Pros and Cons of Circumcision

[RaryGirl]

Now ... I know it will be the same people replying in this thread, so regulars, this thread is for you all to provide information in ... BUT and it's a huge BUT ...

There will be rules for this thread ...

* If you quote articles/studies/research, please provide a link to the source.

* There will be no attacking other members or name calling (no matter how subtle).

* Leave the innuendo and accusations OUT of the thread. We have members of this forum that post ONLY in the circumcision sections from both sides of the fence ... no accusing anyone of having agendas because they only frequent this section.

* Don't attack/belittle another member because you don't agree or like their point of view. Feel free to discredit their information with relevant studies/research - but don't attack the poster personally.


We have some very informative and articulate members who are very passionate about this subject and it would make a very interesting debate if everyone kept to the topic and didn't attack/belittle each other.

Me personally, I'm not pro or anti ... I think it's up to the individuals to make a decision that is right for their situation and I'm sure there are many other members like me. Which is why I have started this thread ... for you all to debate civilly, have a thread that is here for parents and parents-to-be to read and make an informed decision themselves.

Lastly ... I have zero tolerance atm in the circumcision threads, unfortunately I have to read them all, so why not make it a good read!

So ... are you up for it?

[sockstealingpoltergeist]

Con: It doesn't belong to you, you don't own your children.

[Opinionated]

Con- It can't be undone if you change your mind or if your child decides they want a foreskin.

[overitand36]

but I agree with sockstealingpoltergeist

and its not medically necessary

[Twins Kelly]

I'm really looking forward to this thread....lots of unbiased opinions, esp. backed up with research will be great...I'm fence sitting at the moment...but having 2 boys....and erring towards circ....but have done no research yet. I look forward to the information.

[Father]

One website has all the scientific facts without the emotion behind it.

http://www.circinfo.net (http://www.circinfo.net/)

Covers all aspects from purely a scientific aspect.
The choice is yours as parents.

[bada]

Non-therapeutic circumcision should only be chosen by an adult who wants it for themselves.

It simply is not a decision that anyone else is entitled to make for another person.

[misskittyfantastico]

I admire your bravery as a mod! TBH, I think it's been done and dusted many times. I think there are possibly 4-5 posters who only contribute in the circ sections, so yes of course they have an agenda! The majority though, are bog standard members (about 75%) who disagree with RIC. The remaining 20% never comment, for fear of being blasted..the last 5% are the "others":p

All information is biased in some way.

On that note...let the games begine :yelclap:

[sockstealingpoltergeist]

One website has all the scientific facts without the emotion behind it.

http://www.circinfo.net (http://www.circinfo.net/)

Covers all aspects from purely a scientific aspect.
The choice is yours as parents.

Con bias website full of myths and non facts.

[misskittyfantastico]

One website has all the scientific facts without the emotion behind it.

http://www.circinfo.net (http://www.circinfo.net/)

Covers all aspects from purely a scientific aspect.
The choice is yours as parents.

I argue that it doesn't. That site is a known (and widely discredited) stop shop for pro circ information

As for my bolded part of your post, I would say the choice is that of the penis owner.

[Chunkydunks]

con: the foreskin is there for a reason, to protect the head of the penis.

[RaryGirl]

The remaining 20% never comment, for fear of being blasted..

This is who I want this thread for .. those who are too darn scared to every get involved or ask a question.

I would like information here so people can read and not even ask a question if they aren't brave enough.

And even more importantly, I would like the thread to remain open :p

[Father]

Con bias website full of myths and non facts.

http://www.circinfo.net (http://www.circinfo.net/)
An evidence based appraisal.

Yes. It is pro-circumcision. Purely because the information is factual. It's content is not 'mythical'. If there is a statement you don't agree with, you just have to go the applicable reference (it is all well referenced) to read the finer details.

All medical bodies acknowledge the benefits. RACP, AAP, CDC, WHO, etc. They don't ignore them. They also all say that parents should weigh up the pros and cons and make a decision which they think is best for their children.
Parents need to do their research to determine what is best for their child. This involves reading both pro-circ websites and anti-circ websites to get both sides of the arguments. And from all of my research, I find this website to be the most efficient in getting all the facts out there.

[misskittyfantastico]

This is who I want this thread for .. those who are too darn scared to every get involved or ask a question.

I would like information here so people can read and not even ask a question if they aren't brave enough.

And even more importantly, I would like the thread to remain open :p

I do agree, but isn't that what the search function is for? And for stickies? Isn't that why we have a pro/negative/discuss thing? I have *never* set foot in the pro circ area, I respect the terms.

I do however, think it's a bit much to ask me (as a loud non RIC poster on this forum to not object to pro circ websites. Especially in the "discuss it forum" - If someone wants pro circ info, then head to the section. If someone wants to discuss, then it's there...pages and pages of debate, discussion and information.

I'm not trying to be difficult, truly:o

[misskittyfantastico]

father, that site isn't "factual" it's biased. It's rubbish, it's mocked by many of my friends who are GP's, Paeds, PHD students and parents.

[RaryGirl]

Ok ... it seems we have a bit of confusion as to what I have asked for here.

I have asked for an interesting and clean debate on this topic. I don't want the thread to be reduced to name calling and attacks on each other, which happens too often in this section. It is the DISCUSS IT section - for people to debate information/links provided.

Lately all I have seen is Discuss It topics reduced to name calling and ridicule of members for their opinions. :( That's not a debate or discussing it rationally ... we are all adults and should be able to have an interesting discussion on a topic without the attacks on each other.

[Father]

father, that site isn't "factual" it's biased. It's rubbish, it's mocked by many of my friends who are GP's, Paeds, PHD students and parents.

Find a comment that is not referenced. It is all factual. I already admitted it's biased. Just like all anti-circ websites are biased.

There are GP's, Paeds, and people with PHD's who agree with the site too. It just depends on whether they are anti circ or not.

Find me a comment that you find is rubbish. As I said, it is all well referenced.

[delirium]

Here are some studies, done from all around the world, stating the benefits of circumcision in regard to UTI, balinitis, HIV, chlamydia, and others. This was just a tiny fraction of what I've found, which has been 100 fold this. These are not circ sites, but medical journals.

Some are abstracts, feel free to join up to that site to get the full text, I couldn't be bothered joining up to get all of them.

http://archderm.ama-assn.org/cgi/content/abstract/136/3/350

http://aje.oxfordjournals.org/cgi/content/full/162/9/907

http://pediatrics.aappublications.org/cgi/content/abstract/118/5/1971?ijkey=20681bf3c99243b3039be7d6bdc1d582a9064ce d&keytype2=tf_ipsecsha

http://pediatrics.aappublications.org/cgi/content/full/119/5/1006

http://content.nejm.org/cgi/content/full/346/15/1105

http://pediatrics.aappublications.org/cgi/content/full/105/3/e36

http://cpj.sagepub.com/cgi/content/abstract/32/3/130

http://archderm.highwire.org/cgi/content/abstract/126/8/1046

Will come back tomorrow to add more, and there are oodles....

[misskittyfantastico]

Ok ... it seems we have a bit of confusion as to what I have asked for here.

I have asked for an interesting and clean debate on this topic. I don't want the thread to be reduced to name calling and attacks on each other, which happens too often in this section. It is the DISCUSS IT section - for people to debate information/links provided.

Lately all I have seen is Discuss It topics reduced to name calling and ridicule of members for their opinions. :( That's not a debate or discussing it rationally ... we are all adults and should be able to have an interesting discussion on a topic without the attacks on each other.

RaryGirl, with respect, it's been done. It's been said! I guess (on reflection) my posts mean, that *I* am done.

father, references do not restore a foreskin. I can reference right back atcha - JohnC has, Mothernurture has.

You know what saves lives?
CONDOMS. CLEANLINESS.

[Brightsilverstar]

I am one of the newbies who have avoided posting anything about this BUT my hubby was circ'd as a baby and he couldn't imagine being any other way. If we have a son he has already said he wants him circ'd.

I have tried to read the circ posts previously but besides 'its not your decision' i want to know why people are against it?

Please do not attack me. I haven't looked into this as yet im 17 weeks and don't know the sex. Its my hubby who has said if its a boy we will do it. Surely if he thought it was so bad on himself he wouldn't want that for a son?

[delirium]

It has been done, by the anti circers. Any attempt by those that circ to list any benefits are quickly dealt with by mocking, insinuations and hysteria. Tab, have you read my links???

[Father]

I have tried to read the circ posts previously but besides 'its not your decision' i want to know why people are against it?

That is really the only argument against. But we all know that it is the parents decision. A decision that about 20% of Australian are making.

[sockstealingpoltergeist]

Cons: is not endorsed by the RACP, because it is unecessary and the "potential" health benifits do not outweigh the risks.

Con: Babies should not have to worry about STI's so they are irrelevant.

[sockstealingpoltergeist]

I am one of the newbies who have avoided posting anything about this BUT my hubby was circ'd as a baby and he couldn't imagine being any other way. If we have a son he has already said he wants him circ'd.

I have tried to read the circ posts previously but besides 'its not your decision' i want to know why people are against it?

Please do not attack me. I haven't looked into this as yet im 17 weeks and don't know the sex. Its my hubby who has said if its a boy we will do it. Surely if he thought it was so bad on himself he wouldn't want that for a son?

Circ'd men often don't want to believe there is anything wrong with their penis, and think that to be against circ means that you are dissing theirs. Not so!

[Father]

Con: Babies should not have to worry about STI's so they are irrelevant.

Not until they are teenagers. But they do UTIs, phimosis, balanitis, penile cancer etc.

[delirium]

Con: Babies should not have to worry about STI's so they are irrelevant.

Yep, babies don't have sex, but teens and adults do. An adult can have a circ but usually only after repeated infection, multiple UTI, and transmission of HPV/chlamydia which may have lead to infertility of his partner and cervical cancer. All a bit late and reactive rather than pro active. A bit late once the horse has bolted so to speak.

[delirium]

Circ'd men often don't want to believe there is anything wrong with their penis, and think that to be against circ means that you are dissing theirs. Not so!

:laughing: There's nothing wrong with my hubby's circed penis nor my sons. Could you imagine the outcry here if I said there was something wrong with an intact penis? (which I don't think there is)

[misskittyfantastico]

It has been done, by the anti circers. Any attempt by those that circ to list any benefits are quickly dealt with by mocking, insinuations and hysteria. Tab, have you read my links???

Yes. No hysteria. No mocking. I disagree. I have a boy child, I will not do that to him.
Del, if you've ever read my posts on the subject, you will find that I have no issue with those who choose RIC, it's the fact that it's available at all that is abhorrant to me .

If that to you falls under the category of "hysteria"? then, I guess I am.

Brightsilverstar, that is NOT the only argument, although for many, it is fundamental to their beliefs. I'd say many are of the opinion that if it aint broke, don't fix it.

It's just not needed. An intact penis is fully functioning. A foreskin is necessary, it's like a protective shield. IMO, it's like removing a fingernail, or an apendix, just incase.

[misskittyfantastico]

:laughing: There's nothing wrong with my hubby's circed penis nor my sons. Could you imagine the outcry here if I said there was something wrong with an intact penis? (which I don't think there is)

That has absolutely been said. They (intact) are "dirty", "strange looking"

[sockstealingpoltergeist]

:laughing: There's nothing wrong with my hubby's circed penis nor my sons. Could you imagine the outcry here if I said there was something wrong with an intact penis? (which I don't think there is)

:confused:Yes and my husband is circ'd and there is nothing wrong with his penis either. That was my point. anti RICers arn't saying that there is at all, yet many men take it to heart.

[delirium]

Yes. No hysteria. No mocking. I disagree. I have a boy child, I will not do that to him.
Del, if you've ever read my posts on the subject, you will find that I have no issue with those who choose RIC, it's the fact that it's available at all that is abhorrant to me .

If that to you falls under the category of "hysteria"? then, I guess I am.

.

There is constant mocking in general in the circ sections. Insinuations that mothers circ bc of their own sick sexual preferences. Hysteria that circing is so painful, when in aust the vast bulk of circs are done with 2 forms of pain relief.

There are some decisions by parents I find abhorrant, but I don't attack them like circers are attacked here (and that's a general comment not directed at you)

Again, have you read my links? There was so many and it's so late I linked but a tiny proportion. All reputable, many meta analysis. From the US,NZ, UK, not just the ones from Africa that the anti circers love to debunk.

Anyhoo, off to bed, will be back tomorrow :)

[kribby]

Im not commenting but I would like to see how this turns out with some easily accessable info to make my decision I'm also a fence sitter on the matter. And it would be nice to have info from both sides without having to go into both pro and anti sections! Some of us are undecided and I think this is a great thread for people like me!

[delirium]

That has absolutely been said. They (intact) are "dirty", "strange looking"

Well certainly not by me :shakehands: Just as I circed my son believing I'm doing the right thing, those that don't circ are doing the what they see as right too.

I have zero objection to keeping a child intact, what I have an issue with is people trying to brow beat me and those that are trying to decide.

If the anti circ argument is so sound, why not allow parents to decide for themselves since the evidence is so overwhelming?

[Tam-I-Am]

I am one of the newbies who have avoided posting anything about this BUT my hubby was circ'd as a baby and he couldn't imagine being any other way. If we have a son he has already said he wants him circ'd.

I have tried to read the circ posts previously but besides 'its not your decision' i want to know why people are against it?

Please do not attack me. I haven't looked into this as yet im 17 weeks and don't know the sex. Its my hubby who has said if its a boy we will do it. Surely if he thought it was so bad on himself he wouldn't want that for a son?

No attacking here :)

It's a fact that some things can go wrong with the foreskin. It's also a fact that some things can go wrong with the tonsils, with the appendix, with the urinary tract in little girls (in fact it's far more likely to than in little boys, being shorter, less able to flush itself, and in more contact with mucous membranes), but we would never remove those things on an off chance that something would go wrong. We'd wait until something did go wrong, and then treat it.

Other arguments for circ usually include:



Cleanliness: A dirty penis is a dirty penis. Circing doesn't improve cleanliness, it just removes skin. Little girls have far more skins and mucousal tissue to get 'dirty' but the removal of their labia minora is not only considered extremely harmful, even b.arbaric, but also is illegal.
Prevention of STDs: Circumcision might improve rates of STDs EXTREMELY slightly - but wouldn't teaching safe sex be a far better option? Circumcision might afford some extremely limited protection - but for how long? If a man has sex with a STD infected partner, they will eventually catch that STD. Also, whilst circ has been shown to benefit (oh so slightly) rates of male-to-male, and female-to-male HIV transmission, I *believe* (I may be wrong) that it has been shown to increase rates of male-to-female HIV trasnmission. Besides that, babies don't HAVE sex, so if is the reason, surely removal of the foreskin when it becomes necessary - rather than unnecessarily prophylactically would be far better?
To look like their dad: I dunno about you, but I don't really stand around comparing my genitals/breasts to my mum. I'm far more likely to compare my body to my age peers - and circ rates in Australia sit around 10% ATM and are dropping - so if a little boy is done now, he's far more likely to be the 'odd one out' in the locker room than he is to fit in
Because at least if you have it done when they're a baby, they won't remember: That might be true, at least on a conscious level, but trauma is trauma and DOES affect brain development, bonding, chemistry and a whole host of other bodily functions. There are studies regarding the fact that once cortisol (a stress hormone) levels are elevated in a baby, that baby will be primed to be more stressed in the future, and may impact on future mental health. It doesn't seem worth the risk, given the exceedingly small number of problems that are likely to occur in the exceedingly small amounts they are

Aside from all that: I cannot imagine having my genitals sliced open and then having the raw wounds bathed in urine and faeces. This is the reality for little boys who have been circumcised.

The foreskin isn't just a useless piece of skin. It is an incredibly nerve-rich, functional piece of the human anatomy. If a person is going to have such a piece of their anatomy removed for non-medical, cosmetic reasons only, then THEY should be the person to have the choice about whether or not it is done. At the end of the day, the decision NOT to circumcise can be changed. But you can't undo a circumcision once it's been done.

Not my penis, not my choice.

:)

[Brightsilverstar]

Brightsilverstar, that is NOT the only argument, although for many, it is fundamental to their beliefs. I'd say many are of the opinion that if it aint broke, don't fix it.

It's just not needed. An intact penis is fully functioning. A foreskin is necessary, it's like a protective shield. IMO, it's like removing a fingernail, or an apendix, just incase.

Ok, i am still fence sitting atm. I mean i have spoken to my brother about this who is un circ'd or intact and he would prefer to be but can't be bothered going through the pain now and organising everything when he believes it should be done at birth. He believes it is so much cleaner.

What are some of the risks of happening when a baby boy is circ'd?

Thanks in advance

[misskittyfantastico]

There is constant mocking in general in the circ sections. Insinuations that mothers circ bc of their own sick sexual preferences. Hysteria that circing is so painful, when in aust the vast bulk of circs are done with 2 forms of pain relief.

There are some decisions by parents I find abhorrant, but I don't attack them like circers are attacked here (and that's a general comment not directed at you)

Again, have you read my links? There was so many and it's so late I linked but a tiny proportion. All reputable, many meta analysis. From the US,NZ, UK, not just the ones from Africa that the anti circers love to debunk.

Anyhoo, off to bed, will be back tomorrow :)

*I'm* not every anti RIC person, just as much as *you're* not that pro RIC person.

*I* could never subject my child to RIC. I have looked at MANY links, and I've (We've,because DH is agrees) still decided that I and he find that that the risk to benifit senario

[sockstealingpoltergeist]

Ok, i am still fence sitting atm. I mean i have spoken to my brother about this who is un circ'd or intact and he would prefer to be but can't be bothered going through the pain now and organising everything when he believes it should be done at birth. He believes it is so much cleaner.

What are some of the risks of happening when a baby boy is circ'd?

Thanks in advance
Not so, a dirty penis is a dirty penis, many men of older generations believe that myth because of teasing that used to go on when uncirc'd children were the minority. Now uncirc'd are the majority, the teasing doesn't really happen, as it's completely untrue.

There is a risk of infection, shock, permanant disfigurement and death.

Hardly worth it.

[Brightsilverstar]

Thanks so much Tam-I-am for answering my questions :)

[misskittyfantastico]

Thanks so much Tam-I-am for answering my questions :)

Yes, what Tam said.

[Tam-I-Am]

Brightsilverstar, some really interesting reading by Bubhubbers much cleverer and more knowledgable than me:

Foreskin Functions (http://bubhub.com.au/community/forums/showthread.php?t=285983)

Like Father, Like Son (http://bubhub.com.au/community/forums/showthread.php?t=317672)

Circumcised Father, Intact Son (http://bubhub.com.au/community/forums/showthread.php?t=252332)

Silly pro-circ arguments 1 - "infection" (http://bubhub.com.au/community/forums/showthread.php?t=241525)

Pro-circ myths 2-AIDS/HIV (http://bubhub.com.au/community/forums/showthread.php?t=242912)

Circ myths 3 - "younger the better" (http://bubhub.com.au/community/forums/showthread.php?t=245680)

circ myths 4-cancer (http://bubhub.com.au/community/forums/showthread.php?t=246433)

Pro-circ myths 5: STIs (http://bubhub.com.au/community/forums/showthread.php?t=296784)

Circ, Africa and HIV (http://bubhub.com.au/community/forums/showthread.php?t=291631)

Infections etc (http://bubhub.com.au/community/forums/showthread.php?t=6692)

Hope that helps :)

[Father]

Lack of circumcision:


• Is responsible for a 12-fold higher risk of urinary tract infections in infancy. Risk = 1 in 20 to 1 in 50 for uncircumcised infants and 1 in 200 to 1 in 500 for circumcised infants. Higher risk of UTI at older ages as well. Overall lifetime cumulative prevalence of UTI = 1 in 3 for uncircumcised males compared with 1 in 20 for circumcised males, respectively.

• Confers a higher risk of death in the first year of life (from complications of urinary tract infections: namely kidney failure, meningitis and infection of bone marrow).

• One in ~400–900 uncircumcised men will get cancer of the penis, which occurs more than 20 times more commonly in uncircumcised men. A quarter of these will die from it and the rest will require complete or partial penile amputation as a result. (In contrast, invasive penile cancer never occurs or is extraordinarily rare in men circumcised at birth.) (Data from studies in the USA, Denmark and Australia, which are not to be confused with the often quoted, but misleading, annual incidence figure of 1 in 100,000).
• Higher risk of prostate cancer (50–100% higher in uncircumcised men)

• Is associated with 3-fold higher risk of inflammation and infection of the skin of the penis. This includes balanitis (inflammation of the glans), posthitis (inflammation of the foreskin), balanoposthitis (inflammation of glans and foreskin), phimosis (inability to retract the foreskin) and paraphimosis (constriction of the penis by a tight foreskin that will not return after retraction). Up to 18% of uncircumcised boys will develop one of these by 8 years of age, whereas all are unknown or much rarer in the circumcised. Risk of balanoposthitis = 1 in 6. Obstruction to urine flow = 1 in 10–50. Risk of these is even higher in diabetic men.

