View Full Version : Circumcision might be necessary once again.
circangel
11-03-2009, 10:07
I have included this article as a pro circ discussion if anyone would like to comment.
http://www.theaustralian.news.com.au/story/0,25197,24891191-23289,00.html
SHOULD Australia increase infant male circumcision now to control future HIV? The question is controversial, but the case for doing so is getting stronger.
The number of new HIV diagnoses in Australia increased each year from 718 in 1999, reaching 1051 new cases in 2006-07. As in all previous years since the HIV/AIDS epidemic was first recognised in the early 1980s, sex between males still accounts for the largest proportion of new cases.
But the proportion of these cases has been slowly dropping in Australia and has now reached 64 per cent.
In contrast, sex between men and women, the second most numerous category since the 1980s, has been slowly increasing and reached 21 per cent in 2003-07. In most other developed countries, the proportion of new HIV cases attributed to sex between men and women has been growing steadily.
Reducing the spread of HIV among nondrug-using men and women around the world has been particularly difficult. Few have changed their sexual behaviour (including using condoms when having sex with casual partners).
Compelling evidence now shows that male circumcision, surgical removal of the foreskin of the penis, can substantially reduce heterosexual HIV spread. However, the rate of infant male circumcision in Australia may be as low as 20 per cent.
Australia should start trying to increase the rate of infant male circumcision to reduce heterosexual HIV spread in future decades.
Soon after the HIV/AIDS epidemic was first recognised, researchers noted that HIV was much more prevalent in African countries where male circumcision was uncommon (such as Zambia, Zimbabwe, Botswana and Swaziland), and much less prevalent in countries where male circumcision was common (such as Madagascar, Senegal and Guinea). The same pattern was noted in Asia.
Combining the results of 38 studies (mostly from Africa), circumcised men are less than half as likely to contract HIV as uncircumcised men. Three trials carried out recently in South Africa, Kenya and Uganda collectively enrolled over 11,000 men who wanted to be circumcised. These men were randomised to remain uncircumcised for the duration of the study or were circumcised by doctors specially trained for the study.
All three studies were terminated early because such a large protective effect of circumcision was found that it was considered unethical to continue.
These findings have been strengthened by the identification of several plausible biological mechanisms for greater HIV spread among uncircumcised males. Circumcision removes Langerhans cells (which are specific targets for HIV) from the underside of the penis, promotes hardening of the skin of the penis, promotes more rapid drying of the penis after intercourse and reduces the likelihood of some sexually transmitted infections (which increase the likelihood of HIV being transmitted).
Male circumcision has many other benefits apart from reducing HIV. These benefits may
include reducing some sexually transmitted infections (including syphilis, herpes simplex type 2 and chlamydia), urinary tract infections, penile cancer, prostate cancer and cervical cancer in female partners.
No serious complications were reported in any of the 5000 circumcised men in the three African studies. Complications were reported in only 0.2 per cent in major studies of infant male circumcision in developed countries.
How relevant are findings from developing countries with poorly controlled and predominantly
heterosexual HIV epidemics to Australia, where HIV is relatively well controlled and dominated by spread of HIV among men who have sex with other men?
A recent Australian study of over 1400 men who have sex with men found that about one third exclusively practised insertive anal sex. In this sub-group, the chance of becoming HIV positive
was about 85 per cent less among circumcised men.
We should be cautious before recommending that gay men in Australia should be circumcised on the basis of only one study.
There are always possible risks, and a particular concern here would be ‘‘risk compensation’’ — that is, gay circumcised men feeling safer and thus abandoning condoms and other hard-won safer sex strategies.
More research will be needed before circumcision can be recommended to adult gay men.
The situation with infant male circumcision is quite different. We have sufficient information now on both HIV and general grounds to amply justify revising the information provided to young parents about infant male circumcision.
Much of the information provided to parents today is quite biased. Young parents should be able to easily obtain objective information about the advantages and disadvantages of infant male circumcision.
State and territory departments of health should remove the current substantial obstacles to infant male circumcision in our public hospitals.
The Commonwealth Department of Health should revise the relevant Medicare items to reduce the current powerful financial disincentives to infant male circumcision.
