New UN Recommendations....not good... - Page 2

[Sotevenn]

Here is the contact info for WHO, if anyone is up for emailing or writing to them about this:

World Health Organization
Department of HIV/AIDS
20, Avenue Appia
CH-1211 Geneva 27
Switzerland
Email: [e-mail]

Here's a link to the info on their web site & has additional contact info at the bottom:
http://www.who.int/mediacentre/news/.../en/index.html

[glongley]

Here's another article on this latest development:
http://www.newscientist.com/article....ine-news_rss20

Note this comment:

"[Kim] Dickson [coordinator of the joint WHO/UNAIDS working group that produced the report] says promoting the procedure would have greatest impact in countries where more than 15 per cent of heterosexual men are HIV-positive, but fewer than 20 per cent are circumcised."

I.e. even if the African studies were true, it would have little impact on the AIDS situation in the US where very few hetero men are positive, but 75% are circ'd. It is important to repeat Dickson's words over and over to deter any push to promote infant circumcision to prevent HIV in the US.

Gillian

[Kleine Hexe]

I don't get it. I just don't get it. I really really really don't get it.

If a man still needs to take all the same precautions as before then how in the hell can they say circ does anything to prevent infection? Where are the *real* scientists that have an ounce of common sense?

[Daisyuk]

Originally Posted by Kleine Hexe

I don't get it. I just don't get it. I really really really don't get it.

If a man still needs to take all the same precautions as before then how in the hell can they say circ does anything to prevent infection? Where are the *real* scientists that have an ounce of common sense?

You're assuming that logic comes into it at all. It doesn't.

This is the "syphilis panic" of the 1930s all over again, genital mutilation finding a current disease to cure. Only this time it's fatal, and circ'd men will think they can't get it. Oh well. Make sure the people you love have the facts, sit back and watch the cutters self destruct.

[mamasophy]

It makes no sense!

The US has the HIGHEST rate of circ'd men among the developed countries. It has the HIGHEST rate of HIV infection. DUH.:

[pdx.mothernurture]

Originally Posted by Daisyuk

This is the "syphilis panic" of the 1930s all over again, genital mutilation finding a current disease to cure. Only this time it's fatal, and circ'd men will think they can't get it. Oh well. Make sure the people you love have the facts, sit back and watch the cutters self destruct.

Yeah, except desperate people in Africa who are truly at risk are looking to these organizations for advice, and this crap is already motivating parents in the US to cut their infant sons.

I'm afraid the 'destruction' isn't coming for the cutters, but rather the cuttees.

Jen

[pdx.mothernurture]

Another thread on this topic:

Circumcision Is Recommended to Fight HIV says WHO and UNAIDS

[kxsiven]

And yet. NO WHERE there is articles about the fact that circumcising USA has the highest STD&HIV rates when many western intact countries have very low STD&HIV rates.

More circumcisions=more money.

There are HUGE money involved in HIV stidies and in HIV 'industry'. Companies get easily money when they are collecting it to stop HIV.

Yes, I am really sad for this news because I am against genital slicing but I am also really scared...what do you think will happen in Africa...where people believe that if you have sex(=rape)a virgin, you are safe from HIV. Circumcised men will not use condoms since circumcision is advertised as barrier against HIV. We are looking bigger numbers in HIV and who will pay the prize? Women and children!

And how much easier and more effective would be provide education and condoms? Million times more effective! But there are factors and powers in Africa that do not allow that to happen.

So where that leaves everything? Education bad - genital cutting OK?

It is sad sad sad day that we are still this cruel and uncivilised spieces.

[DahliaRW]

Did the article ever actually say to circ babies? All I saw it say were MEN. It's way different for a man to choose to circ then to inflict it on a baby routinely. So I would just counterargue that it's arguing that GROWN MEN should decide if it's beneficial, not that RIC is advocated.

[Quirky]

Originally Posted by DahliaRW

Did the article ever actually say to circ babies? All I saw it say were MEN. It's way different for a man to choose to circ then to inflict it on a baby routinely. So I would just counterargue that it's arguing that GROWN MEN should decide if it's beneficial, not that RIC is advocated.

From the WHO announcement:

A significant public health impact is likely to occur most rapidly if male circumcision services are first provided where the incidence of heterosexually acquired HIV infection is high. It was therefore recommended that countries with high prevalence, generalized heterosexual HIV epidemics that currently have low rates of male circumcision consider urgently scaling up access to male circumcision services. A more rapid public health benefit will be achieved if age groups at highest risk of acquiring HIV are prioritized, although providing male circumcision services to younger age groups will also have public health impact over the longer term. Modelling studies suggest that male circumcision in sub-Saharan Africa could prevent 5.7 million new cases of HIV infection and 3 million deaths over 20 years.

