A Mom left her son intact and regrets it - Mothering Forums
The Case Against Circumcision > A Mom left her son intact and regrets it
KMK_Mama's Avatar KMK_Mama 04:14 PM 04-13-2008
....she said she will most likely circumcise any future sons and she is 35 weeks pregnant and doesn't know what she is having. She said the reason she regrets NOT circumcising is because of all the studies that have come out saying that circumcising reduces STD's and AIDS. Can you please link me to some articles which explain the protective nature of the foreskin against STD's and AIDS? She admits she has never seen any and would like to.....Thanks!

Fellow Traveler's Avatar Fellow Traveler 04:35 PM 04-13-2008
Quote:
Originally Posted by KMK_Mama View Post
....she said she will most likely circumcise any future sons and she is 35 weeks pregnant and doesn't know what she is having. She said the reason she regrets NOT circumcising is because of all the studies that have come out saying that circumcising reduces STD's and AIDS. Can you please link me to some articles which explain the protective nature of the foreskin against STD's and AIDS? She admits she has never seen any and would like to.....Thanks!
OK So here are a few things you can present to her. A study just published in the March 2008 Journal of Pediatrics, "Circumcision and Risk of Sexually Transmitted Infections in a Birth Cohort" by N. P. Dickson, T. Van Roode, P. Herbison and C. Paul, J Pediatr 2008;152:383-7, shows that circumcision does NOT prevent STDs. These findings are consistent with recent population-based cross-sectional studies in developed countries [such as the Australian Study (International Journal of STD & AIDS August 1, 2006; 17(8): 547-54.) of about 10,000 men and the British Study (STI 2003 Volume 79: Pages 499-500, December 2003) of approximately 2,000 men] which found that early childhood circumcision does not markedly reduce the risk of the common STIs in the general population in such countries. And now this one in the April edition of the Journal of STD:
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Circumcision appeared to have an effect on rates of genital warts:

4 1/2% of circumcised men reported having genital warts

2.4% of uncircumcised men reported having genital warts

Perhaps you could ask her if circumcision protects men from HIV then what is a reasonable explanation as to why the US has both the highest rate of HIV in the west while at the same time having one of the highest rates of circumcised men? If in fact a man is circumcised does it relieve his responsibility to practice safe sex? The Australian Federation of AIDS Organization's (AFAO) had two excellent publications on this issue. Their July 2007 statement and this one that was distributed at at last year's International AIDS Society Conference. The second said in part: How a man factors the known risk reduction alongside the unknown variables into his sexual decision-making is the important thing. Unless he opts to use condoms with all sexual partners whose HIV status is positive or unknown, he remains at risk of acquiring HIV (and if he does this, there is no need to be circumcised for added protection)." That's better advice.

There is evidence that the foreskin might provide a protective role. Last March there was a research paper published concerning this in Nature Medicine, Volume 13: Pages 367-371, de Witte et al. which concluded in part that:
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Notably, LCs also inhibited T-cell infection by viral clearance through Langerin. Thus Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function.
What might that say about circumcision? Hint: The foreskin is rich in Langerhans cells. Perhaps (and this is just a theory) perhaps in western countries the Langerin mechanisms are functioning better than in population like Africa. Perhaps it is a genetic thing or perhaps a weakened immune response due to living conditions? Or perhaps we don't know the long term effects. Perhaps when circumcised as an infant by the time one begins sexual activity the head of the penis is sufficiently kerinalized to increase abrasiveness thus spreading HIV more easily? So the thing is we really don't know what is going on but even if there was a protective effect it wouldn't justify infant circumcision as a boy can make a decision based on that when he is old enough.

You may also want to remind her about the differences between relative and absolute risk with regard to this issue and if you think she can handle it ask her if a study came out talking about FGM and HIV protection, like the Stallings would she feel bad that she didn't seek out that 'advantage' for her daughter?