We should aim to raise the rates of infant male circumcision to the levels which existed decades ago (while respecting the right of parents who do not wish to circumcise their infant sons).
Fortunately, the technology of infant male circumcision has improved considerably in recent decades. Acting now will only reduce HIV infections in decades to come. But our community should strongly endorse the objective of maintaining a low prevalence of HIV among Australians into the future.
Dr Alex Wodak is director of the Alcohol and Drug Service at St Vincent’s Hospital, Sydney
I have posted a reply to this misleading piece of polemic here (http://www.bubhub.com.au/community/forums/showpost.php?p=3565886&postcount=3). I would be happy to discuss the facts in any section of this forum.
NibbleCurlynBub
11-03-2009, 17:29
How exactly does it stop HIV, I was sure it is transmitted more than just the one way... Circumcised men aren't immune to STD's anyway though, I was sure of it. :confused:
How exactly does it stop HIV, I was sure it is transmitted more than just the one way... Circumcised men aren't immune to STD's anyway though, I was sure of it. :confused:
No they are not immune to STD's at all.
cmd'smum
11-03-2009, 17:41
males should be practising safe sex by using condoms
MIght have to send that article to my aunt at WAAC ( WA Aids Council) and see what they think about it.
mejoolie
11-03-2009, 18:34
Just wondering……………..how do we know if our boys are going to be gay or heterosexual……………or do we have to chop all boys just in case?????????
I’m confused
:doh::doh:
Just wondering……………..how do we know if our boys are going to be gay or heterosexual……………or do we have to chop all boys just in case?????????
I’m confused
:doh::doh:
I **think** the OP would like for ALL boys to be done "Just Incase"...;)
~Temet Nosce~
11-03-2009, 19:14
I think the obvious solution to help stop the spread of hiv and stds would be to teach males proper care of their foreskins (ie. cleaning) and the use of condoms.
For what it's worth, I have caught an std before (and am very embarrassed to admit so) and it was acctually from a circumcised male.. hmm
Milliner
11-03-2009, 20:48
Now, now girls, this is the pro- section remember. ;)
NibbleCurlynBub
11-03-2009, 20:52
Hm. Pro section.
Not even neutral posts are allowed in the pro-circ section. :no: Just pro.
WorkingClassMum
12-03-2009, 12:09
As babies don't engage in sexual practises I don't see how circumsizing a baby would protect it from HIV etc.
When my son is of an age where he starts to engage in sexual practises, he can then make the decision for himself to be circumsized.
In the mean time he will be shown and encouraged to practise good hygiene - especially around his intact bits - anyhow
I will be encouraging him to utilise safe sex practises like a condom, regardless if he elects to be circumsized. If he chooses to use a condom, then the need to be circumsized will be negated.
I will also be encouraging my daughter to use condoms.
In the mean time information like this should be directed at people whom consensually partake in risky sexual practises, and not at babies.
I have deleted a bunch of off topic posts that were not related to the OP. The OP was about circing and it's relevance to spreading STDs / AIDS. If you have something to add about that, feel free to contribute.
However, because this is the pro-circ section, please keep in mind the description for this section:
For those wanting to ask questions about the procedure, medical practitioners, after-effects etc. Any attempts by viewers to tell viewers why they shouldn't circumcise will be removed. That is the only specific limitation for this pro-circ area.
Cheers
JabberJaw
12-03-2009, 21:30
OP - Pffffffffffffffffffft.
NibbleCurlynBub
12-03-2009, 21:35
Shouldn't we be sticking to facts and opinions related to circumcision in infants though, seeing as this is a parenting forum for parents to discuss about their children?
Shouldn't we be sticking to facts and opinions related to circumcision in infants though, seeing as this is a parenting forum for parents to discuss about their children?
Well, I believe the argument runs as follows:
Premise 1: Circumcision provides substantial protection from HIV infection among sexually active males
Premise 2: Circumcision of infants is easier, cheaper and less traumatic than adult circumcision.
Conclusion: Circumcising male infants is therefore a reasonable prophylactic measure against HIV.
Both premises would need to be correct for the conclusion to have a hope of flying.
I have discussed the first premise in this thread (http://www.bubhub.com.au/community/forums/showthread.php?t=242912). I will attempt to examine the second premise in this Sunday's "myths" post.