• Means increased risk of problems that may necessitate 1 in 10 older children and men requiring circumcision later in life, when the cost is 10 times higher, the procedure is less convenient, and the cosmetic result can be lesser, as stitches or tissue glue are required, as compared with circumcisions done in infancy.

• Increases by 2–4 fold the risk of thrush and sexually transmitted infections such as human papillomavirus (HPV), genital herpes (HSV-2), syphilis, chancroid, Trichomonas vaginalis and thrush.

• Is the biggest risk factor for heterosexually-acquired AIDS virus infection in men. 2 to 8-times higher risk by itself, and even higher when lesions from STIs are added in. Risk per exposure = 1 in 300.

• In the female partners of uncircumcised men lack of male circumcision is associated with an up to 5 fold higher incidence of cervical cancer (caused by sexually transmitted HPV), genital herpes, Trichomonas vaginalis, bacterial vaginosis (formerly called “Gardnerella”), and possibly Chlamydia (which is a cause of pelvic inflammatory disease, infertility from blockage of fallopian tubes, and ectopic pregnancy).


Pros of circumcision:
• Improved hygiene.
• Much lower risk of urinary tract infections.
• Much lower chance of acquiring HIV, the AIDS virus, heterosexually.
• Virtually complete elimination of the risk of invasive penile cancer.
• Slightly lower risk of prostate cancer.
• More favourable hygiene for the man’s sexual partner.
• Much lower risk of cervical cancer and Chlamydia (and thus infertility and other problems) in the female sexual partner.


From http://www.circinfo.net/summary.html

[sockstealingpoltergeist]

It is unecessary and the HIV argument is not relevant here.

In fact the studies used to back the HIV argument are very flawed and even then only appropriate in Africa not Australia.
http://www.nocirc.org/2008-07_Mothering-Fauntleroy.pdf

[Tam-I-Am]

Lack of circumcision:


• Is responsible for a 12-fold higher risk of urinary tract infections in infancy. Risk = 1 in 20 to 1 in 50 for uncircumcised infants and 1 in 200 to 1 in 500 for circumcised infants. Higher risk of UTI at older ages as well. Overall lifetime cumulative prevalence of UTI = 1 in 3 for uncircumcised males compared with 1 in 20 for circumcised males, respectively. And the risk for women is higher again. But we don't go around circing them.



• Confers a higher risk of death in the first year of life (from complications of urinary tract infections: namely kidney failure, meningitis and infection of bone marrow).

Doesn't take into account the risk of death due to kidney infection relative to the risk of death (http://bubhub.com.au/community/forums/showthread.php?t=297782) due to circumcision.



• One in ~400–900 uncircumcised men will get cancer of the penis, which occurs more than 20 times more commonly in uncircumcised men. A quarter of these will die from it and the rest will require complete or partial penile amputation as a result. (In contrast, invasive penile cancer never occurs or is extraordinarily rare in men circumcised at birth.) (Data from studies in the USA, Denmark and Australia, which are not to be confused with the often quoted, but misleading, annual incidence figure of 1 in 100,000).
• Higher risk of prostate cancer (50–100% higher in uncircumcised men) And women have a many times greater chance of getting breast cancer, or cancer of the cervix, but we don't go around prophylactically removing cervices and breasts in infancy.


• Is associated with 3-fold higher risk of inflammation and infection of the skin of the penis. This includes balanitis (inflammation of the glans), posthitis (inflammation of the foreskin), balanoposthitis (inflammation of glans and foreskin), phimosis (inability to retract the foreskin) and paraphimosis (constriction of the penis by a tight foreskin that will not return after retraction). Up to 18% of uncircumcised boys will develop one of these by 8 years of age, whereas all are unknown or much rarer in the circumcised. Risk of balanoposthitis = 1 in 6. Obstruction to urine flow = 1 in 10–50. Risk of these is even higher in diabetic men. See my first point. Girls have much higher rates of genital infections than boys, we do not incise their labias in order to prophylactially treat this. We treat it when there is an actual problem



• Means increased risk of problems that may necessitate 1 in 10 older children and men requiring circumcision later in life, when the cost is 10 times higher, the procedure is less convenient, and the cosmetic result can be lesser, as stitches or tissue glue are required, as compared with circumcisions done in infancy. This point has been addressed many times in many ways in other threads. You KNOW that you are giving WAY overestimated figures here. You're deliberately misleading people.



• Increases by 2–4 fold the risk of thrush and sexually transmitted infections such as human papillomavirus (HPV), genital herpes (HSV-2), syphilis, chancroid, Trichomonas vaginalis and thrush.

Wow. Cause thrush is a reason for surgery.



• Is the biggest risk factor for heterosexually-acquired AIDS virus infection in men. 2 to 8-times higher risk by itself, and even higher when lesions from STIs are added in. Risk per exposure = 1 in 300. Again: Safe sexual practices are far far more logical, and effective, than circ at preventing AIDS and STIs. Not only that, but the studies that show these benefits were conducted in Africa. Australia is NOT comparable.



• In the female partners of uncircumcised men lack of male circumcision is associated with an up to 5 fold higher incidence of cervical cancer (caused by sexually transmitted HPV), genital herpes, Trichomonas vaginalis, bacterial vaginosis (formerly called “Gardnerella”), and possibly Chlamydia (which is a cause of pelvic inflammatory disease, infertility from blockage of fallopian tubes, and ectopic pregnancy). Circumcision does not prevent HPV or Chlamydia transmission. Safe sexual practices prevents STI transmission. Bacterial vaginosis is a naturally-occurring bacteria in the vagina, and flares at times of high-immune system stress regardless of the circ status of the partner.


Pros of circumcision:
• Improved hygiene. Not true. Improved hygiene improves hygiene. Nothing can improve hygiene except more regular attendance to hygiene. As has been said time and time again - a dirty penis is a dirty penis.

• Much lower risk of urinary tract infections. Circing girls would improve their rate of UTI, too. And given they experience them far more often than boys, it would make more sense. However, we recognise that it's not an okay thing to do, just as it isn't for boys.

• Much lower chance of acquiring HIV, the AIDS virus, heterosexually. Misleading, at best. SLIGHTLY lower chance, much better improved by safe sexual practices than by lopping a very sensitive and functional piece of skin off

• Virtually complete elimination of the risk of invasive penile cancer. The risks of which are so low to be almost non-existent to begin with!

• Slightly lower risk of prostate cancer. Heh. Speaks for itself.

• More favourable hygiene for the man’s sexual partner. Says who? You? Clearly you don't know a great deal about hygiene then. Bodies have intricate immune system response. Removing one of them by brute force is not an improvement for anyone. Again, noting improves hygiene but improved hygiene.

• Much lower risk of cervical cancer and Chlamydia (and thus infertility and other problems) in the female sexual partner.


From http://www.circinfo.net/summary.html



Again, you're overstating. SLIGHTLY reduced rates, which would be much better addressed by safe sexual practices than circing.

[Father]

The Centers For Disease Control and Prevention has this factsheet for circumcision:

http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm

[andrewJ]

Find me a comment that you find is rubbish.

"The foreskin has no role after birth. "


http://www.circinfo.net/why_are_human_males_born_with_a_foreskin.html

[andrewJ]

There is constant mocking in general in the circ sections. Insinuations that mothers circ bc of their own sick sexual preferences.

its not an insinuation. its often made explicit by the mothers themselves

[myhusbandswife]

At the risk of getting my head bitten off, Does anyone actually know an adult that regrets being circ'd are a baby?

I am just curious. I have a DD so I havent had to think of what I would do?

My DH is circ'd and he says all his friends that are intact hate it. He has a friend that on a number of occasions has had a torn forskin from intercourse

[andrewJ]

:wave:

[delirium]

It's a fact that some things can go wrong with the foreskin. It's also a fact that some things can go wrong with the tonsils, with the appendix, with the urinary tract in little girls (in fact it's far more likely to than in little boys, being shorter, less able to flush itself, and in more contact with mucous membranes), but we would never remove those things on an off chance that something would go wrong. We'd wait until something did go wrong, and then treat it.

The tonsil arguement has never washed with me and is like comparing apples and oranges.

For a start the most that can happen with tonsils is infection of the tonsil. It hardly compares in severity to the potential to pass HPV and cause cervical cancer, HIV or chlamydia. IMO it is not an adequate example and is designed to minimise the pros of circ to a simple infection.


Prevention of STDs: Circumcision might improve rates of STDs EXTREMELY slightly - but wouldn't teaching safe sex be a far better option? Circumcision might afford some extremely limited protection - but for how long? Did you look at my links? Circ provides more than extremely slight protection. In the course of my research I have found lots more studies in relation to STD's. All reputable studies not done in Africa.

I agree with traching safe sex, of course even for a circed boy. But the fact the western world still has such issues with STD's (chlamydia and gonorrhea are at all time highs) tells me circed or uncired, people are not using condoms. That and people are cheating in long term relationships where the other party believes they are faithful and there is no need to use a condom.

If STD's hardly existed anymore due to very high rates of condom use, I would be making a moot point.

I choose to give my boy the safe sex talk plus have him circed as a double measure.


To look like their dad: I dunno about you, but I don't really stand around comparing my genitals/breasts to my mum. imo this is a red herring used by anti circers to make those that circ look like uneducated sickos. Yep, there are people that do it for that reason, but I believe they are in the vast minority.

I live in the bush were circ rates are high, and out of all my family and friends that have circed, not one was for this reason, it was for health reasons.

Saying this is the reason over and over does not make it so :)


I'm far more likely to compare my body to my age peers - and circ rates in Australia sit around 10% ATM and are dropping - so if a little boy is done now, he's far more likely to be the 'odd one out' in the locker room than he is to fit in Circ rates are actually around 15% and those figures only inlcude neonates for medicare, not infants, toddlers, children that are circed.

Then there are those that don't claim the rebate. I would think based on this circ rates at the moment were at about 20%.

This 'odd one out' thing always perplexes me. I circed my son, not to be cool, but for his health. If tomorrow, suddenly the circ rate went to 90% and you birthed a boy - would you get him circed just to fit in? I think not.


Aside from all that: I cannot imagine having my genitals sliced open and then having the raw wounds bathed in urine and faeces. This is the reality for little boys who have been circumcised.Again emotive language is resorted to. Since you have never had a child that has been circed, with all respect to you, you don't know. You are making assumptions based on your bias. I'm surprised your sliced comment hasn't been removed as I believe it breaches the guidelines for this section for emotive language 'that has those dark connotations' or similar wording in the guidelines.

I have said over and over here that while changing my sons's nappy the day after the circ, he weed and I waited for him to cry. He didn't cry or even flinch, and having a newborn with reflux they most certainly show pain.

[sockstealingpoltergeist]

At the risk of getting my head bitten off, Does anyone actually know an adult that regrets being circ'd are a baby?

I am just curious. I have a DD so I havent had to think of what I would do?

My DH is circ'd and he says all his friends that are intact hate it. He has a friend that on a number of occasions has had a torn forskin from intercourse

Many men, and some have penile issues from circing too, unfortunately it is a sensative and taboo subject, most men do not discuss it, because they want others to believe they have biggest strongest bestest penis in the world.

My ex got torn skin on his penis too, and he was circ'd. It's usually from being in a hurry and not being properly lubricated.

[gana]

There is constant mocking in general in the circ sections. Insinuations that mothers circ bc of their own sick sexual preferences.

i've seen this attack a lot on mothers who elect to circ their sons and i'm puzzled by it. can't we just accept parents are doing their best for their own kids without mocking?

[Fellow Traveler]

Find me a comment that you find is rubbish.

"The foreskin has no role after birth. "


http://www.circinfo.net/why_are_human_males_born_with_a_foreskin.html



Or perhaps:

"although some under-reporting by uncircumcised men was likely as they tended to be less educated."

So intact men are uneducated?

He sites "Zipper injury?" that intact men make a mess in the bathroom?

The site reeks and oozes a circumcision biased.

[delirium]

its not an insinuation. its often made explicit by the mothers themselves

By maybe 2 or 3 members out of hundreds. The reason this tired argument is put forth over and over is to discredit those that circ. It is not steeped in any real fact.

So do you have facts to back this up, or is it a red herring as I know it is?

[delirium]

The site reeks and oozes a circumcision biased.

I have linked multiple meta analysis studies from around the world that are no more than 16 years old. No circ bias, reputable studies published in reputable journals.

I'm wondering why no one has made any comment to them?

[Guest]

At the risk of getting my head bitten off, Does anyone actually know an adult that regrets being circ'd are a baby?

I am just curious. I have a DD so I havent had to think of what I would do?

My DH is circ'd and he says all his friends that are intact hate it. He has a friend that on a number of occasions has had a torn forskin from intercourse
I usually get in trouble when I post in these threads, but I will anyway.
I've never met anyone who's regreted being circed (and I know many, dad, brothers, cousins, friends) I also have never met anyone who regrets not being circed including dh.
Most boys are happy with what they have and don't know the difference either way. If a man is unhappy with his foreskin like men your partner is talking about, they have the choice to go through the procedure. What I've noticed mainly with men when they talk about getting rid of a foreskin are comments made by people that its cleaner, looks better etc. so in that regards men hear it and think wow, I can improve it? I've never met anyone who actually looks at studies and will look at it as an adult for medical benefits. That's just my observation when men talk about their anatomy. I'm sure I'll be corrected, but this is just my opinion and observation from men I've talked to.

There are risks associated with this when it's done to babies and men any age, like with all proedures. There are reasons for a foreskin that have been posted. There are also valid points in circing a penis, however the part of it I have a problem with is mainly it's ralevance and the way the studies are done and presented. Especially these studies in Africa and it's comparison to Australia. For example:
In the days my dad and his dad were boys, this was commonly done (as it was more common around the world) I know people who do it for religious purposes, but thats another issue. My dad wasn't done for religious purposes but cleanliness for all the reasons posted by pro circ arenas and they were valid in my dads younger days and did help them. But heres why, they lived in a village, they had no bathrooms or constant clean running water, there was no such thing as a shower. They had a well or a pump with fresh spring water, they put water in a bucket (heated it first in winter) stood in a bucket and bathed. Ofcourse they never bathed everyday as this was a difficult task to do everyday with a whole family. So ofcourse having no forseskin to keep clean was easier for them and did prevent infections due to not having many baths.
But
How is this relevant today in Australia? They do studies in Africa that probably have the same issues my dad had living in places with no running water where men don't get to shower everyday. Also with sti's std's and sexual practices, men in Africa don't go to the local chemist and buy condoms, as all men who are engaging in sex should be doing, here in Australia you can and it's widely known that this should be taught to boys and girls. Not, get circed and then you don't have to protect yourself, it's really the wrong message your giving your sons, because even if you do circ, won't you still want your children to engage safely (preferably abstain till marriage ;))
Men in Australia can shower and clean themselves properly. Safe sex is the best way to prevent aids and infections. All the points of circing as a baby become invalid in my mind because they're all things that boys should be doing regardless if they are or aren't circed and living in a first world country it's something that is just not necessary as someone living poorly in a 3rd world country where perhaps it may benefit them.

I also have a problem with thrush and things that are said of that nature. I would never circ my son so he never gets thrush. Thrush is such a common thing for women, (particularly when I was pregnant due to hormones) and even as a teenager when I wasn't sexually active, so to suggest it's caused by uncirced men is just not true. It's also easily fixed, you put some cream or take a tablet and its gone, would I go and circ myslef to prevent this? No way. So why would I do my son? This goes with sti's etc. would I engage in casual sex without a condom because the man is circed so I'm safe? no way. So the reasons to circ for me become less and less valid and quite pointless.

Also penile cancer, I don't know how valid this is as the suggestion is a bit iffy, but lets say it's true. Would I cut my breasts off to prevent breast cancer? no. I have a slightly higher chance of cervical cancer as a fact (due to pcos) so would I now go and remove my uterus to prevent this? no. Even though I would be done having kids and have no use for it? still no. If penile cancer was widely known to be the cause of having foreskin and it was as common as breast cancer, I believe it would be recommended by proffessional bodies to remove foreskin at birth, but I don't think the statistics are there to prove this, it's a suggestion.

So besides the fact of leaving foreskin for it's intended purpose, the reasons to remove it from my baby becomes less and less valid as the list goes on.

[Pippi Longstocking]

By maybe 2 or 3 members out of hundreds. The reason this tired argument is put forth over and over is to discredit those that circ. It is not steeped in any real fact.

So do you have facts to back this up, or is it a red herring as I know it is?

The argument is put forward, at least by me, when people themselves have offered it as a reason for circumcising their infant sons. It may not have factored into your decision-making, but it certainly has been said numerous times by those wishing to justify their actions.

[delirium]

The argument is put forward, at least by me, when people themselves have offered it as a reason for circumcising their infant sons. It may not have factored into your decision-making, but it certainly has been said numerous times by those wishing to justify their actions.

Yes,as I said, it has been said. But like you, I've been here a while now and I've only read it a few times over the years.

This reason I would say is in the minority and not a true reflection of the main reason people circ.

My DH is circed. I did countless hours of research for about 5 months before we made the decision. If I had not found the great deal of studies showing a variety of health benefits we would not have circed and there is no way I would have done it just so DS looked his DH. Personally I find that a ridiculous reason and one where those of us that have actually researched, get tarred with the same brush.

[Pippi Longstocking]

This study (Routine circumcision: the opposing view
Andrew E MacNeily
Can Urol Assoc J. 2007 November; 1(4): 395–397) is arguing against RIC on an economical level rather than being based on ethical arguments. It contains some valid points...
(I accessed this study via my uni library so I don't know if everyone will be able to reach it. I will paste the relevant bits, with heavy editing as there is a lot of info there.)

* Urinary tract infections

...incidence of UTI in the first year of life is low. Even a 10-fold reduction in infection rates equates to changing the incidence of UTI from 1 in 100 to 1 in 1000 male babies. It has been calculated that the rate of UTI among infant boys with foreskins must equal or exceed 29% for neonatal circumcision to be cost effective.4 Conversely, for neonatal circumcision to be cost- neutral, each patient hospitalized for UTI would need to cost $229 564!5 In 2004, it is estimated that approximately 1.2 million newborn circumcisions were performed in the United States. The estimated direct cost of these procedures was $1.2 billion, a large sum of health care funds that could be directed toward more effective preventative and therapeutic interventions.6
Most UTIs in male babies are minor, easily treated with antibiotics. Therefore, circumcision to reduce UTIs is invalid.

HIV

...Some studies conducted in Africa have shown that HIV is more common in uncircumcised males, while others have shown the opposite or no difference....A recent Cochrane systematic review found insufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexual men....the United States has the highest rate of HIV and also the highest rate of infant circumcision.5 This alone casts doubt on the utility of routine circumcision in preventing HIV infection in developed countries.

Prevention of cervical carcinoma

...a recent meta-analysis on HPV and circumcision concluded that the medical literature does not support the claim that circumcision reduces the risk of genital HPV infection. (Van Howe RS. Human papillomavirus and circumcision: A meta-analysis. J Infect 2007;54:490-6)...The use of surgery for disease prevention is an unusual public health intervention. It would seem a more prudent health care policy to offer the recently available HPV vaccine against oncogenic strains of the virus to young females before the onset of sexual activity than to perform surgery on all males in the neonatal period

Penile cancer

...It is notable that the incidences of penile cancer in Denmark, Finland, Norway and Japan, where less than 1.5% of men are circumcised, are lower than in the United States, where the majority of men are still circumcised...The American Academy of Pediatrics policy notes that 9–10 cases of penile cancer are diagnosed each year per 1 million men, indicating that, although the risk is higher for uncircumcised men, the overall risk is extremely low.19 Because this disease is rare and occurs later in life, advocating circumcision as a preventive practice is difficult to justify.

Prevention of future foreskin problems

...All newborn males have a physiologic phimosis, with the glans adherent to the inner mucosal surface of the prepuce. Gradual separation of the glans from prepuce takes place spontaneously over many years, often not being complete until puberty.20 Referrals for circumcision later in childhood because of an asymptomatic non-retractile foreskin, possibly with some ballooning upon voiding, are commonly made in error. Usually, in this setting, anxious parents and referring physicians require education on the care of the normal foreskin and the patient does not require an operation...The Canadian Pediatric Society states that no more than 1% of boys will require post-neonatal circumcision, and Australian reports indicate that normal preputial adhesions are often misdiagnosed as phimosis, leading to unnecessary circumcisions.22,23 The rate of true pathological phimosis is less than 1%24 and this usually responds to a short course of topical steroid ointment..

Conclusion

Routine circumcision of all infants is not justified from a health or cost-benefit perspective.

