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As a doula, you all know how I feel about circumcision. I honestly can't believe that mutilating your child is legal...whatever, that isn't my topic.<br><br>
I need information about the HIV/AIDS arguement. That just came up as a reason to do it, and while teaching your children about safe sex and living in America, not Africa seems like something I can say to families, I really need MORE information. Maybe something else to put in my folder.<br><br>
Help!! <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:
 

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Unprotected sex is high-risk with or without circ. Any "protection" afforded by circ is insignificant.<br><br>
A marginal statistical difference does not change the risks and need for condom use and sexual responsibility. Safe sexual behavior would remain the <i>only</i> reliable way to reduce the likelihood of infection. It is also the only way to prevent other major STDs that circ will not affect at all. When you look at the realities of health risks affected by unsafe behaviors, circ changes almost nothing.<br><br>
The cost of circ is too high to pay for a tiny, not fully-confirmed, difference in risk that exists only if one is making other risky choices.
 

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I don't have links to any rebuttals for the studies out or anything, but my dh and I were discussing this the other day and he made a great comment. He said even if the studies were true and they did lower chances by 50%, condom use lowers chances by about 100% so why not go with that? (and there is no chance of surgical complication or permanent sexual desensitization)<br><br>
An oversimplification I know, but makes a lot of sense to me.<br><br>
Take care,<br>
Tara
 

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When a mom threw this stat at me I asked what kind of conditions was the study done in? I don't see the heart of Africa being the most sterile and balanced site for a hiv and circumcision review. I wonder what is wrong with the use of safe sex? Do they think that if you are mutilated you are safe from std's and therefor safe to be unsafe as much as you want? It is such a twisted logic. I guess every male here in the US that has a STD is a intact man/boy, they are so dirty you know, with there foreskin and all. You would think that by what they tell you. What is wrong with doing a study in our OWN country where OUR children will be brought up with an equal across the board subjects? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/soapbox.gif" style="border:0px solid;" title="soapbox">
 

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My response is usually something along the lines of:<br><br>
Since the US has the one of the highest AIDS/HIV rates and the among the highest circumcision rates...that study just doesn't hold water.<br><br>
I would also mention, that this is the same group of people who believe that having sex with a virgin will cure AIDS.
 

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Here are several link you can print out or give them links to.<br><br>
Circumcision and AIDS/HIV<br><a href="http://www.circumstitions.com/HIV.html" target="_blank">http://www.circumstitions.com/HIV.html</a><br><a href="http://www.cirp.org/library/disease/HIV/" target="_blank">http://www.cirp.org/library/disease/HIV/</a><br><a href="http://www.cochrane.org/reviews/en/ab003362.html" target="_blank">http://www.cochrane.org/reviews/en/ab003362.html</a><br><a href="http://www.doctorsopposingcircumcision.org/info/HIVStatement.html" target="_blank">http://www.doctorsopposingcircumcisi...Statement.html</a><br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Since the US has the one of the highest AIDS/HIV rates and the among the highest circumcision rates...that study just doesn't hold water.</td>
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And a BIG <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">:
 

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If they are being unreasonable I just say something stupid like "You can't get cateracts if you gouge out your eyes"<br><br>
but I usually open with:<br>
I am just as unlikely to play russian roluette with 2 bullets than with 1
 

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I'm assuming you mean the WHO study. I don't buy it because it does not relate to the US AT ALL. Kenya and Uganda have some of the highest HIV/AIDS rates in the world. Taking men, circing them, and thereby exposing them to medical intervention and education IS going to change things. It's not the circ, it's the education. I would like to see a comparable study done in the US.<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Since the US has the one of the highest AIDS/HIV rates and the among the highest circumcision rates...that study just doesn't hold water.</td>
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YES!!!!!! By the logic of the WHO study, Europe should be rotting in HIV/AIDS right now. The US is far ahead of Europe in numbers when it comes to cases based on population. (far ahead of course is a bad thing in this case)<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">I would also mention, that this is the same group of people who believe that having sex with a virgin will cure AIDS.</td>
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NO NO NO!!!!!! This is not "the same group of people". Africa is made up of over 50 independent sovereign states, not "a group of people". There are NUMEROUS cultures in Africa and not all of them believe that sex with a virgin will cure AIDS. (though unfortunately some do) Saying something like "this is the same group of people who believe..." will do nothing but make you look ignorant to the facts. You want to make sure your arguments hold water and make you credible.
 