CrankyAndTired
13-03-2009, 19:47
Thank you Circangel for your post. It seems you have been barraged by people with opposing views who can't seem to respect an opposing perspective..
I had my son circumsized at 6 weeks old and I am proud of making that decision, with my DH, for our DS's health.
I circ'd my son based, in part, on the advise of the WHO that not being circ'd can increase the transmission of HIV.
I circ'd my son in part because one of my closest friends IS gay and because he wasn't done as a baby he had to have the proceedure at age 21, a much more painful experience - and embarrassing to explain to workmates.
I circ'd my son in part because as much as we all know boys and men should know and practice fabulous penis hygiene the number of little boys walking into Medical Centres with infections indicates that they don't..
Since I am in the PRO circ section, I hope not to get attacked for sharing my experiences and thanking CircAngel... sadly not even the pro-circ-ing section seems a safe place to share an alternative perspective :no:
they did a study in africa on the rise of HIV and aids.
They took a grown man and circumcised him, and tested the skin for antibodies, etc, and how it may absorb certain viruses bacteria.
I did watch a doco on it, years ago.
They did find that the job (for want of a better word) of the foreskin is to be a first line of defence against disease.
IT apparently absorbs germs (for want of a better term) and takes them to the lymph nodes in the groin.
THE white blood cells then go to work to fight the foreign bodies.
SO the theory is if the foreskin was not there the HIV virus would be less likely to be spread.
BUT it was a theory.
AT best the evidence suggests it may help, but MAY is not WILL.
Obviously circumcision is not for everyone. AND obviously many think it is harmful and unnecessary (sp).
BUT we still live in a world of pro choice.
I would rather it be done to babies then boys or men. Much better healing.
I circ'd my son in part because as much as we all know boys and men should know and practice fabulous penis hygiene the number of little boys walking into Medical Centres with infections indicates that they don't.
Once a boy is circed, it cannot be undone. So it would be pointless to argue about that decision or censure your "alternative perspective".
However, since you mention infection, there is a running thread on the evidence here (http://www.bubhub.com.au/community/forums/showthread.php?t=241525). Please feel free to participate (and I say that as the OP.)
Anecdote is useful in illustrating what the evidence shows, but that doesn't make it evidence, and therefore it is generally not a sound basis for health decisions -- in any area. Genital hygiene is simply one example.
I would be interested in any studies that show genital hygiene is worse among boys than girls, at any age. And what effect genital surgery in either sex has on morbidity outcomes associated with poor hygiene.
BUT we still live in a world of pro choice.
Do we? I thought it was illegal in Australia to circumcise females to any extent and for any reason.
That doesn't seem very pro-choice.
Do we? I thought it was illegal in Australia to circumcise females to any extent and for any reason.
That doesn't seem very pro-choice.
Unless you read something I missed, we're not discussing the circumcision of females.
I moved here from a country where the circ rate is still up around 80%, and I had no idea so much anti-circ existed until we found out we were having a boy. He was circ'd at 3 weeks and we haven't regretted it for a second.
In the same breath, I am nervously waiting for that mum or dad in the parents room or at the swimming lessons who is going to make a comment directed at me for the choices we have made. I know its not their business, and that we have our reasons and don't need to justify it to anyone. But I am still dreading that day.
In regards to the topic/article at hand here, I find there is always research to support a particular stance. There will always be arguments on both sides of the issue, and individuals will arm themselves with the info that supports their belief.
Our Dr told us there was less risk of STDs, infections, cancer and we made our decision.
What a ramble. Sorry.
Unless you read something I missed, we're not discussing the circumcision of females.
This is a circumcision forum. And indeed just about everything you have just said could be stated with equal conviction by the thousands of women who have emigrated here from the Horn of Africa over the past several years.
Having come from cultures that circumcise both sexes, they see little difference.
I agree with them.
circangel
24-03-2009, 12:39
Yes fabulous penis hygiene and I know it might only take another 5 seconds to wash the penis if you are not circumcised but if you are circumcised then it is 0 seconds, certainly seems like a lot of time waisted over a lifetime all because of a piece of skin that may not be required.