[Fellow Traveler]

RaryGirl, I don't think you're going to get exactly what you're looking for; the subject and claims are too broad. There are many facets to this question only the first of which would be is there a "benefit". There is also the broad question of ethics, a topic heretofore ignored by those who promote circumcision.

It might be better to focus on a single purported benefit. Delirium posts the Fergusson (http://pediatrics.aappublications.org/cgi/content/abstract/118/5/1971) study however, in addition to the fact that his first table shows a range of the 95% confidence interval includes 1.0 in all cases which means there is no correlation, his results are counter to several large cross-sectional surveys and a more recent publication by Dickson (http://www.ncbi.nlm.nih.gov/pubmed/18280846?dopt=Abstract).

[delirium]

And the rest of my links Fellow Traveller? I have lots more if you wish to attempt to debunk the ones I have :) The discrepancy you discuss is the adjustment for certain factors. You cannot ignore the factors of how many sexual partners etc, obviously that adds a great deal of context to the results. Clearly a man that has had 100 partners would have more opportunties to contract and pass on and STD, than a man that's had 5, irrespective of circ status.

In relation to the studies on HIV in Africa and the proposition that running water and better sanitation are the reasons this study has methodological flaws - why is it then that the western world still has so many issues with STD's and penile infection? All of the men can't just be dirty. Of course there are issues with not wearing condoms, but studies show STD's are higher amongst men that aren't circed. The US may have a high rate of circ but other countries that don't, report high incidence of several STD's and moderate levels of infection in some cases.

Some anecdotal data - my friend who was due with a boy the same time as me told me why her partner begged her to circ their son. He had constant infections, which were not solved with creams or any other method. She said they passed thrush back and forth and she'd never had thrush with any other partner. She also said he told her this was a pattern with all his past partners. She told me he showered twice a day, was very clean and careful with overall hygeine.

A buddy in high school was dating a guy that got circed while she was with him. She told me he'd had so many infections that he had severe scarring and having an erection was painful bc it stetched the scar tissue. She also pointed out he was clean and bathed regularly.

[susieq1969]

Why mess with what nature gave you IMO?? :confused:

My DS is not circ'd. :no:

If he want's to have it done when he's older then that's his decision to make and I won't stand in his way.

I know we are parents, but sometimes I do wonder what other "bits' the medical profession decide we don't need will be next???

[circangel]

And the risk for women is higher again. But we don't go around circing them.
[/LEFT]



Doesn't take into account the risk of death due to kidney infection relative to the risk of death (http://bubhub.com.au/community/forums/showthread.php?t=297782) due to circumcision.


And women have a many times greater chance of getting breast cancer, or cancer of the cervix, but we don't go around prophylactically removing cervices and breasts in infancy.
[LEFT] See my first point. Girls have much higher rates of genital infections than boys, we do not incise their labias in order to prophylactially treat this. We treat it when there is an actual problem



This point has been addressed many times in many ways in other threads. You KNOW that you are giving WAY overestimated figures here. You're deliberately misleading people.




Wow. Cause thrush is a reason for surgery.


Again: Safe sexual practices are far far more logical, and effective, than circ at preventing AIDS and STIs. Not only that, but the studies that show these benefits were conducted in Africa. Australia is NOT comparable.


Circumcision does not prevent HPV or Chlamydia transmission. Safe sexual practices prevents STI transmission. Bacterial vaginosis is a naturally-occurring bacteria in the vagina, and flares at times of high-immune system stress regardless of the circ status of the partner.

Not true. Improved hygiene improves hygiene. Nothing can improve hygiene except more regular attendance to hygiene. As has been said time and time again - a dirty penis is a dirty penis.
Circing girls would improve their rate of UTI, too. And given they experience them far more often than boys, it would make more sense. However, we recognise that it's not an okay thing to do, just as it isn't for boys.
Misleading, at best. SLIGHTLY lower chance, much better improved by safe sexual practices than by lopping a very sensitive and functional piece of skin off
The risks of which are so low to be almost non-existent to begin with!
Heh. Speaks for itself.
Says who? You? Clearly you don't know a great deal about hygiene then. Bodies have intricate immune system response. Removing one of them by brute force is not an improvement for anyone. Again, noting improves hygiene but improved hygiene.


Again, you're overstating. SLIGHTLY reduced rates, which would be much better addressed by safe sexual practices than circing.

The risks for this procedure are much, much greater and not legal in some countries.
I am not sure if any studies have been done to prove either way
This is true and for good reason possibly due to the fact it might cause some problems later in life.
I have heard this to be true but again circumcision is a much lower risk procedure.
Yes to help avoid this painful condition.
Are you sure of your your information above?
Possibly true
Possibly true

I could not possibly agree with the above. (Improved hygiene improves hygiene)

[Opinionated]

Just for once I will agree with the circ side. Being circumcised does lower the risk of getting some sorts of problems. However, if the initial risk of getting the problem is 0.2 % (2 in 1000) and then an invasive and uncomfortable/painful procedure like circumcision lowers that risk to 0.1% (1 in 1000) is it really worth it? Considering the risks of circumcision itself and the impact on the rights of the child I cannot see the benefit.

[Fellow Traveler]

And the rest of my links Fellow Traveller? I have lots more if you wish to attempt to debunk the ones I have :)


I prefer to focus on one thing at a time. I am also familiar with most of the literature, you're not going to post much I haven't seen but again one thing at a time, and as time permits.



The discrepancy you discuss is the adjustment for certain factors. You cannot ignore the factors of how many sexual partners etc, obviously that adds a great deal of context to the results. Clearly a man that has had 100 partners would have more opportunties to contract and pass on and STD, than a man that's had 5, irrespective of circ status.


I don't at all understand what you're saying; you're going to have to point this out. They studied a birth cohort that were followed for 25 years and surveyed them about sexual exposure and STDs. In presenting the results the authors would have adjusted for number of partners and similar data. I mentioned that the data presented by Fergusson was inconsistent with data from several large cross-sectional studies. This is a fact acknowledged by the author in a correspondence (http://pediatrics.aappublications.org/cgi/eletters/118/5/1971#4725) on the issue in the Journal the following month:


Recent correspondence to the journal has highlighted the fact that our findings are not consistent with cross- sectional studies of the linkages between circumcision and the more common forms of STI (including Chlamydia, genital warts, genital herpes, gonorrhea, and non-specific urethral infections). Of particular relevance is a recent Australian survey of 10,000 male respondents (2), and the preliminary findings from the Dunedin study (3). These discrepancies with our findings are too large to be disregarded, and we are of the view that it would be premature to use our findings to promote the view that circumcision reduces risks of less severe forms of STI, until further research clarifying this issue is conducted.

I then provide a second study, coincidently enough also from New Zealand. Which was performed the same way, following a birth cohort. Their data came out opposite and in line with other larger studies on the issue.

So were do you see a question with number of partners? Both studies would have adjusted for that data.



In relation to the studies on HIV in Africa and the proposition that running water and better sanitation are the reasons this study has methodological flaws - why is it then that the western world still has so many issues with STD's and penile infection? All of the men can't just be dirty.

This is a different issue; if you want to switch gears and speak about HIV we can do that.



Of course there are issues with not wearing condoms, but studies show STD's are higher amongst men that aren't circed. The US may have a high rate of circ but other countries that don't, report high incidence of several STD's and moderate levels of infection in some cases.


Which countries (http://health.msn.com/health-topics/sexual-health/mens-sexual-health/articlepage.aspx?cp-documentid=100170966)?


The U.S. has the highest STD rates of any country in the industrialized world.



Some anecdotal data -

I can't speak to anecdotes. I once had a cavity but I don't wish my parents pulled my teeth; treat conservatively. I don't care if men want to get circumcised for any reason or no reason. All men though should have the dignity of that choice.

[delirium]

Just for once I will agree with the circ side. Being circumcised does lower the risk of getting some sorts of problems. However, if the initial risk of getting the problem is 0.2 % (2 in 1000) and then an invasive and uncomfortable/painful procedure like circumcision lowers that risk to 0.1% (1 in 1000) is it really worth it? Considering the risks of circumcision itself and the impact on the rights of the child I cannot see the benefit.

There are lots more studies that show higher stats than that. Consistantly referring to 1 study which fits your bias and ignoring dozens of others does not make a well rounded debate.

[Opinionated]

Delirium, I have had a look at your articles.

I am not going to discredit them. I don't have enough knowledge of the science to do so. What I will say though is that I find it ridiculous that circumcision is being advocated to prevent sti's, hiv and other conditions that only present in adulthood after someone becomes sexually active. Guardasil is not in the infant immunisation schedule, simply because the medical fraternity does not think it necessary to immunise girls at such a young age to prevent hpv, however circers think it is totally justafiable to have a bit lopped off their son for the same aim:confused: Surely circumcision can wait until the owner of the penis can decide if they see a prophylactic benefit in it.

As for preventing infections and conditions where the foreskin is too tight, these can often be treated with antibiotics and steroid based cream. No other body part is prophylactically removed when completely healthy for it's risk of infection. Most of us have children who at one time suffer some sort of infection in their pants. As a mother with a daughter I would argue that my recent poll shows that more girls suffer these issues than boys. We deal with the problem, we treat the issue, we don't amputate body parts.

I am not against circumcision. I am against it being performed on a very young child to prevent conditions which only occur in later life given certain conditions. I am against the choice for how they want their body to be being taken away from them.

[Opinionated]

There are lots more studies that show higher stats than that. Consistantly referring to 1 study which fits your bias and ignoring dozens of others does not make a well rounded debate.

I didn't refer to any study. I was merely pointing out that while a 50% decrease in illness may seem pretty high, it means nothing unless we know what the initial rate of the illness is. I find often that the pro-circ team does not present initial figures, only %reductions.

[delirium]

I don't at all understand what you're saying; you're going to have to point this out. They studied a birth cohort that were followed for 25 years and surveyed them about sexual exposure and STDs. In presenting the results the authors would have adjusted for number of partners and similar data. I mentioned that the data presented by Fergusson was inconsistent with data from several large cross-sectional studies. This is a fact acknowledged by the author in a correspondence (http://pediatrics.aappublications.org/cgi/eletters/118/5/1971#4725) on the issue in the Journal the following month:

I then provide a second study, coincidently enough also from New Zealand. Which was performed the same way, following a birth cohort. Their data came out opposite and in line with other larger studies on the issue.

So were do you see a question with number of partners? Both studies would have adjusted for that data.

Maybe we're at cross purposes. What I'm saying is that it has been taken into account, yet the conclusion is; These findings suggest that uncircumcised males are at greater risk of acquiring sexually transmitted infection than circumcised males. Male circumcision may reduce the risk of sexually transmitted infection acquisition and transmission by up to one half, suggesting substantial benefits accruing from routine neonatal circumcision.

Simply bc it does agree with the studies you choose to draw from doesn't make it any more or less valuable.

I find it confusing that we are asked to list pros and cons. I list pros with several links. Which are again dismissed bc they don't agree with a few studies that anti circers constantly draw from.

This has confirmed what I already knew. Even listing credible research makes no difference. Your questioning of one study with the excuse 'it doesn't agree with my studies' does not a debate make. You are not here to learn and exachange info, you are here to soap box and belittle others.

[RaryGirl]

RaryGirl, I don't think you're going to get exactly what you're looking for; the subject and claims are too broad. There are many facets to this question only the first of which would be is there a "benefit". There is also the broad question of ethics, a topic heretofore ignored by those who promote circumcision.

What I'm trying to get here is a somewhere that fence sitters can come and read BOTH sides of the 'argument' and make a decision for themselves.

Yes there is the pro and the anti side, but that's not a very interesting read is it? What if someone gets sick of reading after just reading the pro side and they make their decision? Or if they start on the anti side and don't get to the pro side?

If each 'side' can address the others articles/research/studies with information to back up their opinion that would make it alot easier for people to make an informed decision.

We can all sit here and push forward our ideas, but what I would like to see is 'our' ideas backed up with research. If you feel something is biased in it's findings, then please address that with information showing that it is biased and not correct.

I'm aware this has been done before, but it's never ended nice ... it's always ended in name calling and ridicule. Which in turn puts people off reading the thread, therefore missing the parts that are very important.

[Pippi Longstocking]

I think it'd be awesome if people could engage in this debate from a factual and unbiased position, rather than reacting defensively. I don't think anyone has belittled anyone, and making such accusations just fires up the debate. Maybe if belittling does occur, the specific example could be highlighted rather than broad accusations thrown about, as these do nothing but add fuel and detract from information-sharing.

[Opinionated]

Ok then.

The fact is, children generally are not sexually active, therefore do not need a procedure that protects them against sti's until they are older.

Urinary tract infections occur in both boys and girls, possibly more so in girls due to the short length of the tract. Antibiotics are highly effective methods of treatment.

Tightness of the foreskin may be a problem. There is treatments that can be tried first such as steroidal creams.

The foreskin is adhered for the first few years of life so needs no special hygiene attention by a parent. Once it retracts, the operator is often quite adept at performing necessary hygiene, but may need some parental prompting.

There is not a run out sale on circumcisions. It is not now or never. It can be performed when the one most affected can have some input.

[Fellow Traveler]

Maybe we're at cross purposes. What I'm saying is that it has been taken into account, yet the conclusion is; These findings suggest that uncircumcised males are at greater risk of acquiring sexually transmitted infection than circumcised males. Male circumcision may reduce the risk of sexually transmitted infection acquisition and transmission by up to one half, suggesting substantial benefits accruing from routine neonatal circumcision.


And what I am saying is that while it is the case that the author makes that conclusion:

1. The conclusion doesn't follow from the data in Table 1.
2. The conclusion doesn't match results of several large cross-sectional. The author (Fergusson) acknowledged this in his correspondence in a subsequent issue.
3. A study (http://www.doctorsopposingcircumcision.org/pdf/2008_Dickson.pdf) that was very similar found results opposite of these and in line with those other large studies.



Simply bc it does agree with the studies you choose to draw from doesn't make it any more or less valuable.


No what makes it more or less valuable is how well it aligns with other studies among other things. I've made a specific claim about this work: Why does it not match up with other large studies or this other similar study.



I find it confusing that we are asked to list pros and cons. I list pros with several links. Which are again dismissed bc they don't agree with a few studies that anti circers constantly draw from.


Not dismissed, tabled. As I said I'll discuss one topic at a time. And right now I am focused on the Fergusson study.



This has confirmed what I already knew. Even listing credible research makes no difference. Your questioning of one study with the excuse 'it doesn't agree with my studies' does not a debate make. You are not here to learn and exachange info, you are here to soap box and belittle others.

By the way the above is an ad hominem ignoring your anecdote and stating that what men choose to do is a separate issue is not.

[delirium]

No what makes it more or less valuable is how well it aligns with other studies among other things. I've made a specific claim about this work: Why does it not match up with other large studies or this other similar study.

This is by far not the only study that does not match up with yours. Again, that is not a sound basis for judging the validity of the body of work. Based on this reasoning I could say your NZ study is flawed bc it disagrees with mine.

As you appear to have good knowledge of dat collection and research you would know that there are many reasons why research does not match up with others - methodogical flaws, bias by the authors, different demographics etc etc. But bc you are so deeply involved with anti circ feelings you appear to dismiss the fact that the couple of studies you have cited may actually have the bias? Not saying they do, just putting the thought out there.

What I have found is that it is actually pro circ studies that show the most depth and variation and the anti circers rely on the same couple of studies then force the others to conform to their 2 or 3.

I find it interesting that time and time again there are circ rate polls on here and they always come to about 20%. If there are 2000 regular members. That would make 400 circers that are regular to semi regular. It's no wonder no one replies but the same handful of people. Not bc our argument is not sound but bc we tired of the blind refusal to even contemplate some validity even when many studies are put before you.

As you were.

[Opinionated]

your research does not refute my stance in my most recent previous post. Is that why you have chosen to ignore it?

[SalTheGal]

I am wading into this thread with only my own personal story to add. I can’t spout at you medical facts, data, figures ( we looked at all of them when making the decision, but they are long forgotten!)… I leave that for others. I never feel like I can express my opinions articulately, and am sure anyone could rip apart this post if they choose to!



I realise that the point of this thread is more the facts/figures/studies etc, but all I can offer is some anecdotal ‘evidence’, from our personal experiences.

We have chosen to circ our sons, and it was not a decision we took lightly… And truth be told with all of the information on the table- then I do agree that RIC isn’t something that should necessarily be an option for every child…. The likely hood that some of the complications that RIC can avoid will arise is very unlikely for most children…. From our perspective, it is what happens when these complications DO arise that we wanted to avoid. … and I know that each and every person here who is anti RIC can come back and tell me that our boys will probably be fine, and that we have inflicted un-necessary pain on our children… but until the day RIC is illegal, then that is our choice to make, as parents doing the best for our children. And we absolutely made our choice with the best of intentions for our children… and are satisfied with the choice we made.
I don’t readily share my story as quite frankly I think the choice is a highly personal one- but I will share my story here, and then most likely take my polite leave from this thread!!

Both DH and I have been immediately affected by complications arising from an uncircumcised penis…. DH suffered many infections as a child, and had to get circumcised in late childhood… he has quite traumatic memories of the pain he endured, both whilst suffering from infection, but mostly from the procedure, and the healing process afterwards… he was adamant that he did not have to put his sons through this pain if it could be avoided.

I was also with a partner in my late teenage years, whose foreskin tore during sex…. This happened several times, would not heal properly, and became infected, and he ended up having to be circumcised also…. Now if it was traumatic for DH as a child to get circumcised, to have to watch my partner go through it as a young adult was horrible… the pain every time he tore, and the recovery from the procedure was quite a bit for me to bear!

TBH if neither DH nor I had been through these experiences we would not have possibly even considered RIC for our sons…. My brothers are both done, and have no complaints (and yes I asked them when we were doing our research), and I know that I risk ridicule because even just reading back over this post I can see how shallow it appears in text- but the trauma that we both experienced/witnessed was very real at the time, and DH is still quite upset at what he went through.


As I said earlier, to those who are against RIC, these reasons probably seem trivial, and not worth the choice we made…. But until you walk a mile in someone else’s shoes then I personally believe you cannot judge the situation or the choices a person makes.

All I can do I is personally urge anyone who is making the decision to take all of this information with a grain of salt…. Every study can be skewed to get the results the author is looking for, scientific studies need money- and most are sponsored by someone with an agenda…. It is hard to find completely unbiased data.

Talk to you HCP, we discussed our concerns and thoughts with our GP- after consultations with us, and most particularly DH our GP was more than happy to refer us onto a Urologist, we then talked at length with him about the pros and cons, the risks involved etc…. and then made our own decision.

I can only speak from our experience when I say that I do not believe that our sons suffered any ill effect from the procedure… much less so than DH or my Ex suffered at a later stage, when it is documented that the procedure is much more painful, and complicated.

As for raised cortisol levels causing stress and anxiety etc in later life I would love to see some longitudinal studies done looking specifically at RIC and the effects on children later in life. And if we are looking at the effects of raised cortisol then what about babies who suffer from chronic reflux, or colic, or other illnesses, in infancy? And how long do the levels need to be raised for it to create an impact down the track? I am sure that there are many and varied incidences in infancy that will cause a rise in cortisol levels, and yes of course it would be nice if it could be avoided (thus yep I get it- you should avoid circ’ing your child)… but truth be told, it will happen…. And if it really is likely to cause stress and anxiety in the future, then there are a lot of uncircumcised babies out there that we should expect to see this occur in too.

Please I urge anyone making the decision- don’t take it lightly, don’t take only the information you see here… or anywhere on the web for that matter! Talk to your HCP, and make the decision with the guidance of someone who is qualified to help you with that decision based on your personal circumstances.

That is all! :)

[delirium]

your research does not refute my stance in my most recent previous post. Is that why you have chosen to ignore it?

I haven't replied bc I didn't wish to keep posting to this thread. I've already addressed some of it. Children don't have sex, but teens and adults do. It's a bit late to circ after scarring, the transmission of chlamydia that causes infertility or transmission of HIV or HPV that leads to cervical cancer. Bit late then.

UTI - yes girls get them too. But I look at it as a whole. I didn't just circ for UTI, I circed my son as an added barrier against UTI, balinitis, HIV, chlamydia, HPV, and general infection issues.

Not all tightness can be fixed with creams. Nor can infections.

I'm aware the foreskin shouldn't retract before around 6 and yes, a parent should teach them to wash it. But not all infection issues are a result of bad hygeine, as again I've aleady said.

Have I addressed everything?

[Fellow Traveler]

This is by far not the only study that does not match up with yours. Again, that is not a sound basis for judging the validity of the body of work. Based on this reasoning I could say your NZ study is flawed bc it disagrees with mine.


