I wanted to provide all of you with some quick thoughts regarding this whole 'circumcision/hiv' BS. It will give you some perspective when you're talking about the subject.
According to avert.org approximately 56,000 Americans are infected with HIV each year. Overall, about three-quarters of those infected were men, approximately 42,000.
When examined by gender, [men only] approximately 62% were infected via male-to-male sexual contact, 18% were infected via IV drug use, and about 8% were infected via either IV drug use or male-to-male sexual contact. The importance of this is that for 88% of men there is no demonstrated benefit. Not for male-to-male, or IV drug use which account for 88% of cases in men.
What remains is 12% which were thought to be contracted heterosexually, 11% is considered high-risk heterosexual contact while 1% must contain all other possible modes of transmission. According to Avert, the CDC defines high-risk sexual contact as:
So of the 42,000 men infected about 4620 (give or take (42000 * 0.11) were infected via high-risk heterosexual sex. Or about 5,040 (42000 * 0.12) if all heterosexual sex is considered.
The US has a male population 15 - 64 of over 100,000,000. So given these percentages, in any given year a man has about a 0.005% or 1/20,000 chance of becoming HIV positive [via heterosexual sex both high and normal risk], 5,040/100000000. Over 60 years, the chances of turning up HIV positive would be 0.3% or 1/333 (0.005 * 60).
These are exceedingly low numbers for an individual (overall) however, this is for those who fall with in the high-risk heterosexual category, which according to the CDC would include those whose partner are known to be HIV+, suspected to be HIV+, or are at high-risk otherwise (an IV drug user for example). We know that most people will not fall within this category.
If instead we focus on the 1% categorized as 'other' we are only talking about 420 men, assuming their infections were all acquired sexually. If only 80% (80000000) of the population fit this category (the other 20% being high risk takers and or homosexual) then overall in any given year an American man has about a 0.000525% chance of being infected with HIV about (1/200,000). Over the course of 60 years the odds are about 0.03% (1/3333). Which is a very interesting figure (0.03%).
Not long after the circumcision and it's relationship with HIV was published, several national HIV/AIDS organizations reviewed the data, and there national situations, and within months published statements that said in essence what the WHO statement already said, while there may be some relationship between circumcision and HIV it is not a strategy that should be considered for countries where the HIV problem is focused in specific groups of low prevalence countries. The original statement from Australia can be seen here. Recently, in a response to rhetoric by Alex Wodac, published in a local paper's opinion piece, the AFAO published a second data sheet in February where they noted:
* African data on circumcision is context-specific and cannot be extrapolated to the Australian
epidemic.
* The Australian HIV epidemic is driven primarily by male-to-male anal intercourse and social
research has shown that men frequently practice both insertive and receptive anal intercourse.
* Correct and consistent condom use, not circumcision, is the most effective means of reducing
male-to-male transmission, female-to-male transmission, and male-to-female transmission.
* An Australian-born man is estimated to have a 0.02% (0.0002) risk of HIV acquisition if he does not inject drugs or have sex with men. This very low risk means that the population health benefit of an intervention like generalised circumcision programs would be negligible.
So, if the typical American born male (who is not involved in high risk activity) has a lifetime chance of becoming HIV+ of 0.03%, an Australian born man under similar assumptions has a lifetime risk of 0.02%, and the AFAO notes that such a low risk means the population health benefit of generalized circumcision would be negligible. How this doesn't apply to Americans is beyond me.
According to avert.org approximately 56,000 Americans are infected with HIV each year. Overall, about three-quarters of those infected were men, approximately 42,000.
When examined by gender, [men only] approximately 62% were infected via male-to-male sexual contact, 18% were infected via IV drug use, and about 8% were infected via either IV drug use or male-to-male sexual contact. The importance of this is that for 88% of men there is no demonstrated benefit. Not for male-to-male, or IV drug use which account for 88% of cases in men.
What remains is 12% which were thought to be contracted heterosexually, 11% is considered high-risk heterosexual contact while 1% must contain all other possible modes of transmission. According to Avert, the CDC defines high-risk sexual contact as:
Quote:
| "The "high-risk heterosexual contact" category comprises persons who report specific heterosexual contact with a person with, or at high risk for, HIV infection (e.g., an injecting drug user). This does not include adults and adolescents born in, or who had sex with someone born in, a country where heterosexual transmission was believed to be the main mode of HIV transmission, unless they meet the criteria stated in the previous sentence." |
The US has a male population 15 - 64 of over 100,000,000. So given these percentages, in any given year a man has about a 0.005% or 1/20,000 chance of becoming HIV positive [via heterosexual sex both high and normal risk], 5,040/100000000. Over 60 years, the chances of turning up HIV positive would be 0.3% or 1/333 (0.005 * 60).
These are exceedingly low numbers for an individual (overall) however, this is for those who fall with in the high-risk heterosexual category, which according to the CDC would include those whose partner are known to be HIV+, suspected to be HIV+, or are at high-risk otherwise (an IV drug user for example). We know that most people will not fall within this category.
If instead we focus on the 1% categorized as 'other' we are only talking about 420 men, assuming their infections were all acquired sexually. If only 80% (80000000) of the population fit this category (the other 20% being high risk takers and or homosexual) then overall in any given year an American man has about a 0.000525% chance of being infected with HIV about (1/200,000). Over the course of 60 years the odds are about 0.03% (1/3333). Which is a very interesting figure (0.03%).
Not long after the circumcision and it's relationship with HIV was published, several national HIV/AIDS organizations reviewed the data, and there national situations, and within months published statements that said in essence what the WHO statement already said, while there may be some relationship between circumcision and HIV it is not a strategy that should be considered for countries where the HIV problem is focused in specific groups of low prevalence countries. The original statement from Australia can be seen here. Recently, in a response to rhetoric by Alex Wodac, published in a local paper's opinion piece, the AFAO published a second data sheet in February where they noted:
* African data on circumcision is context-specific and cannot be extrapolated to the Australian
epidemic.
* The Australian HIV epidemic is driven primarily by male-to-male anal intercourse and social
research has shown that men frequently practice both insertive and receptive anal intercourse.
* Correct and consistent condom use, not circumcision, is the most effective means of reducing
male-to-male transmission, female-to-male transmission, and male-to-female transmission.
* An Australian-born man is estimated to have a 0.02% (0.0002) risk of HIV acquisition if he does not inject drugs or have sex with men. This very low risk means that the population health benefit of an intervention like generalised circumcision programs would be negligible.
So, if the typical American born male (who is not involved in high risk activity) has a lifetime chance of becoming HIV+ of 0.03%, an Australian born man under similar assumptions has a lifetime risk of 0.02%, and the AFAO notes that such a low risk means the population health benefit of generalized circumcision would be negligible. How this doesn't apply to Americans is beyond me.
) It seems to me that they are just aching to find a way to justify RIC just a little so Medicaid can be reversed.