Thank you Circangel for your post. It seems you have been barraged by people with opposing views who can't seem to respect an opposing perspective..
I had my son circumsized at 6 weeks old and I am proud of making that decision, with my DH, for our DS's health.
I circ'd my son based, in part, on the advise of the WHO that not being circ'd can increase the transmission of HIV.
I circ'd my son in part because one of my closest friends IS gay and because he wasn't done as a baby he had to have the proceedure at age 21, a much more painful experience - and embarrassing to explain to workmates.
I circ'd my son in part because as much as we all know boys and men should know and practice fabulous penis hygiene the number of little boys walking into Medical Centres with infections indicates that they don't..
Since I am in the PRO circ section, I hope not to get attacked for sharing my experiences and thanking CircAngel... sadly not even the pro-circ-ing section seems a safe place to share an alternative perspective :no:
Yes fabulous penis hygiene and I know it might only take another 5 seconds to wash the penis if you are not circumcised but if you are circumcised then it is 0 seconds, certainly seems like a lot of time waisted over a lifetime all because of a piece of skin that may not be required.
I love the "waisted" pun, Circangel :laughing:
And no doubt the extra 5 seconds a day may weigh heavily on the minds of some parents.
However, just as a matter of biology, the foreskin is not "a piece of skin". It is actually a rather complex structure that is more highly developed in humans than in any of our primate relatives.
I have again deleted some off topic posts. The topic for this thread is the relationship between circumcision status and STDs / AIDS, not about circumcision in general.
Thanks to all who have been contributing constructively.
Pippi Longstocking
26-03-2009, 08:50
Yes fabulous penis hygiene and I know it might only take another 5 seconds to wash the penis if you are not circumcised but if you are circumcised then it is 0 seconds, certainly seems like a lot of time waisted over a lifetime all because of a piece of skin that may not be required.
Circangel, I am honestly not trying to be rude here, and please please correct me if I'm wrong, but are you saying that as a circumcised male, you spend 0 seconds washing your penis? As in, you don't wash it at all?
ETA: Sorry X, this is probably off topic but I am curious.
Mathermy
26-03-2009, 08:53
Circangel, I am honestly not trying to be rude here, and please please correct me if I'm wrong, but are you saying that as a circumcised male, you spend 0 seconds washing your penis? As in, you don't wash it at all?
ETA: Sorry X, this is probably off topic but I am curious.
funniest comment ever:yelclap: (not sure if you were even trying to be but that seriously tickled my funny:goodvibes:)
sockstealingpoltergeist
26-03-2009, 09:00
Circangel, I am honestly not trying to be rude here, and please please correct me if I'm wrong, but are you saying that as a circumcised male, you spend 0 seconds washing your penis? As in, you don't wash it at all?
ETA: Sorry X, this is probably off topic but I am curious.:laughing:
My DH is circed and he still washes his penis. I think it would be gross if he didn't as his penis would be dirty, and that would be gross.
My DS isn't circ'd and I imagine he would spend just about the same amount of time washing it when he is older as DH does, well I like to hope so.
If your penis is dirty, then I'm afraid it's dirty regardless of circ circumstance.
There is a thin line of connection between washing and STIs. Namely, the only STI that Australian data shows is more common in intact men is candidiasis (thrush), which is not a big surprise. (Total cases about 700 in 9000 men, 62% intact 44% circumcised.)
The standard remedy is after thoroughly rinsing in the shower, retract the foreskin again when drying and ensure the area is thoroughly dry before replacing. Generally much easier to deal with than thrush in women.
On the other hand, probably the leading cases of balanitis in circumcised men is the use of soap as a lubricant when showering, in what researchers delicately describe as "excessive debrasion and soap washing".
Mathermy
26-03-2009, 09:44
There is a thin line of connection between washing and STIs. Namely, the only STI that Australian data shows is more common in intact men is candidiasis (thrush), which is not a big surprise. (Total cases about 700 in 9000 men, 62% intact 44% circumcised.)
The standard remedy is after thoroughly rinsing in the shower, retract the foreskin when drying and ensure the area is thoroughly dry before replacing. Generally much easier to deal with than thrush in women.