Of course it's not and I am not saying your study doesn't match mine therefore mine is right. I am saying that:

1. The two studies come to different conclusions.
2. The Dickson study came to the conclusions, and I'll quote from them:


There also has been consistency in the results from 3 large population-based cross-sectional studies in developed countries undertaken in the United States, United Kingdom, and Australia that together included 16,000 men.3. The Fergusson was at varience to this and it is a problem that the author (Fergusson (http://pediatrics.aappublications.org/cgi/eletters/118/5/1971#4725)) himself noted in letters about his article:


Of particular relevance is a recent Australian survey of 10,000 male respondents (2), and the preliminary findings from the Dunedin [this was the Dickson study] study (3). These discrepancies with our findings are too large to be disregarded, ...There could be a number of reasons for the difference. Fergusson's study only reported an STD rate of 8.5% while the Dickson study reported a 19.9% so perhaps Fergusson's study suffered from under reporting of STDs. There were more circumcised men in the Dickson study, perhaps the smaller size of the Fergusson study introduced problems.



As you appear to have good knowledge of dat collection and research you would know that there are many reasons why research does not match up with others - methodogical flaws, bias by the authors, different demographics etc etc.

I agree so what do you think the reasons are for the discrepancies? I've provided two, what do you think?

ETA:

Anti circers make it personal when trying to remove our rights as parents and consistantly insinuating sick reasons for us circing.

I take it personal because circumcision (with no valid medical reason) removes my right to decide what I wanted for my body.

[Opinionated]

I haven't replied bc I didn't wish to keep posting to this thread. I've already addressed some of it. Children don't have sex, but teens and adults do. It's a bit late to circ after scarring, the transmission of chlamydia that causes infertility or transmission of HIV or HPV that leads to cervical cancer. Bit late then.

UTI - yes girls get them too. But I look at it as a whole. I didn't just circ for UTI, I circed my son as an added barrier against UTI, balinitis, HIV, chlamydia, HPV, and general infection issues.

Not all tightness can be fixed with creams. Nor can infections.

I'm aware the foreskin shouldn't retract before around 6 and yes, a parent should teach them to wash it. But not all infection issues are a result of bad hygeine, as again I've aleady said.

Have I addressed everything?

The bolded things can all still occur regardless of circ status, the risk is just slightly reduced. Stating that someone has a degree of protection because of their circ status may give them the wrong message and give them a false sense of security. They may actually engage in risky behaviour simply because the believe they have a degree of protection which in the future may actully lead us to see an increase in these things amongst circed men.

Not all tightness and infections can be rectified with creams and antibiotics, I agree, but the vast majority can.

Medically, best practise is to always treat with the most conservative approach for the situation, and to conserve the body in it's original form as much as possible. Circumcision is at odds with best practise in terms of approach and ethics.

[circangel]

Firstly the cons

It may appear to reduce sensitivity but maybe not sexual sensitivity as in sensitivity during intercourse.

It may not be medically necessary.

It can be expensive to have done.

Some boys may wish they were done when they get older and some might wish they were not, possibly through discussion of anticirc.

It can be a medical necessity to be done at an inconvenient time or age.

Cosmetic reasons

Now the pros

Some would suggest better hygiene and sexual responsiveness.

Less chance of an infection occuring.

Reduced or nil phimosis.

[Opinionated]

Wow, I never thought I would say this but excellent post circangel.

[Mathermy]

Firstly the cons

It may appear to reduce sensitivity but maybe not sexual sensitivity as in sensitivity during intercourse.

It may not be medically necessary.

It can be expensive to have done.

Some boys may wish they were done when they get older and some might wish they were not, possibly through discussion of anticirc.

It can be a medical necessity to be done at an inconvenient time or age.

Cosmetic reasons

Now the pros

Some would suggest better hygiene and sexual responsiveness.

Less chance of an infection occuring.

Reduced or nil phimosis.

I'm impressed!:)

[circangel]

Thanks all and I genuinely believe it to be an excelent thing done. But you do need to do it for all the right reasons of which I have stated the obvious ones. Having said this it is not my position to question why it is needed to be done.

[gana]

Firstly the cons

It may appear to reduce sensitivity but maybe not sexual sensitivity as in sensitivity during intercourse.

It may not be medically necessary.

It can be expensive to have done.

Some boys may wish they were done when they get older and some might wish they were not, possibly through discussion of anticirc.

It can be a medical necessity to be done at an inconvenient time or age.

Cosmetic reasons

aren't these pro reasons?

[gana]

As you appear to have good knowledge of dat collection and research you would know that there are many reasons why research does not match up with others - methodogical flaws, bias by the authors, different demographics etc etc. But bc you are so deeply involved with anti circ feelings you appear to dismiss the fact that the couple of studies you have cited may actually have the bias? Not saying they do, just putting the thought out there.

What I have found is that it is actually pro circ studies that show the most depth and variation and the anti circers rely on the same couple of studies then force the others to conform to their 2 or 3.

what we have to remember is that human beings aren't lab rats and the real world is not a controlled laboratory.

all of these studies can be criticized on the grounds that X or Y variable was not properly controlled for. in a lab, you can control all but one variable to get a definitive result. in the real world, that's awfully hard to achieve.

however, it's important to remember that studies with the largest randomly selected sample sizes (larger sample sizes typically give more accurate data) have overwhelmingly come in favor that circ. has a major positive impact in reducing STIs. it's why WHO and CDC have changed their positions on circ. Remember, these orgs have no agenda other than promoting health and are staffed by experts.

there are valid reasons for opposing circ, but claiming that circ. is cosmetic surgery only or has none or minimal health benefits is not one of them.

[Fellow Traveler]

however, it's important to remember that studies with the largest randomly selected sample sizes (larger sample sizes typically give more accurate data) have overwhelmingly come in favor that circ. has a major positive impact in reducing STIs.


You mean like this study with 10,000 Australian participants:

Richters J, Smith AMA, de Visser RO, Grulich AE, Rissel CE. Circumcision in Australia: prevalence and effect on sexual health. Int J STD AIDS 2006;17:547-54.

Which concluded in part: "No significant protective effect of circumcision is discernible for genital warts, chlamydia, genital herpes, gonorrhoea, non-specific urethritis or pubic lice."

[Father]

You mean like this study with 10,000 Australian participants:

Richters J, Smith AMA, de Visser RO, Grulich AE, Rissel CE. Circumcision in Australia: prevalence and effect on sexual health. Int J STD AIDS 2006;17:547-54.

Which concluded in part: "No significant protective effect of circumcision is discernible for genital warts, chlamydia, genital herpes, gonorrhoea, non-specific urethritis or pubic lice."

That same survey also stated:

"Circumcision was unrelated to most sexual difficulties, but circumcised men were less likely to report physical pain during intercourse or trouble keeping an erection;"

If you are that confident on your study, do you agree with that statement too?
That sounds like another pro that Fellow Traveler has added to the list.

[Fellow Traveler]

That same survey also stated:

"Circumcision was unrelated to most sexual difficulties, but circumcised men were less likely to report physical pain during intercourse or trouble keeping an erection;"

If you are that confident on your study, do you agree with that statement too?
That sounds like another pro that Fellow Traveler has added to the list.

They certainly do say that but I am not sure of the relavence. Cutting off ones earlobes won't usually damange them in any clinically significant way; neither does tatooing or ritual scaring. And it's probably (thankfully) true that most people circumcised only recieve the expected amount of damage. But when there little to no benefit why would you do it? Why do we condem the first three examples and not the fourth?

Broadly speaking, the first step needs to be to determine if there is a significant benefit. Then determine if that is the most reasonable way to obtain a given benefit. Then we consider safety and out come. We've not even satisfied the first step.

[Guest]

*Taken from different sources that stand out to me:

No medical organisation in the world recommends routine circumcision of boys. In addition to RACP, the British Medical Association and the American Academy of Paediatrics have issued position statements against male circumcision without medical reason as it is without proven medical benefit.
All studies show that it can reduce the risk of viruses. However, circumcision cannot prevent the spread of viruses. There are marginal health benefits, however these do not outweigh the potential risks.

Circumcision involves tearing the foreskin away from the glans (head of the penis), cutting along the top of the foreskin, then clamping the foreskin and cutting it off. The complication rate of neonatal circumcision is reported to be around 1% to 5%
The risks of circumcision include bleeding, infection, damage to the glans and frenulum, excessive skin removal, scarring, loss of penis, and even death. Excessive skin removal is a common problem which can restrict growth of the penis during puberty.
Circumcision removes complex tissue containing thousands of highly specialised fine touch receptors and nerve fibres. The loss of sexual sensitivity is proportional to the amount of foreskin removed. A tight circumcision that prevents the (remaining) foreskin's movement during intercourse is particularly damaging. Men circumcised as infants may be unaware of this, but many men circumcised as adults report a definite loss.

Baby boys experience excruciating pain during circumcision, and can show behavioural changes such as frequent crying, avoidance of physical contact, reduced feeding and sleep disturbance following the procedure. Local anaesthetic creams do not provide adequate anaesthesia for the operation and a general anaesthetic poses significant risk for infants under the age of 6 months. In adult circumcision, men can undergo general anaesthesia and receive pain relief during the postoperative period.

The risk factors for penile and cervical cancer are cigarette smoking, and exposure to multiple strains of the human papilloma or wart virus (HPV), through unprotected sex with multiple partners. Penile cancer is extremely rare (1:100,000 men), and penile cancer can develop on the circumcision scar. Studies in industrialised nations such as Australia find that circumcision does not reduce the risk of STD transmission.
UTI's are most common amongst girls than boys, yet an extreme prevantative measure is taken against infant boys.

Moral Issues:
Like women have a right to choose in matters conecrning her body, it should be a mans right to choose also.
There is no other routine infant procedure that removes a body part to prevent future (low) risks of infections and/or spread of viruses. And to prevent possible (extremely low risk) adult removal which may cause pain and discomfort.

[Twins Kelly]

Well, having read all of the posts (some skim reading, I can't get into the 'she said. he said' debates, I think i am still 75% in favour of having ours boys done. My husband chose at 28 to get circ'd. His own personal choice, he'd never even had infections or issues with it. But it was an awful process and agonising pain and a long time healing. All of which he knew and still chose to have the chop!
Whatever we do decide I guess we'll be keeping the deision to oursleves seeing how it's such a sensitive topic!
What I do find interesting is that we now have the technology to have foetal tests which can inform us if our child is going to a multitude of issues when they are born....many people then act upon this information....before their child is even born. Not wanting to fuel the fire, but do anti circ. people not have these tests? Are they also ok to go along with whatever 'god' 'genetics' (or whomever) chooses for your child?

[BigRedV]

What I do find interesting is that we now have the technology to have foetal tests which can inform us if our child is going to a multitude of issues when they are born....many people then act upon this information....


:confused: There is absolutely no comparison bewteen finding out issues of a child and preparing your life accordingly, let's say for example the tests revealed a down syndrome child, than to just take action by cutting off the foreskin "just in case" :confused:

I really cannot make out what you mean?

[Twins Kelly]

Beacuse for some people, preparing for life accordingly, can involve termination....and sometimes, after this has been chose, it turns out the baby was ok after all.
I don't know, it just seems these days parents are being given more and more choices and options regarding their unborn and born children...whether it's right or wrong, it really is going to always be a matter of personal choice for your family and your child. Some choices will not always be deemed acceptable by the majoirty of society. Such is life I guess.
Maybe I just don't understand why some people get so heated with each other over such issues.

[Hootenanny]

Beacuse for some people, preparing for life accordingly, can involve termination....and sometimes, after this has been chose, it turns out the baby was ok after all.
I don't know, it just seems these days parents are being given more and more choices and options regarding their unborn and born children...whether it's right or wrong, it really is going to always be a matter of personal choice for your family and your child. Some choices will not always be deemed acceptable by the majoirty of society. Such is life I guess.
Maybe I just don't understand why some people get so heated with each other over such issues.

When a pregnancy is terminated the only people who have to live with that choice are the ones that made it, with circumcision the one who has to live with that choice had no say whatsoever.

[BigRedV]

Beacuse for some people, preparing for life accordingly, can involve termination....and sometimes, after this has been chose, it turns out the baby was ok after all.
I don't know, it just seems these days parents are being given more and more choices and options regarding their unborn and born children...whether it's right or wrong, it really is going to always be a matter of personal choice for your family and your child. Some choices will not always be deemed acceptable by the majoirty of society. Such is life I guess.
Maybe I just don't understand why some people get so heated with each other over such issues.

I still don't get the comparison, but anyhoo.

I will not circumcise my child "just in case" :confused:

People see it as a human rights issue! Every person deserves the right to bodily autonomy and circumcision doesn't grant that right.

[Mathermy]

I assume what PP might mean is that a lot of parents choose to leave their child's body intact just as nature intended it.

However,

I find the comparison to genetic testing

A) completely off topic

B) Slightly presumptuous that all people who choose not to circumcise their children can be wrapped up in some neat homogeneous category with assumptions made about his/her views regarding prenatal testing and goodness knows what else simply due to one shared choice *confused face*

c) Possibly even more presumptuous that all parents *circers or not* accept all prenatal and genetic testing, as there are plenty of parents who choose not to accept a bunch of medical scanning/tests/interventions in a normal, healthy pregnancy.

I would add that my christian sister, who is choosing circumcision for any future sons, would be highly offended if it were assumed that she would be seeking out genetic testing and acting on it as it goes completely against her religious beliefs!

So again, best not to just lump everyone all in the same basket on the basis of very little infomation.

D) I think the consequences of serious genetic defects are a whole different kettle of fish for parents to deal with than the potential complications of an intact penis.

*and in answer to the question, no, I will not be seeking out genetic testing for my children but it has nothing to do with circumcision or god, it's about avoiding unnecessary and possibly stressful medical intervention!*

[Twins Kelly]

Point taken MaLuffly. I know you can't lump people who think one thing into the same boat...I was just curious. At the end of the day, i see all tests carried out once pregnant to carry a risk....some low, some high, and these risks and choices carry on once your child is born. For me, anything that contains a risk has to be weighed up, regardless if it's on a unborn or born child., and then it can only be the parent's decision to choose is best without fear of being judged by others.

[Mathermy]

Point taken MaLuffly. I know you can't lump people who think one thing into the same boat...I was just curious. At the end of the day, i see all tests carried out once pregnant to carry a risk....some low, some high, and these risks and choices carry on once your child is born. For me, anything that contains a risk has to be weighed up, regardless if it's on a unborn or born child., and then it can only be the parent's decision to choose is best without fear of being judged by others.

Did that sound snippy? Sorry:o It wasn't actually intended with a side of snip, I'm just *roolly* tired and stuggling to express my thoughts clearly. I was going for *keeping my thoughts straight* rather than snippy mc snippypants!:laughing:

[Guest]

Well, having read all of the posts (some skim reading, I can't get into the 'she said. he said' debates, I think i am still 75% in favour of having ours boys done. My husband chose at 28 to get circ'd. His own personal choice, he'd never even had infections or issues with it. But it was an awful process and agonising pain and a long time healing. All of which he knew and still chose to have the chop!
Whatever we do decide I guess we'll be keeping the deision to oursleves seeing how it's such a sensitive topic!
What I do find interesting is that we now have the technology to have foetal tests which can inform us if our child is going to a multitude of issues when they are born....many people then act upon this information....before their child is even born. Not wanting to fuel the fire, but do anti circ. people not have these tests? Are they also ok to go along with whatever 'god' 'genetics' (or whomever) chooses for your child?
I find this interesting because there is no comparison to circumcision and genetic testing or vaccinations or anything else really? It's cutting off a body part that has a purpose, there is nothing else we would do to an infant like that for preventative measures that are all due to sexual practices, hygeine or possible future infections.
When you do something to an infant because it has an issue, that is a medical reason. And 'some' children do have to get circumcised due to some type of infection, but it is done when necessary. The argument is about routine infant circumcision for preventative measures, and it's something that the medical proffession does not recommend for all the reasons discussed.

I think also, your husband had the choice to do it, that is very important to consider and a major moral issue this brings up. Your not giving your children a choice and if left as is, they may not decide to do the procedure themselves as adults and be quite happy as they are. And your dh knows the pain and discomfort involved with such a procedure, why put a baby through that and risk possible complications when he was perfectly healthy otherwise and didn't 'need' it? They can't talk and maybe don't assume pain as we do, but it doesn't mean it's not painful for them.

[Twins Kelly]

Did that sound snippy? Sorry:o It wasn't actually intended with a side of snip, I'm just *roolly* tired and stuggling to express my thoughts clearly. I was going for *keeping my thoughts straight* rather than snippy mc snippypants!:laughing:


No not at all. I just wasn''t trying to offend anyone or be judgemental...i just wondered what people thought about all the other tests and choices you can make and do to your child. Sorry to go off topic!

[gana]

You mean like this study with 10,000 Australian participants:

Richters J, Smith AMA, de Visser RO, Grulich AE, Rissel CE. Circumcision in Australia: prevalence and effect on sexual health. Int J STD AIDS 2006;17:547-54.

Which concluded in part: "No significant protective effect of circumcision is discernible for genital warts, chlamydia, genital herpes, gonorrhoea, non-specific urethritis or pubic lice."

is this one of those self-reported studies which found minimal impact? because the african studies did not rely on self-reporting and are therefore considered to be more reliable. plus, the study you quoted doesn't dispute the HIV benefit.

[Fellow Traveler]

is this one of those self-reported studies which found minimal impact? because the african studies did not rely on self-reporting and are therefore considered to be more reliable.


You should really read more. Most studies of that size will have to be self reporting. Fortunately, these results were similar to those found in your "stronger" third world African trials (http://www.ncbi.nlm.nih.gov/pubmed/19545209):


Adult male circumcision does not reduce the risk of incident Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis infection: results from a randomized, controlled trial in Kenya.You see (the multiple) results like these don't tend to make the news even when they align pretty well with earlier observations, all of which were much larger than those studies in Africa. You have to really be paying attention; they don't send out press releases for failures.


plus, the study you quoted doesn't dispute the HIV benefit

Since I doubt you've read the study, I'll point out that they address that questions. Noting that they didn't collect enough HIV positive replies to even attempt to look at that question. The reason this is the case is because the prevalence of HIV in Australia (and other Western countries) among heterosexual non-iv drug using men is ridiculously low and is of little consequence.

I'll put it to you this way Gana. Presuming you're a heterosexual non-iv drug using Australian male, you have about the same lifetime chance of dieing in a commercial airline crash as contracting HIV. But I would expect that someone who as looked at this question as much as you have would know that.

[Father]

I'll put it to you this way Gana. Presuming you're a heterosexual non-iv drug using Australian male, you have about the same lifetime chance of dieing in a commercial airline crash as contracting HIV. But I would expect that someone who as looked at this question as much as you have would know that.

I would still not want to be one of the approx 77 men who acquire it heterosexually each year in Australia. Even though it is rare, why would you skimp on protection. Just like penile cancer. Very rare, but about 67 people get it each year too. 25% of these died as a result. A cancer that could have easily been prevented by circumcision. You tell me how many babies have died as a result of circumcision in Australia.

Yes they are rare. But so are complications from a circumcision.
When you argue against any one of the benefits, it may look as though it is 'not worth it'. But you have to put them all together to form a true analysis.

[Fellow Traveler]

I would still not want to be one of the approx 77 men who acquire it heterosexually each year in Australia. Even though it is rare, why would you skimp on protection. Just like penile cancer. Very rare, but about 67 people get it each year too. 25% of these died as a result. A cancer that could have easily been prevented by circumcision. You tell me how many babies have died as a result of circumcision in Australia.


It's not a question of skimping. If there is a difference in risk, it approaches 0. If an individual believes he needs the added benefit of circumcision they are welcomed to seek them out for themselves. I would bet though that when they learn that they still need to wear a condom and be choosy about sexual partners and the risk changes only about a thousandths of a percent, they wouldn't see value in circumcision

BTW, penile cancer can't be prevented by circumcision. If you're concerned about the very low risk of penile cancer get vaccinated against HPV.


Yes they are rare. But so are complications from a circumcision.

Thankfully rare but outside of the control of the any individual. Whereas the rare risk of HIV or penile cancer is within the individual's ability to control.


When you argue against any one of the benefits, it may look as though it is 'not worth it'. But you have to put them all together to form a true analysis.

You have to look at them individually because they are independent events. You can't accrue in the way you describe this is a form of the Monte Carlo or Gambler's fallacy.

[andrewJ]

Just like penile cancer. Very rare, but about 67 people get it each year too. 25% of these died as a result. A cancer that could have easily been prevented by circumcision.


you have crossed the line between bad advice, and dangerous advice.

[Father]

You have to look at them individually because they are independent events. You can't accrue in the way you describe this is a form of the Monte Carlo or Gambler's fallacy.

They are independant events that have a common link = circumcision.
You have to weigh up all the risks, vs all of the benefits.