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Here's a post I put together at another board. This was specific to a question about a woman considering getting her 2-year-old circed on the basis of the HIV issue, so just ignore the irrelevant parts. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
Bear with me, this will be long! I have to put it in two posts so it will all fit.<br><br><b>AAP Statement</b><br><br>
In 2005, the AAP reviewed its 1999 policy statement on circumcision and reaffirmed it. That statement says: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision." The AAP hasn't revised its statement even with all the discussion about circumcision as a preventative for HIV.<br><br><a href="http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B103/3/686" target="_blank">Link to 1999 statement</a><br><a href="http://aappolicy.aappublications.org/cgi/content/full/pediatrics;116/3/796" target="_blank"><br>
Link to 2005 reaffirmation</a> (doesn't give details)<br><br><b>Circumcision == no more need for safe sex??</b><br><br>
The most important factors in any STD risk are sexual practices and number of partners. Ask this mama this: would she tell her teen son that he can skip condoms and sleep with as many people as he wants because he is circumcised? No? (Conversely, would she tell her dd it's OK to sleep with a circed guy without using condoms?) If her advice to him will be to practice safe sex and limit his number of sexual partners, and ensure that he knows the sexual history of his sex partners, then why deprive him of the most sensitive part of the penis? Circumcision is no magic bullet, and it's not a vaccine against HIV or any other STD. It still takes condoms, safer sex, and good sense to avoid HIV and other STDs.<br><br>
The point about sensitivity is very important. <a href="http://research.cirp.org/func1.html" target="_blank">The foreskin contains far more nerve endings than the glans of the penis itself.</a> <a href="http://research.cirp.org/faq1.html" target="_blank">(More info on structure/function of foreskin.)</a> Circumcision causes the glans, formerly an internal organ, to become an external organ, which leads to chafing and resulting keratinization (the buildup of skin layers over the former mucous membrane of the glans' surface). Between the loss of the sensitive foreskin itself and the keratinization of the glans, a great deal of sexual sensitivity is lost.<br><br>
Men often complain loudly that sex with condoms is no fun, because of the loss of sensitivity from condoms. Desensitized penis from circ + desensitized penis from condom often = male who doesn't want to use condoms at all. Add that to the false sense of security a man may get if he believes that his circed status protects him from STDs, and you have a recipe for a great deal of resistance to consistent condom usage.<br><br><b>Wouldn't it be better to wait until her son is sexually active?</b><br><br>
Moreover, it's going to be a good 14 years or so before her son becomes sexually active. So he's at ZERO risk NOW of contracting HIV or another STD. Who knows what is going to happen between now and then, in terms of an HIV vaccine? In 14 years, there's every chance there could be an HIV vaccine. Why rush to act now, when it's unknown what the future will bring in terms of medical advances?<br><br>
Even if there isn't an HIV vaccine in 14 years, however, when her son is of age he can make his own informed decision about whether he wants to be circumcised if he believes (and the evidence shows) that circumcision reduces the risk of HIV/STDs. It will be far less traumatic for him then, both emotionally and physically. Emotionally, because it will be his decision and he will understand what he is doing, rather than have circumcision forced upon him. Physically, it will be much better because a) he can have adequate pain relief during and after the surgery, and b) his penis will be fully grown, and he and the doctor will be able to determine together how much foreskin to take off and how much to leave in order to facilitate a comfortable erection.<br><br>
This latter point is very important. Basically, when doctors circumcise babies, they are totally guessing how much to take off and how much to leave, because obviously no one knows how big the boy's penis is going to get and how much skin he will need to accomodate his erection. The reason that doctors today are performing much looser circs on infants than in the past is that adult men of our dh's generations often had so much skin taken off that erections are too tight and uncomfortable, causing splitting of the skin, abrasions, bowing, hair being drawn up onto the shaft of the penis, etc. Only on a fully grown penis can it be determined how much foreskin can be taken off -- on adults, the doctor draws the cutting line on the foreskin in marker when the penis is erect. On a baby, it's sheer guesswork. Why risk a lifetime of sexual complications from a surgery that's not going to benefit the boy, if at all, for over a decade to come?<br><br><b>Does circumcision *really* lower the risk of contracting HIV?</b><br><br>
Have your friend her take a good hard look at circumcision and STDs, including HIV, in the United States. The US has the highest percentage of circumcised adult males in the developed world (with the exception of Israel), because, until recent years, routine infant circumcision was nearly universal. The US also has the distinction of having one of the highest rate of HIV/AIDS and overall higher rates of other STDs in the developed world. If circumcision were truly protective against HIV and other STDs, then you would expect to see much lower rates of infection in this country as compared to countries with nearly universal intact men.<br><br><a href="http://www.nationmaster.com/graph/hea_hiv_adu_pre_rat_15_49_yea-prevalence-rate-15-49-years" target="_blank">Link to adult HIV prevalence rate, 15-49 years old, by country</a><br><br>
Although the popular press has reported the three studies occurring in Africa in the last couple of years as "proving" that circumcision protects against HIV, the truth of the matter is that the jury is still out. When you actually look at the numbers of participants in the studies, they're quite small - and all of the studies were ended early.<br><a href="http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0020298" target="_blank"><br>
Here is a link to the study in South Africa</a>. This is the one that first hit the news big time, with editoralists trumpeting that circ is the new HIV vaccine. Well, take a look at the numbers. The study enrolled 3,274 men. It was stopped early, at 18 months, when 20 HIV infections were seen in the circumcised group and 49 in the intact group.<br><br>
There are significant statistical concerns caused by the early termination of the study (as well as the two more recent studies in Uganda and Kenya) because studies terminated early tend to overestimate the benefit of the intervention studied (here, circumcision). <a href="http://medicine.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pmed.0020298#r1000" target="_blank">Link to criticism of South Africa study</a> Essentially, the criticism says that you'd have to get many more incidents of HIV in your study group before you could draw a definitive conclusion that circumcision does (or does not) reduce the incidence of HIV.<br><br>
There are many other concerns with this study. For example, the study did not control for other potential methods of HIV transmission, such as the use of infected needles, unsafe medical and ritualistic procedures, or blood transfusions. Nor did they investigate the sex of the study participants' partners to determine whether the study participants were engaging in heterosexual sex, homosexual sex, or both. In addition, the circumcised men were instructed to avoid sex for 6 weeks post-circ and to use a condom, so the circed group was given a 6-week head start, so to speak, on reducing HIV transmission. All of these factors are potentially very significant confounders.
 