[Daisyuk]

No, it's infant foreskins they're after:

"Dr Alan Brody, national director of the United Nation's Children's Fund, who supports male circumcision as one precaution against HIV infection, asserts that studies on the effectiveness of the procedure, have produced differing statistics. Brody goes on to say, "depending on the report you read, the possibility of infection is reduced by 25 percent to 50 percent in the circumcised male"."
http://www.info.gov.za/speeches/2004/04070212451001.htm

"But two prominent Americans based in the capital have aggressively pushed news of the circumcision research into the public consciousness here. Daniel Halperin, a researcher and AIDS technical adviser for the U.S. Agency for International Development, has convened meetings among Swazi doctors to discuss the research.

Alan Brody, the top official in Swaziland for UNICEF, began incorporating messages about the protective effects of circumcision in public education campaigns in 2002. With the results from South Africa, Brody has become increasingly vocal. Now, official discussions are focusing not on whether to make circumcision more widely available, but how."
http://www.washingtonpost.com/wp-dyn...500749_pf.html

"Recently there appears to be growing interest on the part of
NERCHA, UNICEF and some other stakeholders in expanding access to safe, voluntary male circumcision/male RH services in the country." (my emphasis)
http://pdf.dec.org/pdf_docs/Pdacf094.pdf

"15.5 Activities
The project mobilises communities using innovative communication approaches to seek service and
further guidance from the community clinics to prevent transmission of HIV from mothers to children. The
communication tools provide accurate and in-depth information to both mothers-to-be and their families
and neighbours that are the potential supporters of women making decisions about uptake of HIV testing
and prevention interventions. "

"15.8 Constraints/Issues raised by the field office
Some of the challenges identified in the first progress report are (a) working toward financial sustainability
beyond 2006 (b) improving male participation (c) operationalising the “Plus” component of PMTCT e.g.
availability of ARVs for mother/child treatment, prevention of opportunistic infections, availability of male circumcision etc and (d) follow up of positive cases in the community. "
http://globalism.rmit.edu.au/files/S...n_Sec_2004.pdf

"Dr Alan Brody, national director of the UN Children's Fund, who supports
male circumcision as one precaution against HIV infection, said studies on
the effectiveness of the procedure have produced differing statistics.
"Depending on the report you read, the possibility of infection is reduced
by 25 percent to 50 percent in the circumcised male. This is significant.
The male child is best circumcised at an early age, preferably in
infancy," Brody said."
http://iys.cidi.org/humanitarian/hivaids/04a/ixl24.html


After all, there's no after market in adult foreskins is there.

[mamakay]

Yeah...the babies are cheaper.
Pain relief is expensive.

I need to go throw up now.

[mamakay]

When the studies first came out, I actually lost sleep for a few nights.
It's all just too...horrific...for me to even wrap my mind around.

And how the hell can the WHO endorse RIC but oppose all 4 types of FGM?

The mechanism involves the herpes virus sores increasing HIV transmission. Herpes sores like women's labias. Amputate the labia and you'll get the same thing in girls.
They could totally follow up on the "FGM decreases HIV" study and find this same thing. (not that's I'm advocating that).
But that would be "unethical". Coz FGM is "barbaric".

It's just so schitzophrenic.

[Daisyuk]

Yes, but when you realise it's all about exporting American culture (and harvesting the tissue) it does make more sense.

FGM is not culturally acceptable to Americans and there is no market for female tissue, MGM is not only culturally acceptable to Americans, but there are large profits to be had from the harvested foreskins (I don't believe for one minute that they will only be doing it to adults, it will be the babies that get targetted).

The WHO and the UN have just demonstrated how much under the American thumb they are.

[pdx.mothernurture]

Originally Posted by mamakay

And how the hell can the WHO endorse RIC but oppose all 4 types of FGM?

The mechanism involves the herpes virus sores increasing HIV transmission. Herpes sores like women's labias. Amputate the labia and you'll get the same thing in girls.

I'd like to hear more about this.

The mechanisms I've heard suggested involved Langerhans Cells & keratinization. Anyone have more information on the Herpes-angle?

Thanks,

Jen

[Soxfan Mom]

This is one of the top stories on www.thehuffingtonpost.com today. It's usually a liberal site, but there are some boneheaded comments there, too. Very discouraging.

[mamasophy]

Circ'd women have lower rates of HIV too!

:
http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138
The above links to a study showing that circ'd WOMEN have lower rates of HIV infection.
Is the UN going to start recommending FGM as protection against HIV now too?
I suppose if there were enough money in it...

[mamakay]

Originally Posted by pdx.mothernurture

I'd like to hear more about this.

The mechanisms I've heard suggested involved Langerhans Cells & keratinization. Anyone have more information on the Herpes-angle?