[gana]

You see (the multiple) results like these don't tend to make the news even when they align pretty well with earlier observations, all of which were much larger than those studies in Africa. You have to really be paying attention; they don't send out press releases for failures.

you have a bad habit of attacking points i have never made. it's called a strawman. please point out to me where i discussed Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis infection


I'll put it to you this way Gana. Presuming you're a heterosexual non-iv drug using Australian male, you have about the same lifetime chance of dieing in a commercial airline crash as contracting HIV. But I would expect that someone who as looked at this question as much as you have would know that.



you talk about circumcision being unnecessary because AIDS is not prevalent in Australia, yet you advocate measles vaccine shots even though Australia is measles free (http://www.abc.net.au/science/articles/2009/02/11/2487452.htm)

[Fellow Traveler]

They are independant events that have a common link = circumcision.
You have to weigh up all the risks, vs all of the benefits.

No, behavior plays a far larger, the dominant, roll. However, having said that, incredibly small benefits (if they exist) added together equal incredibly small benefit. If the individual finds an incredibly small benefit (or even more than one) compelling, they are free to exploit it.

To make circumcision a rational or ethical choice, the benefit would have to be overwhelming and necessary to the welfare of a child. This is not currently the case so circumcision can't ethically be performed on a non consenting individual.

[Fellow Traveler]

you have a bad habit of attacking points i have never made. it's called a strawman. please point out to me where i discussed Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis infection


You questioned the value of the Australian study, asked if it was a self reporting study, and then put forward that a RCT would be stronger. So I provided you with a RCT (from Africa of all places) that supported the data and some of the conclusions from the Australian study of over 10,000 participants. That is not a straw man.





you talk about circumcision being unnecessary because AIDS is not prevalent in Australia, yet you advocate measles vaccine shots even though Australia is measles free (http://www.abc.net.au/science/articles/2009/02/11/2487452.htm)

Try to understand this if you can, Australia is Measles free because of the vaccination. Australia is not HIV free, and never will be, because of circumcision.

Do you understand the difference?

ETA: If they stopped vaccinating in Australia, it soon wouldn't be Measles free.

ETAA: Free doesn't mean free either. In the text they say it's no longer endemic and neither is HIV. Also they note that, "He says if 6% of individuals lost their immunity after 10 years then large measles outbreaks could be expected after 2015." It doesn't take much loss to start the wild fire again. Do you understand the difference now?

[gana]

You questioned the value of the Australian study, asked if it was a self reporting study, and then put forward that a RCT would be stronger. So I provided you with a RCT (from Africa of all places) that supported the data and some of the conclusions from the Australian study of over 10,000 participants. That is not a straw man.

except it is a strawman because i never claimed circ. helped prevent gonorrhea or chlamydia. i do think that circ. can prevent transmission of yeast infections from man to woman but i haven't seen definitive proof in any study, so i've never made that claim either.


Try to understand this if you can, Australia is Measles free because of the vaccination. Australia is not HIV free, and never will be, because of circumcision.

Do you understand the difference?

so what? they're both close to statistically zero. it doesn't matter how they got there.

your argument is that as long as the disease you're trying to prevent is close to statistically zero, why bother preventing it.

please provide a principled explanation why vaccination for something that is close to statistically zero is OK but circ. is not.


[ETAA: Free doesn't mean free either. In the text they say it's no longer endemic and neither is HIV. Also they note that, "He says if 6% of individuals lost their immunity after 10 years then large measles outbreaks could be expected after 2015." It doesn't take much loss to start the wild fire again. Do you understand the difference now?

i understand you're opposing circ. because it MAY prevent future outbreaks of AIDS which is present in statistically close to zero percent of Australians.

i understand you're supporting measles vaccines because it MAY (please note the bolded "if") prevent future outbreaks of measles which is present in statistically close to zero percent of Australians.

[Fellow Traveler]

except it is a strawman because i never claimed circ. helped prevent gonorrhea or chlamydia. i do think that circ. can prevent transmission of yeast infections from man to woman but i haven't seen definitive proof in any study, so i've never made that claim either.

Except it was not a straw man. A straw man is where someone creates the illusion of having refuted a proposition by substituting a superficially similar proposition and the refuing it. This is quite clearly not what occurred. Rather you challenged the veracity of a large study because of its design. I provided you with a study of a design that you felt was stronger which supported parts of the data and conclusions of the study you challenged. That is just not a straw man.



so what? they're both close to statistically zero. it doesn't matter how they got there.

Actually it matters quite a lot how it got there. If only a relatively small number of people stopped vacinating many of these diseases would reemerge and again be endemic in the population. Those diseases are kept in check because of high rates of vaccination not inspite of them. Conversely heterosexual HIV rates are well below endemic levels in most of the first world and rates of circumcision make little practical difference.



your argument is that as long as the disease you're trying to prevent is close to statistically zero, why bother preventing it.


That is only part of it it is also a question of effectiveness among other things. This is also the reason some vaccines aren't offerred. Did you get a Yellow Fever vaccination? Why or why not?



please provide a principled explanation why vaccination for something that is close to statistically zero is OK but circ. is not.


I already have but you've choosen to ignore it. So here it is again, the chances of catching a vaccine preventable disease are statistically zero are so because of he vaccine and high rates of vaccination not inspite of them. Vaccines are highly effective circumcision is not. One is theraputic the other is not.



i understand you're opposing circ. because it MAY prevent future outbreaks of AIDS which is present in statistically close to zero percent of Australians.

this sentence doesn't even make sense.



i understand you're supporting measles vaccines because it MAY (please note the bolded "if") prevent future outbreaks of measles which is present in statistically close to zero percent of Australians.

do you now understand why you're talking out of both sides of your mouth?

No because these are clearly two seperate issues.

[gana]

Except it was not a straw man. A straw man is where someone creates the illusion of having refuted a proposition by substituting a superficially similar proposition and the refuing it. This is quite clearly not what occurred. Rather you challenged the veracity of a large study because of its design.

you have serious reading comprehension issues.

i did not challenge the study. i've never read or heard of the study. i only asked if this was one of those studies whose results depended upon self-reporting.

the reason i asked that is that i read that the 3 african studies were going to be definitive because:

1) there were going to be large sample sizes
2) the diseases tested for were present in large numbers of the population giving statistics a chance to work
3) doctors were going to examine them instead of self-reporting

you are arguing a straw man because you are trying to refute a point I NEVER MADE. I never said circ. prevents chlamydia or gonorrhea


Actually it matters quite a lot how it got there. If only a relatively small number of people stopped vacinating many of these diseases would reemerge and again be endemic in the population. Those diseases are kept in check because of high rates of vaccination not inspite of them.

this is pure speculation on your part. there is no proof that diseases which are down to just about zero come back to life, just speculation.

i didn't get smallpox vaccine, it's not making any comeback at all.


Conversely heterosexual HIV rates are well below endemic levels in most of the first world and rates of circumcision make little practical difference.

what about herpes? you always forget that one

and if you're OK with 95% effective vaccine for nonexistent measles, why are you so opposed to 60% effective operation for AIDS, 35% for herpes, 30% for HPV

are you now saying that your only objection to circ is that you want a higher standard of efficacy?

[Fellow Traveler]

i did not challenge the study.

You certainly were and preparing to dismiss the results and challenge the veracity of their conclusions based on the design. I just decided to cut you off before you got there.


i've never read or heard of the study.

Why am I not surprised. I guess it's because they don't publicize failures much, especially with regard to circumcision. I guess if there wasn't a press release then you hadn't heard of it. I'll keep that in mind.


i only asked if this was one of those studies whose results depended upon self-reporting.

the reason i asked that is that i read that the 3 african studies were going to be definitive because:

1) there were going to be large sample sizes
2) the diseases tested for were present in large numbers of the population giving statistics a chance to work
3) doctors were going to examine them instead of self-reporting


No study is ever really definitive. And certainly not one where the thing being studied is affected by large number of random variables which can't always be controlled for and can be affected by context.

It also doesn't help when studies are cut short since this has the affect that it may overestimating a positive result, treatment effect. I am sure you could find the recent study on this or you could just read the press release (http://www.medscape.com/viewarticle/719011).


you are arguing a straw man because you are trying to refute a point I NEVER MADE. I never said circ. prevents chlamydia or gonorrhea

You were heading in that direction but still that is not what a straw man is.



this is pure speculation on your part. there is no proof that diseases which are down to just about zero come back to life, just speculation.


It's not speculation. It is a problem of growing concern. Here is another press release (http://www.scpr.org/news/2010/04/05/measles-resurgence-tied-to-parents-vaccine-fears/) for you


i didn't get smallpox vaccine, it's not making any comeback at all.

You didn't get small pox vaccine because it isn't offered any longer because it is of no practical clinical value since small pox is considered extinct in the wild. There are stores of weaponized small pox around that could get out. Aren't you concerned about that?


what about herpes? you always forget that one

What about Herpes? Three large studies in western countries found no association between circumcision and risk of Herpes including the aforementioned Australian study of 10,000 men:

Circumcision in Australia: prevalence and effects on sexual health. J Richters, AM Smith, RO de Visser, AE Grulich, and CE Rissel
Int J STD AIDS, August 1, 2006; 17(8): 547-54.

But also retrospective studies such as:
Circumcision and risk of sexually transmitted infections in a birth cohort Dickson NP, van Roode T, Herbison P, Paul C., March 2008

or:

Herpes simplex virus type 2 status at age 26 is not related to early circumcision in a birth cohortDickson N, van Roode T, Paul C., August 2005

and some others.

Besides that a 30% reduction, if it is even true, is rarely enough to advance a treatment or vaccine under consideration even for far worse conditions and diseases. Why would I make an exception for circumcision and say that a low efficiency result is something worth talking about? I know that circumcision is all about exceptions: exceptions to ethical practice of medicine, exception to rational thinking, and others. Should we add exception to evaluation of potential clinical results to that too?



and if you're OK with 95% effective vaccine for nonexistent measles, why are you so opposed to 60% effective operation for AIDS, 35% for herpes, 30% for HPV


As I said measles are non-existent because of the vaccine not in spite of it.

Relative risk reduction isn't the entire story it tells you nothing without proper context. As noted previously (and you seem to continue to forget this) heterosexually transmitted HIV is rare in the first world. A 25%, 30%, or 35% reduction in any other trial would be considered a failure and is not worth pursuing. Having said that there is also plenty of data that say there is no relationship between circumcision and herpes and as for HPV well again we have a vaccine for that; not that it is of particular concern for men anyway.


are you now saying that your only objection to circ is that you want a higher standard of efficacy?

No it's much more than that

[Father]

As noted previously (and you seem to continue to forget this) heterosexually transmitted HIV is rare in the first world.

Short question for you Fellow Traveler; do you agree with the international medical bodies who are endorsing male circumcision in Africa as another tool to fight HIV?
Or do you think circumcision is bad regardless of where you are in the world?

[gana]

Why am I not surprised. I guess it's because they don't publicize failures much, especially with regard to circumcision. I guess if there wasn't a press release then you hadn't heard of it. I'll keep that in mind.

the african studies have been pronounced as definitive by WHO, UN, CDC and even acknowledged as legit by RACP. the people staffing these elite organizations are tops in their field.

so yeah, what can i say, i go by what they say.


No study is ever really definitive. And certainly not one where the thing being studied is affected by large number of random variables which can't always be controlled for and can be affected by context.

it's amazing how you treat the studies you think support your position as definitive, but the african studies which the experts treat as definitive you criticize for "random variables" .

i said this before, human beings aren't lab rats, the real world isn't a lab. you're waiting for godot if you're waiting for the perfect study. you would have to have a huge margin of error to counteract 60% HIV, 30% herpes, 35% HPV reductions.


It also doesn't help when studies are cut short since this has the affect that it may overestimating a positive result, treatment effect. I am sure you could find the recent study on this or you could just read the press release (http://www.medscape.com/viewarticle/719011).

the african studies were cut short so that all the men could get circ'd to save lives.

your link opens to an unaccessible page


It's not speculation. It is a problem of growing concern. Here is another press release (http://www.scpr.org/news/2010/04/05/measles-resurgence-tied-to-parents-vaccine-fears/) for you

16 people in Vancouver, 73 unvaccinated exposed children in San Diego and the press release doesn't even say if they got it? thats .0000000000000000001% of the population of Canada and US

you've written a novel on how circ is irrelevant in Australia because the number of AIDS cases is statistically zero, and now you're crying wolf on not vaccinating measles which isn't even fatal disease like AIDS over 16 confirmed cases?

and here's a further point. notice how your article states that even if there is no measles in the country, it can be IMPORTED from abroad.

now please explain to me why you are so concerned about measles being imported from abroad into Australia that you want everyone vaccinated, but you are not concerned about AIDS being imported from abroad.


What about Herpes? Three large studies in western countries found no association between circumcision and risk of Herpes including the aforementioned Australian study of 10,000 men

you're spitting out cirp.org articles (i'm assuming that's where you do your scholarship). New England Journal of Medicine, which is very prestigious and neutrel on circ, says you're wrong.

http://content.nejm.org/cgi/content/short/360/13/1298


Besides that a 30% reduction, if it is even true, is rarely enough to advance a treatment or vaccine under consideration even for far worse conditions and diseases. Why would I make an exception for circumcision and say that a low efficiency result is something worth talking about? I know that circumcision is all about exceptions: exceptions to ethical practice of medicine, exception to rational thinking, and others. Should we add exception to evaluation of potential clinical results to that too?

the 30% herpes is in addition to 35% HPV, 60% HIV and who knows how many other health benefits. plus, the hygiene and convenience benefits are tremendous

besides, the point you ignore is that disease like measles, you get sick and then you're fine (for healthy people, obviously weak or sick people it's different). herpes and AIDS are permanent and even if you survive your life is changed for the worst forever. i'm not saying 30% and 60% are great but it's much much better than nothing.


As I said measles are non-existent because of the vaccine not in spite of it. .

i never said measles vaccine didn't work.

[Lillystar]

Most of my male friends / family and people I have dated / slept with have all been circumsized. Not one have them had ever said "Gee I wish I had my foreskin back, I wish I was never circumsized I feel so violated".

I personally am for circumsized penis's. Purely for the fact that I think that look nicer and IMO are cleaner :yes:

BUT when it comes to my son (if I ever have one). I will probably leave it up to my husband to decide what we should do, him being the man and the one who actually has a penis and knows what it feels like etc.

[Fellow Traveler]

the african studies have been pronounced as definitive by WHO, UN, CDC and even acknowledged as legit by RACP. the people staffing these elite organizations are tops in their field.

Legitimate yes definitive no. Knowledge is always evolving. Besides you continue to ignore context; the yellow fever vaccine is over 95% efficient but it's not provide in Australia or most western countries. Just because something may work doesn't mean it's useful.



so yeah, what can i say, i go by what they say.


And what they say is the data is context sensitive and has little if any relevance outside of countries with high HIV prevalence. It sounds to me like you only ever read part of what is said and ignore the caveats.



it's amazing how you treat the studies you think support your position as definitive, but the african studies which the experts treat as definitive you criticize for "random variables" .


I've never treated any study as definitive I provided five or six studies which point in the opposite direction regarding HSV2. I am not going to ignore those because some third world study conflicts with it. Rather I'll try to determine why. Like perhaps the poverty or lack of sanitation. I am not like you; I don't read some article in a tabloid and form a position based in it.



i said this before, human beings aren't lab rats, the real world isn't a lab. you're waiting for godot if you're waiting for the perfect study. you would have to have a huge margin of error to counteract 60% HIV, 30% herpes, 35% HPV reductions.


Not really. It's not a question of overturning it's a question of context and consistency. Why don't you explain to me why the Dickson study (among others performed in the West) found no correlation with HSV2? They followed their group for more than 26 years and tested seriologically.If there was a strong connection they would have also found it. Yet you ignore work that doesn't agree with your position. At least I am familiar with and read most of the work you by your own admission barely know it exists. How does one come to a rational conclusion when they don't have all the information?



the african studies were cut short so that all the men could get circ'd to save lives.
Don't be so dramatic. How does circumcision save a life if it doesn't change what I should be doing anyway? Cutting studies short does lead to overestimation of treatment effect, by a lot and this has been documented.



your link opens to an unaccessible page

You need to register.



16 people in Vancouver, 73 unvaccinated exposed children in San Diego and the press release doesn't even say if they got it? thats .0000000000000000001% of the population of Canada and US


Of a disease that infects 90% of those unvaccinated people it comes in contact with. Just for purposes of comparison the risk of HIV infection when having sex with an HIV positive individual is about 1/2000; see:

European Study Group on Heterosexual Transmission of HIV (1992). "Comparison of female to male and male to female transmission of HIV in 563 stable couples". BMJ. 304 (6830): 809–813.

Varghese B, Maher JE, Peterman TA, Branson BM,Steketee RW (2002). "Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use". Sex. Transm. Dis. 29 (1): 38–43.



you've written a novel on how circ is irrelevant in Australia because the number of AIDS cases is statistically zero, and now you're crying wolf on not vaccinating measles which isn't even fatal disease like AIDS over 16 confirmed cases?

Measles killed hundreds of children and caused brain damage in thousands per year who did nothing in particular to get infected. A small decrease in vaccination rates will lead to endemic measles low circumcision rates does not lead to endemic HIV.


and here's a further point. notice how your article states that even if there is no measles in the country, it can be IMPORTED from abroad.

now please explain to me why you are so concerned about measles being imported from abroad into Australia that you want everyone vaccinated, but you are not concerned about AIDS being imported from abroad.
That is a concern and I think that all people over say 15 should be required to get annual testing and that data should be required for travel. In fact a large number of hetero cases are in immigrants who were infected before they arrived. But circumcision won't have a practical impact on those rates or its spread; it's just not infectious enough in heterosexuals.


you're spitting out cirp.org articles (i'm assuming that's where you do your scholarship). New England Journal of Medicine, which is very prestigious and neutrel on circ, says you're wrong.

What did CIRP have to do with the articles I posted? Did they fund the study? Did they conduct the study? Did they publish the study? Please tell me their roll that invalidated the study. As far as I know CIRP had no roll in those or any other study. One was in the Journal Pediatrics and the other in Sexually Transmitted Diseases. I'll check if you want but I don't think CIRP runs those journals.

And you should be one to talk all you do is read a news paper and seemingly do no other critical thinking. I do most of my reasearch at the National Library of Medicine in Bethesda.



http://content.nejm.org/cgi/content/short/360/13/1298


Wow you found the article you read about in the paper, bravo. I like this article because it is very interesting to illustrate the bias of the researchers. In this article the conclude:



Conclusions In addition to decreasing the incidence of HIV infection, male circumcision significantly reduced the incidence of HSV-2 infection and the prevalence of HPV infection, findings that underscore the potential public health benefits of the procedure.
They seem pretty sure of themselves. Whereas a similar group who conducted the same type of experiment (linked to earlier) in Africa but found no correlation concluded (emphasis added):



Conclusions.Circumcision of men in this population did not reduce their risk of acquiring these nonulcerative STIs. Improved STI control will require more-effective STI management, including partner treatment and behavioral risk reduction counseling.
Talk about biased. Both results should have been "in this population". When they get a result they don't like (and all of this work is from one group of people) they dismiss it when they get a result they like it's treated as gospel; then they write a press release for you to read.

the 30% herpes is in addition to 35% HPV, 60% HIV and who knows how many other health benefits. plus, the hygiene and convenience benefits are tremendous


That is your subjective evaluation. I prefer more robust approaches like condoms, an HPV vaccination, and an occasional shower. I suspect that if I didn't do these thing circumcision might appeal to me too but I live and spend most of my time in the first world so I use first world approaches.


besides, the point you ignore is that disease like measles, you get sick and then you're fine (for healthy people, obviously weak or sick people it's different). herpes and AIDS are permanent and even if you survive your life is changed for the worst forever. i'm not saying 30% and 60% are great but it's much much better than nothing.

And you're ignoring context. I have a better shot at dieing in a plane crash than catching HIV and there has been no observed reduction of herpes in the first world. If there is a benefit it's trivial. If an adult finds such slight reductions appealing then he should get circumcised but each man should be given the dignity of that decision.

[Fellow Traveler]

Short question for you Fellow Traveler; do you agree with the international medical bodies who are endorsing male circumcision in Africa as another tool to fight HIV?
Or do you think circumcision is bad regardless of where you are in the world?

As long as it is limited to adults, adults are free to do what they want. Though I think they are wasting their time and circumcision will prove to be a long term failure. I think the money would be better spent on approaches that have a chance at getting results. Circumcision is a Hail Mary pass or Kamikaze dive by those who feel their backs are against the wall and they have no other choice.

[Fellow Traveler]

...

[gana]

Legitimate yes definitive no.

let me put it this way. who do i trust more?

some guy on the internet whose sig is stop RIC or neutrel health organizations staffed by top experts such as WHO, UN, CDC. Even RACP has admitted the legitimacy of the African studies.

i mean, come on, it's not even close. you're a nobody, the experts at these neutrel orgs are not.