On the other hand, probably the leading cases of balanitis in circumcised men is the use of soap as a lubricant when showering, in what researchers delicately describe as "excessive debrasion and soap washing".
Pure Gold!:yelclap: This thread is tops for a cranky woman who hasn't yet had her coffee but managed to have lots of giggles:goodvibes:
Circangel, I am honestly not trying to be rude here, and please please correct me if I'm wrong, but are you saying that as a circumcised male, you spend 0 seconds washing your penis? As in, you don't wash it at all?
ETA: Sorry X, this is probably off topic but I am curious.
:laughing:.......:eek:.........:barf:
sockstealingpoltergeist
26-03-2009, 13:07
*snorts*:laughing::laughing:
Seriously- 5 seconds in a day? your kidding right? Any man/boy/child/ spends a lot more than 5 seconds a day paying his doodle some attention...sheesh.
:laughing: Isn't the trouble that they might want to spend too much time cleaning it regardless?:laughing:
forbetoel
26-03-2009, 17:15
Circangel, I am honestly not trying to be rude here, and please please correct me if I'm wrong, but are you saying that as a circumcised male, you spend 0 seconds washing your penis? As in, you don't wash it at all?
.
Well I am going to assume that this is a serious question, as it is in direct response to circangel using the fact that you have to spend 5 seconds cleaning a foreskin as a good reason to circ.:confused:
Circangel - please explain? :detective:
circangel
26-03-2009, 17:21
Yes I wash it and while I do not know how long it takes I do not have to make an effort to do it. Anyhow if you can tell me if circumcised males get problems with smeg we will be able to continue the arguement.
Pippi Longstocking
26-03-2009, 17:56
Circdude, I can't imagine there would be much difference in washing a circumcised penis to washing an intact one. It's pretty much all the same thing. It's like washing a glass as opposed to washing a cup with a handle - either way, it's gonna get washed the same way.
I'll check with my husband but I'm pretty sure that washing his intact penis isn't a major chore. :p
Nobody is comin' near my smeggy bits with a scalpel! :eek:
circangel
26-03-2009, 18:17
Problems like you will read here are all too common I would think. It is no laughing matter.
http://www.askmehelpdesk.com/mens-health/penis-retract-foreskin-trouble-smeg-21765.html
Thanks so much for the info. circangel. If we ever decide to become unhygenic and not wash ourselves properly I'll be sure to get DH circ....and any future sons too (all girls here).
Until that day though...we'll just all use basic hygeine and then there's no need to lob off anyone bits.
forbetoel
26-03-2009, 18:53
Problems like you will read here are all too common I would think. It is no laughing matter.
http://www.askmehelpdesk.com/mens-health/penis-retract-foreskin-trouble-smeg-21765.html
Mmmmm, let me guess, you are the one member on this link who recommended circumcision as the cure?:detective:
C'mon Circangel, normal healthy males DO NOT have a problem with smegma. You know this. For the rest of the population a little bit of smeg between friends is completely normal and harmless. Do you dispute this?
Yes I wash it and while I do not know how long it takes I do not have to make an effort to do it. Anyhow if you can tell me if circumcised males get problems with smeg we will be able to continue the arguement.
The difference between your washing time and the washing time of a male that is complete is the time it takes to pull back the foreskin: really no time at all.
Babies don't need to have their foreskins retracted to clean them as it is entirely self-cleaning when still adhered. When it is beginning to come away, the general tugging that boys subject themselves to during bath time is plenty enough to get them clean.
If grown men are having issues with smegma and are too lazy to clean themselves, they should certainly consider circumcision - for themselves, not other people.
forbetoel
26-03-2009, 19:41
so should all girls get the clitoral hood cut off to avoid smeg as well?
It is completely normal to have some smegma.
To use an analolgy soaked in a bit of naughtiness...."what's a cheeseburger without the cheese":p
So all bad jokes aside, can you not admit that the majority of the population both male and female, both circed males and uncirced males are likely to have some smeg present, and which will only ever develop into any real problem when the genital area is hardly ever washed.:)
Two points:
1. The people who have the biggest problem with smegma build-up are actually those circumcised males who have skin bridges as a result of the procedure. Smegma accumulates in the sulcus beneath the bridges and cannot be removed by normal cleansing.