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Part deux...<br><br>
But the bottom line is that even if circumcision is somewhat effective in reducing the risk of contracting HIV in a particular sexual encounter with an infected person, repeated sexual contacts with infected people over time are going to result in likely HIV acquisition. <a href="http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030078" target="_blank">Here's a link to a very important critique of the South African study discussing this.</a><br><br>
It's worth quoting the article:<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Similarly, for persons who are highly exposed to risk of HIV infection, as are the young men of South Africa, a 60% reduction in annual risk will ultimately protect only a smaller proportion. Basic probability calculations show that in discordant couples exposed for 30 years, some 74% will contract the HIV virus if circumcised, compared with 97% if uncircumcised (with incidence of 11% per year)—a small reduction indeed if compared with a highly efficacious vaccine (comparable figures would be 4% versus 97% for children vaccinated against measles who are exposed between 1 and 15 years of age).<br><br><br>
One could argue that the population effect could exceed the individual risk for a variety of reasons ranging from herd immunity to prevention of other sexually transmitted diseases (STIs). If all men are circumcised, then prevalence among women will be lower, and men will have lower risk of being exposed and infected. However, several natural experiments do not confirm this argument. For instance, Tanzania has some 110 ethnic groups, some groups using universal male circumcision, others not circumcising. After controlling for urbanization, there was no difference in male HIV prevalence between the two groups: in urban areas, HIV seroprevalence was 9.5% in circumcised groups and 9.7% in uncircumcised groups, and conversely, 4.6% and 5.2%, respectively, in rural areas—none of the differences being significant [3]. In South Africa, the KwaZulu-Natal province, where few are circumcised, has a higher HIV seroprevalence than other provinces, reaching 37% among antenatal clinic attendants in 2003. But, in the Eastern Cape, where circumcision is the rule, the dynamics of the epidemic are almost the same, simply lagging a few years behind, increasing from 4.5% in 1994 to 27% in 2003. Finally, it was argued that the large epidemic in Abidjan, Côte d'Ivoire, and surrounding areas in the late 1980s was largely due to the lack of male circumcision of the local ethnic groups. This, however, did not impede the rapid increase in HIV infection among migrant workers from Burkina Faso and Mali living in Abidjan, who were circumcised.</td>
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Indeed, there have been other researchers who have expressed alarm at the rush to declare circumcision the "HIV vaccine" we've been looking for, precisely because, epidemiologically speaking, there are many populations that show high HIV rates and high circumcision rates as well. The US is a good example, as I stated above. Another epidemiological study, presented at the 2006 World AIDS conference, found that, out of 8 countries studied, in only 1 did circumcision status correlate with lower HIV rates. <a href="http://www.iasociety.org/abstract/show.asp?abstract_id=2197431" target="_blank">Link to study</a><br><br>
To sum up, there's not enough convincing evidence that circumcision prevents HIV to justify performing a surgery on a baby boy who is at zero risk of contracting HIV by sex.. When the boy is an adolescent, before he engages in sexual activity, he and his family can revisit the issue and make a decision then based on the best available scientific data on the HIV/circumcision connection as well as on the important functions of the foreskin.
 