And what they say is the data is context sensitive and has little if any relevance outside of countries with high HIV prevalence. It sounds to me like you only ever read part of what is said and ignore the caveats.

except you don't even support RIC in African countries where all the other neutrel organizations do.

you sit around pretending to argue facts, but you already have a predetermined conclusion in mind, as evidenced by your sig.

so pardon me, but you are not a credible source of information. any person looking to get accurate information would disregard everything you say.

i, on the other hand, am only parroting what's been said by neutrel world health orgs staffed by experts. i trust that they don't have any agenda to push other than saving lives, unlike you, so they have credibility. plus they are experts.

like Father has said to some anti-circs, don't complain to me, take it up with the UN, WHO, RACP, CDC.

also, the context you're ignoring is that HIV and herpes can't be cured, and HIV is fatal. circ is a tool in the box to combat this. it should be used, just like vaccines are used.


I've never treated any study as definitive I provided five or six studies which point in the opposite direction regarding HSV2. I am not going to ignore those because some third world study conflicts with it. Rather I'll try to determine why. Like perhaps the poverty or lack of sanitation. I am not like you; I don't read some article in a tabloid and form a position based in it.

well that's great, but like i told you, i'm the wrong guy to discuss these studies in depth with and, frankly, so are you.

so what if you read these studies? unless you have MD and PhD in these areas and strong statistical background, you have no idea what you're talking about.

why don't you write your concerns and analysis of these studies to WHO, UN, CDC, RACP and all the other countries and organizations who are now changing their policies based on the African studies instead of wasting time trying to create this fake aura of expertise on an internet message board.


Why don't you explain to me why the Dickson study (among others performed in the West) found no correlation with HSV2? They followed their group for more than 26 years and tested seriologically.If there was a strong connection they would have also found it.

see my above post. i don't have to explain anything. you have to explain why WHO, CDC, UN and bunch of African countries found the African studies along with bunches of other studies to have overwhelming evidence.

again, don't argue with me, i'm not qualified. take it up with the real experts. (http://online.wsj.com/article/SB123802256715541879.html)

"Circumcised heterosexual men are 35% less likely to contract human papillomavirus (HPV) and 25% less likely to catch herpes than their uncircumcised counterparts, according to the study, published in this week's New England Journal of Medicine.

The study, led by scientists from Johns Hopkins University and Makerere University in Uganda, relied on data from the same randomized control trials in Africa that already showed that circumcision cuts in half the risk of contracting human immunodeficiency virus (HIV), which can cause AIDS."


Yet you ignore work that doesn't agree with your position. At least I am familiar with and read most of the work you by your own admission barely know it exists. How does one come to a rational conclusion when they don't have all the information?

I ignore nothing. I made the rational decision to trust the judgment of top experts at neutrel world health organizations. I'm sure these guys are aware of all the studies, and they disregarded the studies you mentioned for good reason, probably because they're wrong.

I don't pretend to know everything. Unlike some, I am prepared to admit my own shortcomings and deficiencies. What's the point of me reading studies I don't understand anyway? So I can discuss them on an internet board with someone equally clueless who wants to take the other side of WHO, UN, CDC and RACP experts? no thanks mate.


Don't be so dramatic. How does circumcision save a life if it doesn't change what I should be doing anyway? Cutting studies short does lead to overestimation of treatment effect, by a lot and this has been documented.

I'm sorry mate, if you don't understand the difference between "what people actually do" vs "what people should do" I can't help you. If people did what they should, circumcision might be unnecessary. But then so would police, weapons of mass destruction, government, corporations, armies, laws, courts, etc.

And I don't understand why you have a problem with cutting studies short. Isn't saving lives more important than getting the data you need to support your position?


Of a disease that infects 90% of those unvaccinated people it comes in contact with. Just for purposes of comparison the risk of HIV infection when having sex with an HIV positive individual is about 1/2000

you're grossly wrong, once again you cherry pick numbers and studies to support your absurd belief circ. doesn't help AIDS, contrary to the policies of every legit health organization

there is a circumcision belt in africa for a reason

In heterosexual couples with enough other risk factors, transmission risk can climb as high as 1-in-10 for penile-vaginal sex and 1-in-3 for penile-anal sex.....heterosexual sex can be a remarkably efficient way to transmit HIV.... (http://www.natap.org/2008/Trans/Trans_03.htm)


Measles killed hundreds of children and caused brain damage in thousands per year who did nothing in particular to get infected. A small decrease in vaccination rates will lead to endemic measles low circumcision rates does not lead to endemic HIV.

tons of people don't take the MMR vaccine because of autism controversy. i don't see measles popping up. you've cited 16 people in vancouver canada, that's nothing to lose sleep over.


That is a concern and I think that all people over say 15 should be required to get annual testing and that data should be required for travel. In fact a large number of hetero cases are in immigrants who were infected before they arrived. But circumcision won't have a practical impact on those rates or its spread; it's just not infectious enough in heterosexuals.

what you suggest is not going to happen. and you're off on heterosexual infection rates


What did CIRP have to do with the articles I posted? Did they fund the study? Did they conduct the study? Did they publish the study? Please tell me their roll that invalidated the study. As far as I know CIRP had no roll in those or any other study. One was in the Journal Pediatrics and the other in Sexually Transmitted Diseases. I'll check if you want but I don't think CIRP runs those journals.

you tell me. every article you cite i google and it's on CIRP.


They seem pretty sure of themselves. Whereas a similar group who conducted the same type of experiment (linked to earlier) in Africa but found no correlation concluded (emphasis added):

Talk about biased. Both results should have been "in this population". When they get a result they don't like (and all of this work is from one group of people) they dismiss it when they get a result they like it's treated as gospel; then they write a press release for you to read.

first, you and other anti-circs are doing exact same thing, cherry picking studies so for you to complain is hypocritical at best, and deceptive at worst.

second, it's obvious the anti-circ study was wrong and performed by biased researchers who fixed the study to get the results they wanted. if the anti-circ study was legit, WHO, UN and CDC would be anti-circ but they're not, they're pro-circ.


That is your subjective evaluation. I prefer more robust approaches like condoms, an HPV vaccination, and an occasional shower. I suspect that if I didn't do these thing circumcision might appeal to me too but I live and spend most of my time in the first world so I use first world approaches.

o you daredevil you


And you're ignoring context. I have a better shot at dieing in a plane crash than catching HIV and there has been no observed reduction of herpes in the first world. If there is a benefit it's trivial. If an adult finds such slight reductions appealing then he should get circumcised but each man should be given the dignity of that decision.

well you're wrong. it seems you live in US and AIDS and herpes are rampant there, as you should know. in fact, according to studies you said you've read, AIDS and herpes is most prevalent in hispanics and blacks which is the least circumcised group in the US.

[Mrs Nietzsche]

A beautiful example of the consequences of confusing causation with correlation.

[Mrs Nietzsche]

By the way, Gana, you might want to update your knowledge about the incidence of vaccine-preventable diseases. I know kids have died recently from measles in the UK. Whooping cough is spreading through areas of NSW where people don't vaccinate. Etc.

When people don't take precautions to prevent communicable diseases, they tend to spread (ie vaccines for whooping cough, ie *condoms* for AIDS (not circumcision).

As you prob know America has a far higher rate of AIDS infection than Aus, and also a far higher circ rate.

[gana]

A beautiful example of the consequences of confusing causation with correlation.

good grief


By the way, Gana, you might want to update your knowledge about the incidence of vaccine-preventable diseases. I know kids have died recently from measles in the UK. Whooping cough is spreading through areas of NSW where people don't vaccinate. Etc.

as your friend fellowtraveler is so fond of saying, those casualties don't count because it's a number statistically close to zero

if you have a problem with this, take it up with fellowtraveler, it's his argument, not mine.


When people don't take precautions to prevent communicable diseases, they tend to spread (ie vaccines for whooping cough, ie *condoms* for AIDS (not circumcision).

i favor using all the tools in the toolbox instead of lecturing them to use vaccines and condoms. Obviously, preaching isn't working.


As you prob know America has a far higher rate of AIDS infection than Aus, and also a far higher circ rate.

the highest rate of AIDS and herpes is among blacks and then hispanics, which also have the lowest circ rates. your friend fellowtraveler will tell you this is true.

something to think about. you'd rather save forskins than lives. i'd rather save lives than forskins.

[susieq1969]

I really think that we shouldn't circumsise babies.


I think that When they are older and can make a more informed decision then they can decide if they want it done or not.

After all, how many babies/children do you know run around having sex!!!!

And after all, who are we to go and cut bits of our babies off?? What gives us the right?

[Guest]

i favor using all the tools in the toolbox instead of lecturing them to use vaccines and condoms. Obviously, preaching isn't working.


Education and the message of safe sex practice IS working in this country. Aids rates have dropped dramatically since the message has come out, so condom use should always be at the forefront. Circumcision has not played a part in this.

[Opinionated]

the highest rate of AIDS and herpes is among blacks and then hispanics, which also have the lowest circ rates. your friend fellowtraveler will tell you this is true.
I don't doubt it. You will also find that those groups are the most socioeconomically disadvantaged, with many having little access to health care or health promotion information. I would argue that this factor has a lot more to do with their higher incidence of STI's than their lower circ rate does.



something to think about. you'd rather save foreskins than lives. i'd rather save lives than forskins.
Well how about this one. If we totally removed a person's penis in childhood, rates of HIV and STI's could be dropped to virtually zero. Think of all the lives that could be saved in a world where penetrative sex no longer existed. We have the technology to reproduce without intercourse, so we could make that disease spreading penis a thing of the past altogether. Ridiculous? Well you are the one advocating amputation as a means to harm minimisation, more extreme amputation would have more extreme results.

[Father]

Aids rates have dropped dramatically since the message has come out,

Except that it has been steadily increasing over the last decade.

[gana]

I don't doubt it. You will also find that those groups are the most socioeconomically disadvantaged, with many having little access to health care or health promotion information. I would argue that this factor has a lot more to do with their higher incidence of STI's than their lower circ rate does.

your friend fellowtraveler likes to pretend that living in 1st world countries makes circ. unnecessary.

are you now saying you have to be living in a 1st world country and rich to make circ. unnecessary?

as for being poor, yes if you can't afford circ. that will raise AIDS rates by 50%.


Well how about this one. If we totally removed a person's penis in childhood, rates of HIV and STI's could be dropped to virtually zero. Think of all the lives that could be saved in a world where penetrative sex no longer existed. We have the technology to reproduce without intercourse, so we could make that disease spreading penis a thing of the past altogether. Ridiculous? Well you are the one advocating amputation as a means to harm minimisation, more extreme amputation would have more extreme results.

come on, this analogy is silly. removing the foreskin doesn't affect functioning of the penis

[Opinionated]

your friend fellowtraveler likes to pretend that living in 1st world countries makes circ. unnecessary.

are you now saying you have to be living in a 1st world country and rich to make circ. unnecessary?

as for being poor, yes if you can't afford circ. that will raise AIDS rates by 50%.

No Fellow Traveller and I believe that RIC is always unneccessary. Rich or poor, 1st world, 3rd world or Mars. Sex education, the use of prophylactics and good hygiene are much more effective for STI's and every other argument you present for circ. I am saying that the increased rates you site in populations that do not circ are much more likely to be linked to lower education rates and lower usage of prophylactics than rates of circumcision. Also just a question, where is the thin air you pulled that 50% figure from?



come on, this analogy is silly. removing the foreskin doesn't affect functioning of the penis
No, what is silly is that you advocate circumcision and you don't know how circumcision can affect the functioning of a penis. Even sillier is that I never even mentioned function and foreskin removal yet you chose to quote me and discuss that:confused:

[Father]

No, what is silly is that you advocate circumcision and you don't know how circumcision can affect the functioning of a penis.

Gana. Can you please confirm with me (more for Opinionated's benefit) that you were uncircumcised, but got circumcised as an adult?
I would imagine that you would then know how circumcision does affect the 'functioning of a penis'?

[Opinionated]

Gana. Can you please confirm with me (more for Opinionated's benefit) that you were uncircumcised, but got circumcised as an adult?
I would imagine that you would then know how circumcision does affect the 'functioning of a penis'?

Sample size of one. Irrelevant, subjective and not peer reviewed. Like my experiece of men with damaged, circumcised penis's that could have had better function if left alone. Just because one mans penis functions fine after circumcision does not mean that they all will.

Gana has previously told me that his circ was carefully performed. I also assume that given his age, his foreskin was retractable for the procedure, not forcibly seperated from his glans. Circ on a full grown penis is one thing, circ on a developing penis is totally another and the two cannot be compared.

I am all for circ in adulthood. It is RIC I am against.

[Father]

Sample size of one. Irrelevant, subjective and not peer reviewed. Like my experiece of men with damaged, circumcised penis's that could have had better function if left alone. Just because one mans penis functions fine after circumcision does not mean that they all will.

Gana has previously told me that his circ was carefully performed. I also assume that given his age, his foreskin was retractable for the procedure, not forcibly seperated from his glans. Circ on a full grown penis is one thing, circ on a developing penis is totally another and the two cannot be compared.

I am all for circ in adulthood. It is RIC I am against.

You did accuse him of not knowing about foreskins. That was the reason for my response.

In regard to infant vs adulthood. They can be compared, and yes, they are different. All studies show that infant circumcision is safer, cheaper, and with less complications than adult circumcision.

[Opinionated]

You did accuse him of not knowing about foreskins. That was the reason for my response. No, I accused him of not knowing that removing the foreskin can affect the functioning of a penis. Just because his was unnaffected is irrelevent. Some men have suffered adverse functionality due to circumcision.


In regard to infant vs adulthood. They can be compared, and yes, they are different. All studies show that infant circumcision is safer, cheaper, and with less complications than adult circumcision.

How many studies have looked at long term complications of circumcision, there may be less short term complications, but I would imagine there is a considerable number of long term complications of circ. Safer? I am not convinced. Cheaper, shouldn't be a consideration. If all circs were performed on adults only, the price would come down.

[Father]

How many studies have looked at long term complications of circumcision, there may be less short term complications, but I would imagine there is a considerable number of long term complications of circ.

Imagination is a wonderful thing. Not very factual though.
Maybe you should talk to your friends at NOCIRC, CIRP, or circumstitions.com and get them to throw together some articles?

[Fellow Traveler]

You did accuse him of not knowing about foreskins. That was the reason for my response.

In regard to infant vs adulthood. They can be compared, and yes, they are different. All studies show that infant circumcision is safer, cheaper, and with less complications than adult circumcision.

Cheaper shouldn't be a consideration when concidering ethical Medicine. But what greater risks does an adult face that an infant doesn't?

A bit longer healing? Who cares?

A slightly higher risk of bleeding? That can easily be controled so who cares?

I would find it hard to believe there is a greater risk of post operative infection.

Can anyone point me to an adult who recieved more damage than expected? Severed penis lacerated glans? In an adult circumcision performed in the west. Can someone point me to any information that an adult died as a result of their circumcision in a surgical theater? What are these greater risks?

It seems to me the only advantage to doing it to an infant is that they can't say no.

[Opinionated]

Imagination is a wonderful thing. Not very factual though.
Maybe you should talk to your friends at NOCIRC, CIRP, or circumstitions.com and get them to throw together some articles?

*sigh* Your wonderful imagination loves to think that everyone against RIC is off at whatever organisations you are going on about conspiring to try to deny you your choice to do what you will to your sons. Who is the conspiracy theorist now?

[gana]

No Fellow Traveller and I believe that RIC is always unneccessary. Rich or poor, 1st world, 3rd world or Mars. Sex education, the use of prophylactics and good hygiene are much more effective for STI's and every other argument you present for circ.

except the evidence doesn't agree with you. i guess that's why you like to speculate so much.


I am saying that the increased rates you site in populations that do not circ are much more likely to be linked to lower education rates and lower usage of prophylactics than rates of circumcision.

Do you have any proof or is this speculation?

And even if you're right, is this really a good argument for your position? I think it'd be a lot easier to RIC than to improve the education levels of minority groups who have for generations fallen behind in education.


Also just a question, where is the thin air you pulled that 50% figure from?

From the United Nations, actually it's 60%

2007 saw an important landmark in the history of HIV prevention – the finding that male circumcision reduces the risk of men acquiring HIV infection by approximately 60%. This was based on the results of three controlled trials in South Africa, Uganda and Kenya. Thanks to this research, the efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt. (http://www.unaids.org/en/PolicyAndPractice/ScienceAndResearch/default.asp)

I don't even know why there is even debate anymore about the health benefits to circ. Every respected medical org. recognizes these studies as definitive.

One thing I want to mention. What made these studies so compelling is that they were 1) large, random sample sizes and 2) not self-reporting, i.e., doctors regularly examined the study participants to determine what they had. In addition, I think 1 of these 3 studies had the participants do timelines of their sexual activities to provide better idea of when infection occurred.

My understanding (and again, I'm just going off what I read, I don't have any deep knowledge of the medicine and statistics used) is that other studies had flaws in that they weren't large enough, or there was no random assignation to control groups, or they were self-reporting.

The self-reporting is a big deal because a lot of times people think they're healthy when they are in fact infected and are actually acting as carriers, this is especially true for herpes and HPV. So a self-reporting study might show that uncirc'd men are healthy when they are in fact infected.

In any case, I don't know all the reasons why these 3 African studies have been deemed conclusive. I don't have the education or brains to figure out why these studies are better. I am trusting that the experts at UN, WHO, etc know what they're doing and have our best interests in mind.


No, what is silly is that you advocate circumcision and you don't know how circumcision can affect the functioning of a penis.

Why would I not know? I was circ'd as teenager.


Even sillier is that I never even mentioned function and foreskin removal yet you chose to quote me and discuss that:confused:

You said why don't we just remove the penis to stop STIs, in jest I believe. I said why don't we just remove the foreskin so that there is a working penis that won't get STIs. So what's the problem?

[gana]

Gana has previously told me that his circ was carefully performed. I also assume that given his age, his foreskin was retractable for the procedure, not forcibly seperated from his glans. Circ on a full grown penis is one thing, circ on a developing penis is totally another and the two cannot be compared.

Actually I was put under general so I have no idea how carefully it was performed. I think I implied my son's was carefully performed when I said the doctor told me he was careful to leave a little extra skin to accommodate future growth.

You're assumption I was fully retracted is correct.

This is not a large sample size and it's based only on my experience and my son's, but I do honestly believe it's so much easier and faster healing on infants.

[susieq1969]

This is not a large sample size and it's based only on my experience and my son's, but I do honestly believe it's so much easier and faster healing on infants.

Again, this is a con. It might very well be easier and faster healing on infants, but they still don't get a say in it do they?????

It's all very well you arguing the medical advantages/disadvantages, but have any of you stopped to think about how the child/baby feels about this???

And yes they might be young, and have no idea (in the case of babies). But I still feel it is wrong to take away something that is meant to be there without the babies/childs permission.

Which is why I feel it should wait until the person is old enough to make a decision themselves!!!!!

[BigRedV]

Every respected medical org. recognizes these studies as definitive.

Yet the medical boards do not recommend infant circumcision :detective:

[gana]

Yet the medical boards do not recommend infant circumcision :detective:

RACP says it's parents choice, so feel free to exercise your choice on your kids, and please respect my choice on my kid

[Fellow Traveler]

I am going to go ahead and ignore the incoherent ramblings and ad hominems if it's alright with you.



let me put it this way. who do i trust more?

some guy on the internet whose sig is stop RIC or neutrel health organizations staffed by top experts such as WHO, UN, CDC. Even RACP has admitted the legitimacy of the African studies.

i mean, come on, it's not even close. you're a nobody, the experts at these neutrel orgs are not.

If you trusted those organizations then you would have followed their advice. The recommendations of the WHO state that this strategy is aimed at countries with high prevalence, and not at countries with low prevalence or in countries where it relates specifically to one part of the population such as in Australia or the United States. The RACP agrees this and has issued statements that they don't plan to recommend routine circumcision in Australia.

The Australian Federation of AIDS Organization (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf) noted that:


This very low risk means that the population health benefit of an intervention like generalised circumcision programs would be negligible.So it seems to me that you're not following the recommendations of your local group of experts who state that circumcision is not recommended routinely for Australians. You've instead chosen a side a priori and stuck with it.


except you don't even support RIC in African countries where all the other neutrel organizations do.


You're right, I don't. I support informed consent of the individual, the ethical practice of medicine. If an adult man believes he can skate by with circumcision then he is more than welcomed to it. But that is a decision for each individual man to make. Nothing is lost by giving each man the dignity of the decision when they are old enough to decide.


you sit around pretending to argue facts, but you already have a predetermined conclusion in mind, as evidenced by your sig.