2. Despite heroic efforts half a century ago to prove smegma was a disease causative, no link was ever established.
The ubiquity of reticulated plumbing and indoor bathrooms in the developed world has rendered the whole matter rather moot.
sockstealingpoltergeist
26-03-2009, 21:35
Smegma, this topic doesn't come up much in our house, but now that it's up for discussion can any one say it 100 times fast?
Again having a circ'd husband he still has to wash or he would be drity and have a smegma problem. We all wash in this house daily, so it isn't really a problem. If it ever becomes one I shall tell all the family to go and have a good wash and get rid of their smegma.:yes:
misskittyfantastico
26-03-2009, 21:40
Just so I'm clear (and as the mother of a small male, I'm interested) Smegma is basically a natural sebacious gland secretion? Like a protective oil? It's only when there is a build up that it becomes whiffy?
Just so I'm clear (and as the mother of a small male, I'm interested) Smegma is basically a natural sebacious gland secretion? Like a protective oil? It's only when there is a build up that it becomes whiffy?
Smegma production is actually slightly different in men and women; the latter have glands that produce sebum, while men do not - a similar oil is produced directly by the inner foreskin. This is combined with exfoliated skin cells and other secretions. In both cases the purpose is lubrication and protection.
Accumulation obviously only happens when production exceeds removal by regular bathing. In the normal course of events, the foreskin, glans, clitoris, and labia minora will, and should, have an undetectable coating of smegma.
In males production peaks during puberty, and probably declines in later years. In circumcised males smegma is produced by the remnant inner foreskin, but of course no longer acts to protect the glans.
Smegma may become "whiffy" when it accumulates and then suffers bacterial colonisation. Normal rinsing is all that is required to remedy the situation in both sexes.
misskittyfantastico
26-03-2009, 22:28
Smegma production is actually slightly different in men and women; the latter have glands that produce sebum, while men do not - a similar oil is produced directly by the inner foreskin. This is combined with exfoliated skin cells and other secretions. In both cases the purpose is lubrication and protection.
Accumulation obviously only happens when production exceeds removal by regular bathing. In the normal course of events, the foreskin, glans, clitoris, and labia minora will, and should, have an undetectable coating of smegma.
In males production peaks during puberty, and probably declines in later years. In circumcised males smegma is produced by the remnant inner foreskin, but of course not longer acts to protect the glans.
Smegma may become "whiffy" when it accumulates and then suffers bacterial colonisation. Normal rinsing is all that is required to remedy the situation in both sexes.
Cheers for that.
circangel
27-03-2009, 10:31
One may presume your view is correct, but really I am not sure. And is every parent going to ask a boy child till puberty if the foreskin retracts. I would seriously doubt it. How many parents have discussed retraction of the foreskin with pubescent boys? You will need to discuss this with a medical professional but I believe smegma and its associated problems might be justification for a parent considering circumcision for their child. I am circumcised and I have never noticed any smegma and I believe it is of a much less of a problem in circumcised males as the oil secreting glands might be removed with the foreskin during the circumcision procedure. About "both male and female, both circed males and uncirced males are likely to have some smeg present, and which will only ever develop into any real problem when the genital area is hardly ever washed". This statement might be true however boys can have problems at various ages with phimosis and it might not always be brought to the attention of the parent/parents and then they might not be able to wash the penis adequately. I am not able to stress enough to get professional medical advice.
It is completely normal to have some smegma.
To use an analolgy soaked in a bit of naughtiness...."what's a cheeseburger without the cheese":p
So all bad jokes aside, can you not admit that the majority of the population both male and female, both circed males and uncirced males are likely to have some smeg present, and which will only ever develop into any real problem when the genital area is hardly ever washed.:)
Phyllis Stein
27-03-2009, 11:11
I am not able to stress enough to get professional medical advice.
The irony is that "professional medical advice" recommends against RIC.
OK, I think that the discussion of smegma is probably off topic, given that there does not seem to be a link between it and STDs/AIDs. Can we move on now :)
Powered by vBulletin® Version 4.1.9 Copyright © 2013 vBulletin Solutions, Inc. All rights reserved.