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ETA: links are live. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Discussion Starter · #12 ·
Everyone here rocks! Thank you, and I would love the links when you have time (I know it is a lot of work for you Quirky, thank you!)
 

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Wonderful responses, everyone. It's so great to see some valid arguments against the study. I just had someone tell me that they attended a seminar about this very issue and that the speaker was saying that circ was a better prevention than any vaccination against HIV could ever offer.<br><br>
Personally, I think education and resources would far, FAR outweigh any supposed 'benefit' of genital mutilation <i>or</i> vaccines, thankyouverymuch.
 

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I would ask them that if there were a study that showed that performing genital mutilation on baby girls reduced their risk of HIV, would they be considering having that done, too?<br><br>
At least that's the bottom line for me.<br><br>
--Olive
 

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Quirky, you are awesome!!!<br><br>
I just want to add that I think this is circumcision`s last stand. Every decade a new excuse is thought up for circ & every time its destroyed. Soon enough this whole HIV excuse will be disproven & shown to be as dangerous as we know it is. After this, there will be really nothing left to support the pro circ side. And finally, RIC will go away.<br><br>
At least I have to hope so.
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>l_olive</strong> <a href="/community/forum/post/7301568"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I would ask them that if there were a study that showed that performing genital mutilation on baby girls reduced their risk of HIV, would they be considering having that done, too?<br><br>
At least that's the bottom line for me.<br><br>
--Olive</div>
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ITA. Indeed, there is such a study:<br><br><a href="http://www.iasociety.org/abstract/show.asp?abstract_id=2177677" target="_blank">Link to World AIDS 2006 conference abstracts</a><br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Results: By self-report, 17.7 percent of women were circumcised. Circumcision status varied significantly by region, household wealth, age, education, years resident, religion, years sexually active, union status, polygamy, number of recent and lifetime sex partners, recent injection or abnormal discharge, use of alcohol and ability to say no to sex. 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.<br><br>
Conclusions: <b>A lowered risk of HIV infection among circumcised women was not attributable to confounding with another risk factor in these data.</b> Anthropological insights on female circumcision as practiced in Tanzania may shed light on this conundrum.</td>
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And for some shocking reason, no one is pounding the drums to promote FGM as an HIV vaccine. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:
 

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The allegedly susceptable cells are Langerhans cells, prevalent in <b>all</b> mucus membranes. When every such surface of the body is scarred, dried out and abraded 'to prevent HIV', including women's labia & facial cheeks & lips of both sexes, I'll talk foreskin amputation.
 