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Female circumcision and HIV infection in Tanzania: for better or for worse? Stallings R.Y.1, Karugendo E. presented at the 3rd IAS Conference on HIV Pathogenesis and Treatment in 2005. They concluded in part that: "In the final logistic model, circumcision remained highly significant [OR=0.60; 95% CI 0.41,0.88] while adjusted for region, household wealth, age, lifetime partners, union status, and recent ulcer."
Let us know if you need more.
Bm31's Avatar Bm31 05:22 PM 04-13-2008
If her son feels it truly will provide some protection, he can always make the decision, and assume the risks, to have part of his penis amputated when he becomes sexually active.
KMK_Mama's Avatar KMK_Mama 05:29 PM 04-13-2008
Quote:
Originally Posted by Bm31 View Post
If her son feels it truly will provide some protection, he can always make the decision, and assume the risks, to have part of his penis amputated when he becomes sexually active.
Yes, I know. She already said she will not have him circumcised. I am more concerned about her future children, as she said she would most likely circumcise because she regrets NOT having DS#1 circumcised. Her DS is 2 and she is currently pregnant.
Bm31's Avatar Bm31 05:41 PM 04-13-2008
Quote:
Originally Posted by KMK_Mama View Post
Yes, I know. She already said she will not have him circumcised. I am more concerned about her future children, as she said she would most likely circumcise because she regrets NOT having DS#1 circumcised. Her DS is 2 and she is currently pregnant.
Yes, but she can apply that same principal to any future sons; let them decide what protective measures they believe would be appropriate. I don't see the reason for her big "regret." The son's choice in the matter has still been preserved.
Fellow Traveler's Avatar Fellow Traveler 05:46 PM 04-13-2008
Quote:
Originally Posted by Bm31 View Post
Yes, but she can apply that same principal to any future sons; let them decide what protective measures they believe would be appropriate. I don't see the reason for her big "regret." The son's choice in the matter has still been preserved.
This, of course, is the best argument. Even before all the papers, leaving the decision to the son is the only ethical choice.
mntnmom's Avatar mntnmom 06:38 PM 04-13-2008
She never knows what research will come out between now and the time her LO's are thinking about sex. Atleast if its NOT done all the bases are covered. If she gets them circed, and some amazing new study comes out 10yrs from now, it can't be undone.
Fellow Traveler's Avatar Fellow Traveler 06:49 PM 04-13-2008
Quote:
Originally Posted by mntnmom View Post
She never knows what research will come out between now and the time her LO's are thinking about sex. Atleast if its NOT done all the bases are covered. If she gets them circed, and some amazing new study comes out 10yrs from now, it can't be undone.
Exactly, options. Consider the de Witte paper.
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Notably, LCs also inhibited T-cell infection by viral clearance through Langerin. Thus Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function.
One thing they note in this paper, and I can get you the whole thing if you want it, is that they found some variation of Langerin expression in the samples. This implies that there could be a genetic or external factors (poverty for example) that causes Langerin levels to vary. Now consider in 10 years they find a way to improve Langerin expression it might very well work better on intact boys.
glongley's Avatar glongley 06:52 PM 04-13-2008
Tell her: if her son gets HIV or an STD, it's going to be because of his behavior, not whether he has a foreskin or not. She's going to have to teach him about safe sex behavior whether he's circumcised or not. Suggest that she resolve to teach her sons safe sex behavior, and leave the right to make their own decision when they're old enough to be sexually active and old enough to weigh the scientific evidence and their own feelings about having a whole penis for themselves.

The ethical basics of considering infant circumcision for any particular touted medical benefit (aside from knowing the methodological weaknesses of the studies, being familiar with the countervailing evidence, and seeing through the media distortion) are:

1) do the benefits outweigh the risks? (in the case of infant circ = NO)
2) is circumcision the ONLY way to obtain those benefits? (NO, i.e. safe sex behavior)
3) is protection from sexually transmitted diseases necessary for the well-being of the child? (NO, children are not sexually active)

Gillian
eepster's Avatar eepster 10:41 PM 04-13-2008
Quote:
Originally Posted by jwhispers View Post
Perhaps (and this is just a theory) perhaps in western countries the Langerin mechanisms are functioning better than in population like Africa. Perhaps it is a genetic thing or perhaps a weakened immune response due to living conditions? Or perhaps we don't know the long term effects. Perhaps when circumcised as an infant by the time one begins sexual activity the head of the penis is sufficiently kerinalized to increase abrasiveness thus spreading HIV more easily?
Perhaps the men in the African study, which only lasted 18 months, Did not have sex for several weeks to a few months at the begining of the study since they had just had very painful sugery on their penises.
kldliam's Avatar kldliam 10:47 PM 04-13-2008
haven't read this thread, just the OP. Seems to me if she teaches her son about SAFE SEX, he will be just fine.