Thanks,

Jen

Look through the fulltext of the 2 RTC's. Almost every guy that seroconverted came in for herpes, and when they ran the HIV test, they found that they had been infected with that, too, probably at the same time.

They were having sex with prostitutes who are co-infected with herpes and HIV (most likely).

That also means that the intact guys who initially seroconverted represent an unusual behavioral high-risk sub-group, which is another reason why ending the study early is going to give an inflated figure. The effect will be smaller in the guys who aren't addicted to condomless sex with prostitutes.

The effect is going to be really pronounced in the short term for guys with high risk behaviors, but probably fizzle out progressively after that, to a 0% difference on the other behavioral end with the guys who never ever engage in high risk behaviors.

http://www.washingtontimes.com/natio...5203-2809r.htm

ASSOCIATED PRESS
Treating genital herpes can also help keep the AIDS virus under control in women with both infections and might also reduce the spread of HIV, the first major study to test this strategy suggests.
Many people with HIV are also infected with the herpes type 2 virus, and scientists have long known that herpes sores on the genitals can make it easier to become infected with the AIDS virus and could increase the risk of transmitting HIV to others.

So circumcise (via type 1 or type 4) the girls, too, and you'll get a MUCH bigger effect.
But that would be "an atrocity".

Coz removing the bits off of girls would be a violation of human rights.

[mamakay]

Here, pdx...

(Lancet registration for the fulltext is free)

http://www.thelancet.com/journals/la...03134/fulltext

Table 3 shows HIV incidence by study arm and follow-up visit intervals, together with cumulative incidence over 2 years. The intention-to-treat analysis showed a progressive decrease in incidence in the intervention group over the entire follow-up period (p for trend 0·014). Incidence fell in the control group between the time of first follow-up and the time of second follow-up, and remained stable thereafter; however, the trend was not significant (p=0·6). The IRR of HIV acquisition associated with circumcision also fell over time; this increase in efficacy was of borderline significance (p=0·054 for the time-by-study arm interaction). The 24 month cumulative HIV incidence was 0·66 cases per 100 person-years in the intervention group, compared with 1·33 cases per 100 person-years in the control group

I'm seeing that as being a type of bellcurve effect. Among the circ guys and the intact guys both, the initial cases of HIV are coming from those guys with unreal high-risk behaviors. (probably regular condomless sex with prostitutes). Being circed basically "buys" a guy who's going to do that one year of that behavior before becoming infected compared to his intact peers behaving in the same way.

Men reporting symptoms of sexually transmitted diseases during a follow-up interval had higher rates of HIV acquisition than did asymptomatic participants, but the protective effects of circumcision were observed irrespective of the presence of such symptoms.

Again...these are the guys who regularly have sex without condoms, with prostitutes who are co-infected with HIV and herpes, among other sexually transmitted pathogens.
So yeah...it delays their infection by about a year, which looks impressive in a study that's cut short like these were. But by next december, 20 something more of the circed guys will be HIV positive, and probably fewer of the intact guys...because it's the guys who are doing the risky stuff that are going to be most/all of your initial cases of HIV.

Consistent condom use during this interval was slightly higher in the intervention group than it was in the control group (table 6; p=0·11). Similarly, inconsistent condom use was higher in the intervention group than it was in the control group (table 6; p=0·0004). At the 12 and 24 months follow-up visits, the number of sexual partners, non-marital relationships, and condom use were much the same in the two groups

AND...
Recently circed guys were more likely to initially use condoms than their intact peers. But then they apparently got bored with the whole "exciting new penis" thing and went back to doing whatever they were doing before.
This totally skews the findings in favor of circumcision.

Since genital ulcer disease is a risk factor for the acquisition of HIV,14–16 and symptomatic genital ulcer disease was associated with higher rates of HIV acquisition in this trial (table 4), it is plausible that the protective effect of circumcision on HIV could be mediated in part by the protective effects of the procedure on self-reported genital ulcer disease. By contrast, there was no effect of circumcision on symptoms of discharge or dysuria (table 5), which is consistent with data from observational studies that indicate a lack of an effect of circumcision on gonorrhoea or chlamydia prevalence

So you could do horrible things to women's genitals, too, and make it harder for herpes to spread.

If they're worried about money (which is the rationale for RIC...the babies are cheaper)...they should focus on TREATING THE SEX WORKERS. It is the sex workers who are co-infected with herpes and HIV who are infecting the most men the most quickly.
Give the sex workers antivirals for HIV and herpes, and they're not going to be infecting as many men.

That would make the most sense if resources are an issue.

Leave the damn babies alone.

[pdx.mothernurture]

God, it would be so helpful to compile all of this information into a single documment we could refer to/share. The whole thing just makes me angrier and angrier.

Jen