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If I may, here is a report with references that has been around for awhile.<br><br>
Summary of evidence that the foreskin and<br>
lysozyme may protect against HIV infection<br>
By George Hill<br><br><br>
This file contains a summary of the evidence that the foreskin and the sub-preputial wetness under the foreskin (prepuce) may protect against human immunodeficiency virus.<br>
Lysozyme is an enzyme with anti-bacterial action that is found in body fluids. (An enzyme is a protein or conjugated protein produced by a living organism and functions as a biochemical catalyst.1) Lysozyme breaks down cell walls and kills bacteria.<br><br>
Prakash and others reported in 1983 that sub-preputial wetness contains lysozyme2 and Lee-Huang finds lysozyme in human urine.3 Lee-Huang et al. report that lysozyme is also an effective agent for killing HIV in vitro.3<br><br>
Laumann et al. report that about 77 percent of adult American males are circumcised. 4 Thus, these circumcised males have no sub-preputial wetness and no lysozyme protection. Laumann finds that circumcised men are slightly more likely to have both a bacterial and a viral STD in their lifetime.4<br><br>
World Health Organization data show that the incidence of HIV infection in the United States is four or more times greater than in any other advanced industrial nation.5 Other advanced nations either do not circumcise males or have a very low incidence of circumcision compared to the United States.6<br><br>
Chao reports that a circumcised husband is a risk factor for HIV infection amongst pregnant women in Rwanda.7 Grosskurth et al. find a higher incidence of HIV infection in circumcised men in Tanzania.8<br><br>
The high incidence of HIV in the United States and its correlation with the high rate of circumcision has been noted by Storms9 and Nicoll. 10 Furthermore, Tanne reports a general epidemic of STD, including chlamydia and HIV, in the United States.11<br><br>
Moreover, Fleiss and others report that the increased friction and more vigorous and prolonged thrusting required to achieve orgasm with a circumcised penis may be more likely to cause "breaks, tears, microfissures, abrasions, and lacerations through which HIV in semen can enter the receiving partner's bloodstream."12<br><br>
More research is needed to verify the protective effect of lysozyme and the foreskin in vivo.<br><br>
References<br>
The American Heritage Dictionary of the English Language, 3rd edition. Houghton Mifflin Company, Boston: 1992.<br><br>
Prakash S, Rao R, Venkatesan K, et al. Sub-preputial wetness--its nature. Ann Nat Med Sci 1982:18:109-112.<br><br>
Lee-Huang S, Huang PL, Sun Y, et al. Lysozyme and RNases as anti-HIV components in beta-core preparations of human chorionic gonadotropin. Proc Natl Acad Sci (U S A) 1999 (Mar 16);96(6):2678-2681.<br><br>
Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: prevalence, prophylactic effects, and sexual pratice. JAMA 1997;277:1052-1057.<br><br>
World Health Organization. The Current Situation of the HIV/AIDS Pandemic, Quarterly Report. World Health Organization, Geneva: July 3, 1995.<br><br>
Wallerstein, E. Circumcision: the uniquely American medical enigma. Urologic Clinics of North America 1985;12(1)<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lovestory.gif" style="border:0px solid;" title="lovestory">-132.<br><br>
Chao A, Bulterys M, Musanganire F, et al. Risk factors associated with prevalent HIV-1 infection among pregnant women in Rwanda. National University of Rwanda-Johns Hopkins University AIDS Research Team. Int J Epidemiol 1994; 23:371-380.<br><br>
Grosskurth H., Mosha F, Todd J, et al. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. AIDS 1995;9(8):927-934.<br><br>
Storms MR. AAFP fact sheet: a need for updating. Am Fam Physician 1996;54:1216,1218.<br><br>
Nicoll A. Routine male neonatal circumcision and risk of infection with HIV-1 and other sexually transmitted diseases. Archives of Disease in Childhood (London) 1997;77(3):194-195.<br><br>
Tanne JH. U.S. has epidemic of sexually transmitted disease. BMJ 1998;317:1616.<br><br>
Fleiss P, Hodges FM, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf 1998;74(5):364-367.<br>
19 March 1999<br><br><br>
--------------------------------------------------------------------------------<br>
Return to opening page.
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>ShaggyDaddy</strong> <a href="/community/forum/post/7300475"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">but I usually open with:<br>
I am just as unlikely to play russian roluette with 2 bullets than with 1</div>
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<br>
That's the one I like. Every one of these studies has showed that circ'd men were still contracting AIDS, just at lesser rates. Even if everything else about the studies were valid, that just tells me it's a matter of time and a few more exposures before the circ'd men catch up. Also, every time one of these studies gets promoted, they still always warn that the circ'd men must wear a condom. So what's the point of it all?? <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:
 

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I just keep it short and simple<br><br>
"That study was so flaw that <b>none</b> of the medical journals would publish it."
 
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