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Can you please link me to some articles which explain the protective nature of the foreskin against STD's and AIDS? She admits she has never seen any and would like to.....Thanks
There is NO body part that completely protects anyone from getting AIDS and STD's. Except maybe your brain, that is, if you use it. Gotta use a good 'ol fashion condom during sex to ward off disease.
Frankly Speaking's Avatar Frankly Speaking 01:51 AM 04-14-2008
You have to consider what is believeable and what is not with the HIV studies from Africa. For them to be valid, they have to show the same results in real life and real life studies have not found these same results. Three studies in Australia, New Zealand and The US have found no difference in the HIV acquisition rate between circumcised and intact men. That invalidates the African studies for these 3 countries at least if not for the entire world.

Risk assessment is an important tool in making such a decision. A person would on average have to have unprotected sex with more than 200 people in The US to have one chance of being exposed to the HIV virus. That is a very low risk factor for most. However, the HIV infections are clustered in certain demographic groups notably blacks and Hispanics. If this is a white baby, the relative risk of being exposed jumps to well over 1 in 500 sexual encounters. Very few men ever have this many sexual partners.

Another relative risk assessment is the risk of potentially deadly MRSA infections of the circumcision site. The risk of these infections is 12.2 times the risk of HIV infections. Another relative risk assessment is the survival rate after the infection. The current survival rate of an HIV infection is 24.5 years from the initial infection. The survival rate of an MRSA infection is days or weeks. Consider that an HIV infection would be contracted in adulthood in almost all cases, the man could on average live into middlle age or later, maybe to their average life expectancy. An MRSA infection would end the man's life before it really even began.

Other genital infections are eminently treatable with simple medications.

The relative risk of all the reasons for circumcision (HIV, penile cancer, etc.) are far lower than the risk of death from the circumcision itself. (estimated at 1 death per 6,000 to 7,000 procedures) For instance, the relative risk of death from circumcision is 7 times higher than the risk of penile cancer. The risk of death from circumcision is probably 100 times higher than the risk of death from penile cancer.

Looking at the relative risk factors, taking the relative death risk of anything circumcision is proposed to prevent is far lower than the relative death risk of the procedure itself. You also have to factor in when the death will occur. A circumcision death is immediate. The death from any thing circumcision is supposed to prevent will take place decades later.



Frank
Yulia_R's Avatar Yulia_R 12:08 PM 04-14-2008
Worth while mentioning most recent scientists discovery that Langerhans cells that are present in the foreskin are behave as ‘natural barrier’ to HIV.
Bellow are the links.

http://www.womenshealth.gov/news/english/602421.htm
http://body.aol.com/news/articles/_a...28234109990019
http://www.washingtonpost.com/wp-dyn...030500357.html
http://www.ncbi.nlm.nih.gov/entrez/q..._uids=17334373

Another study shows no HIV protection from circumcision
http://www.jaids.org/pt/re/jaids/abs...195628!8091!-1

Outside of Israel, the U.S. is the 2nd highest circumcising country in the world and after Africa, has the 2nd highest infection rate. Plus the fact that more than 80% of the world's men are "uncircumcised" and countries in Europe have an extremely low HIV+ rate.
KMK_Mama's Avatar KMK_Mama 09:46 PM 04-14-2008
Thanks guys....I know she will need more convincing than just telling her to teach him about save sex etc, so I figured I'd back it up with some GOOD things that the foreskin has to offer. Ya know? I will pass on the info.
Fellow Traveler's Avatar Fellow Traveler 10:13 PM 04-14-2008
Quote:
Originally Posted by KMK_Mama View Post
Thanks guys....I know she will need more convincing than just telling her to teach him about save sex etc, so I figured I'd back it up with some GOOD things that the foreskin has to offer. Ya know? I will pass on the info.
Well you have a lot of good info including two recent studies which refute links to intact boys and STDs. Since she is opened to your info hopefully that plus discussions of the functions will be enough to assure her. Good Luck and of course if more questions come up we're here to help.
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