection.
I took the liberty to dig through the US and UK numbers a bit and this is just a napkin kind of estimate but here it goes. According to
Avert, the number of US men who are thought to have acquired HIV through heterosexual contact was about 11%, I think that is a bit more than 4,500 give or take in 2007 and that is a 34 state estimate only but lets just say that this is a good representation.
In the UK, there were an
estimated 7,734 new cases in 2007. The total number of heterosexual transmissions in 2007 were 3,614 found
here. Also found in the previous link was that in 2007 an estimated 152 were thought to be via IV drug use (You'll see why this is important in a second). Female acquired HIV in 2007 (note this is almost ALWAYS via heterosexual sex) is found
here: 2,846. Now females could have gotten HIV from IV drug use but even if all IV drug users diagnosed were female it would amount to even 10% of the female diagnoses. So let's say half (but I am willing to bet that more than half of the IV drug diagnoses were men).
So the number of males who acquired HIV via heterosexual sex has to be:
(3614 - (2846 - 76)) = 844. If there were 7,734 new cases of HIV in the UK then male heterosexually acquired HIV made up about 11% of the new cases. That is the same as the US.
I should also point out that on the same page, Avert points out that:
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| he major component of the rapid increase in recent years has been in heterosexually acquired infections. Although around 80% of these are contracted in countries with high HIV prevalence, infections acquired within the UK have also risen. |
That can't be stressed enough, 80% of the 3,614 new cases in 2007 were thought to have been acquired in high-risk countries. That means that only about 700 were acquired locally. It's not really enough to draw any conclusions on. This could be immigrants from Africa or a husband traveling to Thailand to be unfaithful and contract a VD for is wife. It might be that immigration to Europe from those high risk places is higher than the US. I don't see a similar declaration about the US number so I don't know how many are home grown infections versus somebody immigrating to the US and then getting diagnosed (where most of the UK and probably European numbers are coming from). I want to say that you noticed that Japan was different, I would point out that immigration to Japan is nearly impossible no matter where you come from.
So what you say isn't necessarily true, that is the US isn't really doing any better than the UK despite our embrace of circumcision.
And for another example, you can check out
Australia.
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| Professor Murray goes on to point out that of the 854 Australians men diagnosed with HIV in 2006, only about 77, about 9%, were thought to have acquired it through heterosexual contact. While this is an increase since 2000 (62), a close look at the statistics reveal that the average age of HIV infection for these 77 men was 46, most of the increase (10) were in men 60 and over, and none of the men were younger than 24. The vast percentage of new infections therefore were in men of a generation that was already circumcised. |
Australia is also concerned with the importation issue, they believe most of those 77 were also acquired in high risk countries. I think you'll find that a close look at the rest of Europe will yield numbers that were similar.
ETA: I also want to point out that for whatever reason minorities, particularly African American minorities are dis-proportionally affected in both countries. And not by a little, by a lot between 70-80%.
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