My predetermined conclusion is that medicine should be practiced conservatively and ethically. For all other procedures except circumcision, that means that unnecessarily invasive procedures should not be used where alternative, less invasive techniques, are equally efficient and available. We apply this rule to all other situations, circumcision shouldn't be an exception to the rule.

If ever there was presented facts that circumcision was important to the well being of a child and there was no superior, less invasive, alternatives then it would become acceptable to consider. At this point we aren't even close to that.



so pardon me, but you are not a credible source of information. any person looking to get accurate information would disregard everything you say.

Another ad hominem. I would skip this but instead I'll say they are free to believe me or not based on their own evaluation of the facts I bring to bare. I am happy to say I have convinced most people that I've spoken with. They aren't all obtuse.



i, on the other hand, am only parroting what's been said by neutrel world health orgs staffed by experts. i trust that they don't have any agenda to push other than saving lives, unlike you, so they have credibility. plus they are experts.

That's right, parroting; no thinking. Do what you're told and all will be well. Of course if you did that and payed attention to the RACP or AFAO you would not be promoting circumcision.


like Father has said to some anti-circs, don't complain to me, take it up with the UN, WHO, RACP, CDC.

also, the context you're ignoring is that HIV and herpes can't be cured, and HIV is fatal. circ is a tool in the box to combat this. it should be used, just like vaccines are used.


A blunt and ineffective tool; I guess when all you have is a hammer everything looks like a nail?


well that's great, but like i told you, i'm the wrong guy to discuss these studies in depth with

Clearly. You're set in your mind.


see my above post. i don't have to explain anything. you have to explain why WHO, CDC, UN and bunch of African countries found the African studies along with bunches of other studies to have overwhelming evidence.

again, don't argue with me, i'm not qualified. take it up with the real experts. (http://online.wsj.com/article/SB123802256715541879.html)

"Circumcised heterosexual men are 35% less likely to contract human papillomavirus (HPV) and 25% less likely to catch herpes than their uncircumcised counterparts, according to the study, published in this week's New England Journal of Medicine.

That article was from last year. You see no critical thinking skills. :rolleyes: A critical thinker such as myself will realize that there is a vaccine available for HPV, the data on HSV2 is not clear, and the risk of HIV in developed countries is a statistical non-starter. You don't have to be an expert to figure that out.

And that's right don't explain anything, don't try to think Gana you'll get a headache.



I ignore nothing. I made the rational decision to trust the judgment of top experts at neutrel world health organizations. I'm sure these guys are aware of all the studies, and they disregarded the studies you mentioned for good reason, probably because they're wrong.


You didn't make a rational decision. They were aware of much of this that is why they were sure to note that this is only a plan for countries with high HIV prevalence, not countries like Australia.


I don't pretend to know everything. Unlike some, I am prepared to admit my own shortcomings and deficiencies. What's the point of me reading studies I don't understand anyway? So I can discuss them on an internet board with someone equally clueless who wants to take the other side of WHO, UN, CDC and RACP experts? no thanks mate.

You should be reading the work and understanding them. That's the only way you can make an informed decision. I pity those who don't take the time to read and understand. It's people like you who miss the important caveats in medical treatments. It's people like you who probably also don't read the contracts they sign and then complain when they get into a bind.



I'm sorry mate, if you don't understand the difference between "what people actually do" vs "what people should do" I can't help you. If people did what they should, circumcision might be unnecessary. But then so would police, weapons of mass destruction, government, corporations, armies, laws, courts, etc.


And since I do what I am supposed to do circumcision is of no value to me, plus I live in a country where it's pointless anyway. You probably felt like you couldn't rely upon yourself to make good decisions so perhaps that's why you choose circumcision. Each individual should be allowed to make that decision for themselves. The value of circumcision is subjective to each individual and they deserve to make the choice.


And I don't understand why you have a problem with cutting studies short. Isn't saving lives more important than getting the data you need to support your position?

Because it leads to errors which again has been documented (http://www.medscape.com/viewarticle/719011) to occur in studies cut short. The overestimate of treatment effect can be quite large. It is actually an increasing problem in medical studies.


you're grossly wrong, once again you cherry pick numbers and studies to support your absurd belief circ. doesn't help AIDS, contrary to the policies of every legit health organization

there is a circumcision belt in africa for a reason

In heterosexual couples with enough other risk factors, transmission risk can climb as high as 1-in-10 for penile-vaginal sex and 1-in-3 for penile-anal sex.....heterosexual sex can be a remarkably efficient way to transmit HIV.... (http://www.natap.org/2008/Trans/Trans_03.htm)


I will again remind you that all organizations add the caveat that the use of circumcision is context sensitive and apply only countries of high prevalence. You also over look the "with enough other risk factors". Most studies peg the rate of transmission at least 1/1000 nominally. The prevalence of HIV in most heterosexual populations don't bare out risk of transmission as high as they quote. It might get that high under some circumstances (as the author noted) but it isn't the norm. If it was we'd all be in much deeper trouble. Rather there were only about 80 hetero male cases in Australia last year which works out to what about 1/100,000 or so? Most were in older men if I recall.


tons of people don't take the MMR vaccine because of autism controversy. i don't see measles popping up. you've cited 16 people in vancouver canada, that's nothing to lose sleep over.

Tons might be an overestimate depending on where you live. There is no link between vaccines and autism and you clearly don't understand the weight of that problem.



what you suggest is not going to happen. and you're off on heterosexual infection rates


Absent a vaccine, universal testing is the only way you're going to get HIV under control in places like Africa. All other attempts don't have a chance. Fortunately, this approach is gaining (http://www.msnbc.msn.com/id/35506018/) some traction. This would be trivial to implement in a place like the US or Australia and would halt the spread of HIV better than anything currently on the table.



you tell me. every article you cite i google and it's on CIRP.

All of those articles were published in reputable journals. Just because they are available at CIRP doesn't invalidate them. CIRP had nothing to do with any of them as far as I know. I get my copies of those and other articles from a library.



first,
o you daredevil you


Ad hominem



well you're wrong. it seems you live in US and AIDS and herpes are rampant there, as you should know. in fact, according to studies you said you've read, AIDS and herpes is most prevalent in hispanics and blacks which is the least circumcised group in the US.

Latinos have cultural and language barrier issues. African Americans and Latinos are more often at the lower end of the social/economic scale and tend to be incarcerated at higher rates. All much greater risk factors of HIV status.

Some suggestions, avoid the ad hominems and try to organize your thoughts a little more.

[gana]

all the respected organizations recognize validity of the African studies. in africa, they recommend RIC.

in 1st world countries, the organizations, including RACP, recommend parent choice.

my position is, parents should be informed about the medical benefits of circ., which have been accepted as valid by UN, WHO etc., and make their choice.

your position is, throw out a bunch of contradictory studies that have been rejected by UN, WHO, etc. and trick parents into making the choices you want them to make.

[susieq1969]

You're both just going over the same old same old now. :yes:

Don't forget, that there are religions out there too that say the boys have to be circumsised, it's not just about medical facts and figures

I still think it's wrong even for religious reasons!

[gana]

Clearly. You're set in your mind.

like you're any different?


That article was from last year. You see no critical thinking skills. :rolleyes: A critical thinker such as myself will realize that there is a vaccine available for HPV, the data on HSV2 is not clear, and the risk of HIV in developed countries is a statistical non-starter. You don't have to be an expert to figure that out.

except you're not critical thinker. you've already admitted you have a predetermined conclusion and are looking for reasons to support your predetermined conclusion.

a critical thinker would realize, the HPV vaccine only protects against some strains and its effects wear off over time. the HSV2 evidence is clear as same results were found in all 3 african studies. and 60% reduction of AIDS transmission is worth having.

there is no reason not to utilize every tool. your whole logic is based on utilizing every other tool to exclude circ. that's not critical thinking, that's just bias


And that's right don't explain anything, don't try to think Gana you'll get a headache.

why should i explain anything to you? you've already admitted you have a predetermined conclusion.

a critical thinker should realize this.


You should be reading the work and understanding them. That's the only way you can make an informed decision. I pity those who don't take the time to read and understand. It's people like you who miss the important caveats in medical treatments. It's people like you who probably also don't read the contracts they sign and then complain when they get into a bind.

I pity you. You have tossed out studies and concluded first world areas with running water circ. doesn't protect against herpes or HPV. It took me 2 mins. to realize the study you cited relied on self-reporting, and that most people don't even know they have HPV or herpes. Which is why UN, WHO etc. relied on the African studies.

Honestly, you're not very good at what you pretend to be expert in. What's your background anyway?

You're holding yourself out like you know what you're talking about but you've made so many clueless shoddy mistakes, like saying HPV vaccine is 95% effective when the literature states it only protects against 4 or 6 strains and is only 60% effective against bunch of other strains. It doesn't take math PhDto realize your 95% claim doesn't add up.


And since I do what I am supposed to do circumcision is of no value to me, plus I live in a country where it's pointless anyway.

you live in the US. AIDS and herpes rates are skyhigh there. good luck.


You probably felt like you couldn't rely upon yourself to make good decisions so perhaps that's why you choose circumcision.

yeah OK :rolleyes:

actually i got circ'd when i was a teen before all these studies came out. my reasons were hygiene and convenience. but it makes sense circ reduces diseases. if you put on your critical thinking cap, you'll realize it's dryer after circ. thus making it less conductive to bacterial growth.

[Fellow Traveler]

all the respected organizations recognize validity of the African studies. in africa, they recommend RIC.

in 1st world countries, the organizations, including RACP, recommend parent choice.


Routine circumcision is not supported by any of these groups.



my position is, parents should be informed about the medical benefits of circ., which have been accepted as valid by UN, WHO etc., and make their choice.


And they should know that none of those organizations recommend circumcision in first world countries.



your position is, throw out a bunch of contradictory studies that have been rejected by UN, WHO, etc. and trick parents into making the choices you want them to make.

First, none of those studies have been rejected. Nobody is tricked, they are informed so they know why it's not necessary.

You were given the dignity of a choice for your body, why do you reject giving your son (or others' son) the same consideration?

[susieq1969]

actually i got circ'd when i was a teen before all these studies came out. my reasons were hygiene and convenience. but it makes sense circ reduces diseases. if you put on your critical thinking cap, you'll realize it's dryer after circ. thus making it less conductive to bacterial growth.


This is what I'm saying.

Leave it to the child when they are old enough to make a decision which is what you clearly did

So as said by Fellowtraveler, why didn't you do the same for your son (or anyone elses):confused:

[Fellow Traveler]

except you're not critical thinker. you've already admitted you have a predetermined conclusion and are looking for reasons to support your predetermined conclusion.


No, I've admitted what groups like the RACP already state, there is no rational for supporting routine infant circumcision.



a critical thinker would realize, the HPV vaccine only protects against some strains and its effects wear off over time. the HSV2 evidence is clear as same results were found in all 3 african studies. and 60% reduction of AIDS transmission is worth having.


You're going to have to provide evidence of waning effect because so far as I've seen that hasn't been demonstrated yet.

The HSV2 result isn't at all clear. Particularly in western countries and even if it was it is minimal.

Again for HIV I'll point you to the AFAO statement read (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf) all about it.


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.

You do know what negligible means right?



there is no reason not to utilize every tool. your whole logic is based on utilizing every other tool to exclude circ. that's not critical thinking, that's just bias


No that is evaluating the contribution of specific tools. The AFAO states the usefulness of circumcision in Australia (indeed any first world country) is essentially zero.



why should i explain anything to you? you've already admitted you have a predetermined conclusion.

a critical thinker should realize this.


If you can't just say so. We'll all understand.



I pity you. You have tossed out studies and concluded first world areas with running water circ. doesn't protect against herpes or HPV. It took me 2 mins. to realize the study you cited relied on self-reporting, and that most people don't even know they have HPV or herpes. Which is why UN, WHO etc. relied on the African studies.


No one was a self report the two others were seriologically tested. The one from New Zealand followed their group for 26 years. Seems like a good amount of time. And guess what, no difference.



You're holding yourself out like you know what you're talking about but you've made so many clueless shoddy mistakes, like saying HPV vaccine is 95% effective when the literature states it only protects against 4 or 6 strains and is only 60% effective against bunch of other strains. It doesn't take math PhDto realize your 95% claim doesn't add up.


It is >= 90% effective against the strains that are of concern. If you don't want to admit that I'll provide links. >= 90% (>99 for females) is better than 35% surely you know that.



you live in the US. AIDS and herpes rates are skyhigh there. good luck.


Not that high though about 3x higher than places like Europe, Japan, and Australia where circumcision is rare.




actually i got circ'd when i was a teen before all these studies came out. my reasons were hygiene and convenience. but it makes sense circ reduces diseases. if you put on your critical thinking cap, you'll realize it's dryer after circ. thus making it less conductive to bacterial growth.

I see you were lazy. Why didn't you just say so. :rolleyes:

[gana]

Routine circumcision is not supported by any of these groups.

I believe UN and WHO do support it, at least in Africa.

The evidence that adult male circumcision is efficacious in reducing sexual transmission of HIV from women to men is compelling. The partial protective effect of male circumcision (approximately 60% reduction in risk of heterosexually acquired HIV infection) is remarkably consistent across the observational studies (ecological, cross-sectional and cohort) and the three randomized controlled trials conducted in diverse settings.


In response to the urgent need to reduce the number of new HIV infections globally, the World Health Organization (WHO) and the UNAIDS Secretariat convened an international expert consultation in March 2007 to determine whether male circumcision should be recommended as an HIV prevention measure.


Based on the existing evidence, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men. (http://www.unaids.org/en/PolicyAndPractice/Prevention/MaleCircumcision/default.asp)



And they should know that none of those organizations recommend circumcision in first world countries.

i never object to telling truth, so that is fine with me.


First, none of those studies have been rejected. Nobody is tricked, they are informed so they know why it's not necessary.

those studies have been rejected. all over the UNAIDS pages, WHO, CDC all cite the African trials as definitive. Your studies are treated the same as the African trials by expert world health organizations.

You are tricking people when you mention your studies and then neglect to mention that experts at UN, WHO, CDC etc. all believe the African trials are definitive.


You were given the dignity of a choice for your body, why do you reject giving your son (or others' son) the same consideration?

I understand this argument. I even understand your argument that in countries where HIV isn't so prevalent circ. may not be necessary, although I don't agree with it.

I was thinking maybe I'll wait until he's older but after I saw the AIDS data, I believed it should definitely be done.

[susieq1969]

(http://www.unaids.org/en/PolicyAndPractice/Prevention/MaleCircumcision/default.asp)I was thinking maybe I'll wait until he's older but after I saw the AIDS data, I believed it should definitely be done.


Again, you are taking away his right to choose.

As is everyone else who has their son circumsised.

[Pax]

******* runs through flashing boobies at Susie ******

[susieq1969]

******* runs through flashing boobies at Susie ******


I just burst out laughing at the pc, my DP is looking at me really strangely now........:laughing::laughing::laughing::laughing :

[Fellow Traveler]

I believe UN and WHO do support it, at least in Africa.


I've read all that long before you heard of this. The key point is highlighted.



i never object to telling truth, so that is fine with me.


I wasn't looking for your validation. I don't think you're at all informed on the issue.



those studies have been rejected. all over the UNAIDS pages, WHO, CDC all cite the African trials as definitive. Your studies are treated the same as the African trials by expert world health organizations.


They haven't been rejected, they only speak to the HIV benefit primarily.



You are tricking people when you mention your studies and then neglect to mention that experts at UN, WHO, CDC etc. all believe the African trials are definitive.


No study is ever definitive. And the statement (where it relates to the 'African' work) only relates to HIV, transmitted in a specific way, and only in specific settings. They were very careful to mention that. Any thing further is speculation.



I understand this argument. I even understand your argument that in countries where HIV isn't so prevalent circ. may not be necessary, although I don't agree with it.


Then you disagree with the findings of your own professional organizations and went against their recommendations.



I was thinking maybe I'll wait until he's older but after I saw the AIDS data, I believed it should definitely be done.

That is too bad for him, I am not sure which of you I pity more though.

[Fellow Traveler]

Again, you are taking away his right to choose.

As is everyone else who has their son circumsised.

He doesn't care Susieq.

[susieq1969]

He doesn't care Susieq.


Ahhhhhh thank you!!! At long last one of you acknowledges me!! ;):laughing::laughing:

[Fellow Traveler]

Ahhhhhh thank you!!! At long last one of you acknowledges me!! ;):laughing::laughing:

I am always happy to acknowledge anyone, did you ask me something I missed?

[susieq1969]

It was the fact that I was putting my opinion across and noone acknowledged it or challenged it. :no:

Both you and Gana are so caught up in the thread and each others's posts that other people seem to be left out. :yes:

My comment was also meant as lighthearted as you can see by the laughing smileys at the end.

:laughing:

[Fellow Traveler]

It was the fact that I was putting my opinion across and noone acknowledged it or challenged it. :no:

Both you and Gana are so caught up in the thread and each others's posts that other people seem to be left out. :yes:

My comment was also meant as lighthearted as you can see by the laughing smileys at the end.

:laughing:

What was your opinion? I didn't mean to ignore you. I did see you mention religion. I would be against that too (for infants) but if it meant ending the secular practice, I would table religion since I don't think as a society we are not ready to block anything religious people do.
Though boys in those groups deserve the same respect as other boys, it's a tough question.

[Guest]

It was the fact that I was putting my opinion across and noone acknowledged it or challenged it. :no:

Both you and Gana are so caught up in the thread and each others's posts that other people seem to be left out. :yes:

My comment was also meant as lighthearted as you can see by the laughing smileys at the end.

:laughing:
No I was aknowledging your post and just agreeing with it, so it's not going unheard :yes:

[BigRedV]

RACP says it's parents choice, so feel free to exercise your choice on your kids, and please respect my choice on my kid

Actually,
The Royal Australasian College of Physicians (http://www.racp.edu.au/) recommends parents who want to circumcise their infant sons should consider waiting until they are old enough to make their own decisions.;)

[circangel]

Gana you have put up some relevant and incredible arguements. Thanks for your arguements for all others may I suggest you stop refering to literature and speak to a doctor, someone that professionally understands if it needs to be done or not or is it just an incredible thing to do as a preventative measure. Personally I do not like the idea of RIC but I do think it needs to be done before he can decide for himself especially to prevent a situation where there is a problem that he is not able to talk about it and also the penis can not be any better off for having a foreskin that is a ridiculous notion if I have ever heard one.

[Father]

Actually, ;)

I went looking for that statement and did not find it on the RACP website at all. Can you please show me where they actually say that?

In any case. I followed their 'recommendation'. I considered waiting, but then used my parental right to make a decision to circumcise him because we believe it was in his best interest.



Parents have the right, indeed duty, to make informed medical decisions on behalf of their children.


We were informed. We knew both the risks and benefits, and we fulfilled our 'duty' to make a medical decision on behalf of our child. Will I make the same decision again? Unless there is a big change in opinion by major medical bodies before August 2010.....then yes, we will make the same decision again.

Note: A decision not to circumcise is also a valid decision. There is no right or wrong.

[sockstealingpoltergeist]

Con it's not yours.

Con trying to own someone elses penis is weird.

The end.

[Opinionated]

the penis can not be any better off for having a foreskin that is a ridiculous notion if I have ever heard one.

Actually, the only part of the body without a function in modern man is the appendix. It defies logic that a piece of the anatomy would function better with a bit chopped off.:confused: Of course it has increased function when in tact.

[Guest]

Gana you have put up some relevant and incredible arguements. Thanks for your arguements for all others may I suggest you stop refering to literature and speak to a doctor, someone that professionally understands if it needs to be done or not or is it just an incredible thing to do as a preventative measure. Personally I do not like the idea of RIC but I do think it needs to be done before he can decide for himself especially to prevent a situation where there is a problem that he is not able to talk about it and also the penis can not be any better off for having a foreskin that is a ridiculous notion if I have ever heard one.
Can I understand what you just wrote? You're saying that if I spoke to a dr, he would tell me it's recommended to circumcise an infant? Are you also saying a foreskin has no purpose and its a ridiculous notion to suggest otherwise?
Only Gana has put up a good argument and everyone else who doesn't agree with your beliefs hasn't? So no literature against circumcision, or medical organisation that does not recommend RIC are wrong and you and Gana are a more credable source of information?
hmmm interesting, it kinda makes it useless to discuss it with you if you choose to close your eyes to anything that doesn't agree with what you believe. I also find it interesting you say you don't like the idea of ric, but think it's 'necessary' before they understand? That really doesn't make sense.
btw I think you will be very hard pressed to find a dr. that does agree with ric or who'll perform it. So it's a good suggestion to just go straight to a dr, perhaps ric rates will drop even further once people stop reading pro circ propaganda online and go by what medical professionals recommend.

[circangel]

Can I understand what you just wrote? You're saying that if I spoke to a dr, he would tell me it's recommended to circumcise an infant? Are you also saying a foreskin has no purpose and its a ridiculous notion to suggest otherwise?
Only Gana has put up a good argument and everyone else who doesn't agree with your beliefs hasn't? So no literature against circumcision, or medical organisation that does not recommend RIC are wrong and you and Gana are a more credable source of information?
hmmm interesting, it kinda makes it useless to discuss it with you if you choose to close your eyes to anything that doesn't agree with what you believe. I also find it interesting you say you don't like the idea of ric, but think it's 'necessary' before they understand? That really doesn't make sense.
btw I think you will be very hard pressed to find a dr. that does agree with ric or who'll perform it. So it's a good suggestion to just go straight to a dr, perhaps ric rates will drop even further once people stop reading pro circ propaganda online and go by what medical professionals recommend.

The rates of circumcision might drop once people go to the professionals and ask, good for them, but it is the only way to know what is best. I think parents should be properly informed and I am not sure it is happening here. Maybe a foreskin should have been called before underwear as that is when it provided any use eg protection.

[gana]

No, I've admitted what groups like the RACP already state, there is no rational for supporting routine infant circumcision.

I've already addressed this. I have posted numerous links to UNAIDS and WHO where they recommend circ., particularly Africa.

Also, the RACP acknowledges that circ. is useful for UTI, HIV and penile cancer. They then say those are not prevalent enough to recommend RIC. They conclude by saying that accurate, unbiased and updated information must be provided so that parents can choose.

You are not being truthful when you tell them half of RACP statement, without including the portion where they acknowledge some benefits and conclude parents should choose.


You're going to have to provide evidence of waning effect because so far as I've seen that hasn't been demonstrated yet.

how can there be any evidence of waning effect? the vaccine has barely been around for 2 years. and that's the basic problem, not much is known because it's so new.

if you recall my post on HPV vaccine in the thread that was closed, one concern was that this vaccine was so expensive and if its effect waned in 10 years it wasn't worth the cost.

also, you mentioned before you'd rather have the HPV shot than circ. to prevent HPV. Well, that's not an option if you're over 26 like I am, the vaccine is approved for 9 to 26. It's probably an option for you because based on your posts you definitely seem under 26.


The HSV2 result isn't at all clear. Particularly in western countries and even if it was it is minimal.

when you show me a study that had the same randomly assigned control groups, large sample sizes and doctor inspection like the 3 African studies, i'll consider your position.

but when 3 studies like that have results so similar, it is powerful proof.

again, it's you vs the UN, WHO, CDC. I'd have to be an idiot to pick against top experts in neutral orgs.


Again for HIV I'll point you to the AFAO statement read (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf) all about it.

You do know what negligible means right?

You have insisted it is critical that MMR vaccine be administered even though measles affects just about 0%. And the fact is, it has remained at statistically 0% even though large percentage of people don't take MMR vaccine because they fear it will cause autism.

Now I think those fears are wrong and I read somewhere the authors of the original study linking MMR vaccine to autism have withdrawn their paper and there was some fudging of data.

But whether the reasons for avoiding MMR vaccine are legit or due to mistaken overhyped controversy, a significant percentage of the population has not gotten the measles vaccine.

And what has been the result? Has your doomsday prediction of measles pandemic come close to being true? You mentioned 16 people getting sick in Vancouver, Canada and 60 that might have got sick in California. Someone else mentioned a few deaths in Britain. As a percentage of the populations of Canada, America and Britain the number of actual deaths and illness is .00000001%.

Yet you continue to insist MMR vaccine be administered despite .0000001% illness and death, and RIC not be done because the AIDS illnesses and deaths are "negligible."

I am fully aware of what negligible means. The question is, are you?


No that is evaluating the contribution of specific tools. The AFAO states the usefulness of circumcision in Australia (indeed any first world country) is essentially zero.

First, essentially zero is not the same as zero, as I discussed above.

Second, why are you still hammering on the the effectiveness of circ. under Australian conditions like it actually matters to you? You've said you wouldn't support RIC even in sub-Saharan African countries where AIDS is endemic and the primary means of transmission is hetero sex.

Third, your 0.2% figure (which is still higher than the .00001% of measles you're so uptight over) excludes homo anal sex, and the publication you cite states there are studies, not yet peer reviewed, showing that circ. reduces transmission rates from anal sex. Frankly, this makes 100% sense. Circ. reduces the penis vulnerability to HIV in the vagina, so it should reduce its vulnerability in the anus as well. There's no reason why it shouldn't.

So once you factor in the protection for gays, you're starting to get more significant benefits from circ.


No one was a self report the two others were seriologically tested. The one from New Zealand followed their group for 26 years. Seems like a good amount of time. And guess what, no difference.

I said the UN studies were good because they had large sample sizes. You responded with a study coming to opposite conclusions from the UN. I asked you if this large study of yours was self-reporting, because self-reporting results on STIs are inherently unreliable because many people don't know what they have.

You failed to respond to my question. I wonder why? I googled this study, found it on cirp.org. It turns out this large study relied completely on self-reporting. So I think we can safely say your large numbers study which relies on self-reporting is inferior to and superceded by the UN studies, which have large numbers and doctor examinations.

As for the other two seriological studies, I ask you, do they have large sample sizes and randomly assigned control groups? I await your answer.


It is >= 90% effective against the strains that are of concern. If you don't want to admit that I'll provide links. >= 90% (>99 for females) is better than 35% surely you know that.

I'm not here to knock the vaccine. But if I remember right there are hundreds of variations of HPV, Gardasil directly protects 4 and is pretty good for 10 others. That's not bad, but it's not perfect. As I'm sure you know, prevnar was supposed to wipe out certain types of pneumonia. Instead, new strains became more prevalent so now there's prevnar-13. Maybe 10 years from now there will be prevnar-65.

The point, which you should admit, is that Gardasil + circ >>> Gardasil alone.

[gana]

I will again remind you that all organizations add the caveat that the use of circumcision is context sensitive and apply only countries of high prevalence. You also over look the "with enough other risk factors". Most studies peg the rate of transmission at least 1/1000 nominally. The prevalence of HIV in most heterosexual populations don't bare out risk of transmission as high as they quote. It might get that high under some circumstances (as the author noted) but it isn't the norm. If it was we'd all be in much deeper trouble. Rather there were only about 80 hetero male cases in Australia last year which works out to what about 1/100,000 or so? Most were in older men if I recall.

I want to address this point because I think fellowtraveler is oversimplifying a complex issue because he doesn't understand it.

In an earlier post, you said that female to male HIV transmission rate is 2000 to 1, which is absolutely ludicrous given the rate that AIDS has spread in Africa through heterosexual activity. You later changed it to 1,000 to 1 as you apparently realized how ludicrous 2,000 to is, but you're still way off.

The point you're ignoring is that HIV transmission is linked to other confounding factors, including other diseases, especially STIs and particularly herpes. The reason why herpes is so deadly is that it can't be cured and it's generally not fatal, so herpes infected people for the rest of their lives are vulnerable to HIV at a much higher rate than 1,000 to 1, and they transmit it at a much higher rate than 1,000 to 1.

In Africa, where there's a high rate of herpes, other diseases, other STIs (basically a lot of confounding factors), the rate of HIV transmission through hetero sex is going to be very high, especially since AIDS is so prevalent in Africa.

Australia already has a high rate of herpes. Fortunately we don't have a high rate of HIV as in Africa. But if HIV ever gets a foothold here, then with the huge number of herpes cases which is growing ever larger, the rate of transmission of HIV through hetero sex is not going to be 1,000 to 1, it'll be a much higher rate of transmission.


Latinos have cultural and language barrier issues.

doesn't that make communicating safesex, condoms, abstinence message much harder, and argue for RIC which does not incur communication barriers?


African Americans and Latinos are more often at the lower end of the social/economic scale and tend to be incarcerated at higher rates. All much greater risk factors of HIV status.

Well if you're worried about prison sex, you cited an article which said circ. lowers HIV transmission through homo anal sex.

So you're basically making an argument for circ. for blacks and hispanics.

[gana]

I've read all that long before you heard of this. The key point is highlighted.

you highlighted Africa as if UNAIDS only supports circ. in Africa. that's actually not true. if you had read the link, it says that circ. should be universal.


In response to the urgent need to reduce the number of new HIV infections globally, the World Health Organization (WHO) and the UNAIDS Secretariat convened an international expert consultation in March 2007 to determine whether male circumcision should be recommended as an HIV prevention measure. Based on the existing evidence, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men


Male circumcision should always be considered as part of a comprehensive HIV prevention package. Moreover, wherever male circumcision services are offered, training and certification of providers, as well as careful monitoring and evaluation of programmes, will be necessary to ensure that these meet their objectives and that quality services are provided safely, with adequate equipment and with appropriate counselling and other services (http://www.unaids.org/en/PolicyAndPractice/ScienceAndResearch/default.asp)



I wasn't looking for your validation. I don't think you're at all informed on the issue.

do you really think i'm not at all informed :rolleyes:


They haven't been rejected, they only speak to the HIV benefit primarily.

strange

the UNAIDS pages mention all 3 african studies repeatedly endorsing them. your studies, on the other hand, are never mentioned by UNAIDS. the results of your studies are explicitly rejected.

how is that not rejection?


No study is ever definitive. And the statement (where it relates to the 'African' work) only relates to HIV, transmitted in a specific way, and only in specific settings. They were very careful to mention that. Any thing further is speculation.

You are wrong again and again. You have every right to advocate your position, but it's wrong to lie to people tricking them. The statement of UNAIDS is not equivocal, it is not limited to Africa. Here's their exact words.

2007 saw an important landmark in the history of HIV prevention – the finding that male circumcision reduces the risk of men acquiring HIV infection by approximately 60%. This was based on the results of three controlled trials in South Africa, Uganda and Kenya. Thanks to this research, the efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt (http://www.unaids.org/en/PolicyAndPractice/ScienceAndResearch/default.asp)

Male circumcision should always be considered as part of a comprehensive HIV prevention package. (http://www.unaids.org/en/PolicyAndPractice/Prevention/MaleCircumcision/default.asp)


Then you disagree with the findings of your own professional organizations and went against their recommendations.

you're wrong again. RACP says parents choice. UNAIDS favors RIC as shown above.


That is too bad for him, I am not sure which of you I pity more though.

I was raised to make decisions based on accurate and truthful information. I was raised not to lie to people to get them to do what I want. I will raise my son the same way.

I think it's a pity you think it's OK to affect people's lives, decisions and health with deception.

[RaryGirl]

This thread was started so everyone could provide INFORMATION and LINK on the pro's and con's of circumcision.

As usual people can't help themselves and are taking things too far.

I would like one 1 thread regarding circumcision to remain open ... I would like this thread to be that one thread.

Please stay on topic, don't attack, don't share TMI, don't belittle others opinions and one more thing .... DON'T use :rolleyes: icon anymore.

[gana]

It was the fact that I was putting my opinion across and noone acknowledged it or challenged it. :no:

Both you and Gana are so caught up in the thread and each others's posts that other people seem to be left out. :yes:

susieq, sorry i'm not trying to be rude to you. as you noticed, i was busy replying to fellowtraveler.

i believe you're taking a human rights stand on an infant's foreskin. while i think there is merit in a human rights stance, i am convinced it is not as clear cut as you are trying to portray it.

first, RIC is not universally regarded as a human rights violation. genocide is a universal human rights violation. imprisoning political dissenters is a universal human rights violation. there is no way africa is ever going to regard RIC as a human rights violation.

so i think it is safe to say that RIC, as a human rights issue, ranks lower than genocide or other human rights issues that are universally recognized as human rights violation. in fact, i'd class RIC as even lower ranking a human rights issue than abortion, because life is more important than forskin.

i also think it inconsistent to emphasize child's choice in RIC, and completely disregard it in abortion. also, when the purpose of RIC is to try to save the child from HIV, that does not fit my idea of a human rights violation. how can something benefiting or intended to benefit a child be a human rights violation?

i also bring up abortion when discussing RIC as a human rights issue because if RIC is determined to be a human rights violation, it will not happen unless abortion is also deemed to be a human rights violation.

i just think there is no way politically RIC will ever take precedence as a human rights issue over abortion, no way.

so for anti-RICs who are also pro-choice on abortion, i think they're going to have to pick their poison. do they want pro-choice abortion and RIC not a human rights violation, or do they want both RIC and abortion to be human rights violations?

i'm absolutely convinced that pro-choice is more important to more women and men than anti-RIC. they are not going to sacrifice pro-choice for anti-RIC, it's never gonna happen.

so i basically view anti-RIC talk as a guaranteed dead end. plus i do believe RIC saves lives ultimately

[misskittyfantastico]

With respect, what on earth does abortion have to do with this thread? "The pros and cons of circumcision"?:confused:

ETA. This thread http://www.bubhub.com.au/community/forums/showthread.php?t=326881&highlight=debate might be a useful read. Not just for you, Gana, but for all of us posting in this thread. It's essentially a debate, and Rarygirl is working her bottom off to keep it open, so maybe we could all try and debate fairly and well (myself included - no more fart jokes. Promise)

[susieq1969]

I agree with Taboulirasta - what the hell has abortion got to do with it!!

:eek:

I still think RIC is wrong, and if you want to call it a human rights issue, then so be it.

But it still takes away an individuals choice. And as said to you previously, you had a choice and you chose to have it done when you were a teenager, so why not give your son and others that same choice??

[Fellow Traveler]

I've already addressed this. I have posted numerous links to UNAIDS and WHO where they recommend circ., particularly Africa.

You have posted a single link, the same statement. Nobody is disagreeing with that unfortunate decision but it applies only to sub-Saharan Africa.

Here is the relevant statement (http://www.google.com/url?sa=t&source=web&ct=res&cd=2&ved=0CAwQFjAB&url=http%3A%2F%2Fwww.who.int%2Fhiv%2Fmediacentre%2 FMCrecommendations_en.pdf&rct=j&q=%22In+settings+with+lower+HIV+prevalence+in+the+ general+population%2C+including+where+HIV%22&ei=N7O_S_6bCYKC8gaTnPniDg&usg=AFQjCNG-qPXGIp-6Fyhr2ekotm7lyMfuBg):


In settings with lower HIV prevalence in the general population, including where HIV infection is concentrated in specific populations at higher risk of HIV exposure, such as sex workers, injecting drug users or men who have sex with men, limited public health benefit would result from promoting male circumcision in the general population. However, there may be individual benefit for men at higher risk of heterosexually acquired HIV infection such as men in sero-discordant partnerships and clients presenting at clinics for the management of sexually transmitted infections.Here is what the French National Council on AIDS (http://www.cns.sante.fr/IMG/pdf/2007-05-24_rap_en_politique_internationale.pdf) said about this issue:


The same measures are not applicable to the Northern countries. The recommendations of the WHO state that this strategy is aimed at countries with high prevalence, and not at countries with low prevalence or in countries where it relates specifically to one part of the population such as in [Australia,] France or the United States.And once again your very own AFAO (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf) not to be out done:


This very low risk means that the population health benefit of an
intervention like generalised circumcision programs would be negligible.So the bottom line here is that there is no practical value to those outside of some very specific contexts. There is no endorsement or recommendation for circumcision outside of Sub-Saharan Africa.



Also, the RACP acknowledges that circ. is useful for UTI, HIV and penile cancer. They then say those are not prevalent enough to recommend RIC. They conclude by saying that accurate, unbiased and updated information must be provided so that parents can choose.


I am glad you brought up UTIs; in the RACP's last statement (http://www.racp.edu.au/index.cfm?objectid=B5606813-F174-8FA9-0522EE1FC3053078) they noted:


In summary, routine circumcision in boys cannot be justified on the basis of preventing a UTI. On the other hand, there may be a role for circumcision in boys with recurrent symptomatic UTI and/or underlying renal tract abnormalities.This conclusion was also reached in a subsequent review of the literature by an independent researcher:

Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Archives of Disease in Childhood 2005; 90(8): 853–858

They noted that while there is a slightly reduced risk of UTI, after reviewing about 12 studies concluded that their review did not support the routine circumcision of normal boys with standard risk in order to prevent UTI and suggested that circumcision of boys with higher than normal risk of UTI should be considered.

And of course there is this link to an editorial written by the head of the RACP committee looking at this issue. Who stated (http://www.6minutes.com.au/articles/z1/view.asp?id=498029):


Further the stated benefits of protection against urinary tract infection are marginal, and do not justify mass circumcision. Our changing understanding of the relationship between urinary tract infection and chronic renal disease further weakens the case for routine circumcision.We already know how rare HIV infection is among heterosexual in Australia and we know that penile cancer is also extremely rare and will become more so with the introduction of Gardasil.



You are not being truthful when you tell them half of RACP statement, without including the portion where they acknowledge some benefits and conclude parents should choose.


They note there are potential benefits but the benefits are trivial in most cases and don't outweigh the risk. That is what they say.



how can there be any evidence of waning effect? the vaccine has barely been around for 2 years. and that's the basic problem, not much is known because it's so new.


I don't know, you said: "and its effects wear off over time." Please provided evidence of this if you have it.

Gardasil has been available since 2006 so that is four years. It's been studied since at least 2002. So there is a potential for at least eight years of data. There was, in fact, a recent paper on this too (http://www.medscape.com/viewarticle/716166).


After as long as 6.4 years of follow-up, vaccine efficacy was 95% for preventing incident HPV-16/18 infection, 100% for preventing persistent HPV-16/18 infection, 97% for preventing any HPV-16/18–related cervical cytopathology, and 100% for preventing HPV-16/18–related cervical intraepithelial neoplasia (CIN).This was in women, the men's work is a bit behind but there is no reason to believe that the results won't be the same. Even if it does wane, that is what boosters are for.



if you recall my post on HPV vaccine in the thread that was closed, one concern was that this vaccine was so expensive and if its effect waned in 10 years it wasn't worth the cost.


There is no evidence of waning effect. If you find research demonstrating this, post it. And if the effect does wane, a booster is in order. The vaccine may be expensive but it's a far better option since protection of the level it provides could eliminate these diseases from the population much like other vaccine preventable diseases.

The only reason there is a controversy in providing the vaccine at that cost is that HPV infection is not in anyway considered serious for the vast majority of people, especially men.



also, you mentioned before you'd rather have the HPV shot than circ. to prevent HPV. Well, that's not an option if you're over 26 like I am, the vaccine is approved for 9 to 26. It's probably an option for you because based on your posts you definitely seem under 26.


You can still get it if you're over 26. The only reason they have a cut off is that it is believed it is a bit less effective if you've already been exposed. However for the vast majority of people exposure to HPV causes no problems anyway. This can be an option for anyone willing to pay for it at the end of the day. And while that might be a good excuse for you it's not for a child born today.



when you show me a study that had the same randomly assigned control groups, large sample sizes and doctor inspection like the 3 African studies, i'll consider your position.

again, it's you vs the UN, WHO, CDC. I'd have to be an idiot to pick against top experts in neutral orgs.


Nobody is doubting the results and it's not a question of "picking against" them. I don't doubt that the Yellow Fever vaccine (http://en.wikipedia.org/wiki/Yellow_fever_vaccine) is >90% effective but we don't get the Yellow Fever vaccine in the west because we don't need it. Likewise we shouldn't do circumcision in the west because it is equally pointless. If a man in the first world countries finds himself in a high risk group then he might want to consider circumcision. Just like if you're going to travel to a country with endemic yellow fever you might consider vaccination. Neither is nor should be offered.



You have insisted it is critical that MMR vaccine be administered even though measles affects just about 0%. And the fact is, it has remained at statistically 0% even though large percentage of people don't take MMR vaccine because they fear it will cause autism.


It is critical and the number who've refuses has fortunately not been that large (in most places). Those fears of autism were clearly unfounded to anyone paying attention.



And what has been the result? Has your doomsday prediction of measles pandemic come close to being true? You mentioned 16 people getting sick in Vancouver, Canada and 60 that might have got sick in California. Someone else mentioned a few deaths in Britain. As a percentage of the populations of Canada, America and Britain the number of actual deaths and illness is .00000001%.


Not my prediction, public health officials' prediction.



Yet you continue to insist MMR vaccine be administered despite .0000001% illness and death, and RIC not be done because the AIDS illnesses and deaths are "negligible."

I am fully aware of what negligible means. The question is, are you?


It's not clear to me that you do know what negligible means. Once again though, you confuse the issue. I'll try and make it as simple as I can for you:

If vaccination rates drop by more than five or 10 percent in the US or Australia, a disease like measles would become endemic again.

If circumcision became rare in the US and finally snuffed out in Australia, HIV would not become endemic in the population, just like it's not endemic in Australia.



First, essentially zero is not the same as zero, as I discussed above.

Second, why are you still hammering on the the effectiveness of circ. under Australian conditions like it actually matters to you? You've said you wouldn't support RIC even in sub-Saharan African countries where AIDS is endemic and the primary means of transmission is hetero sex.


You're nit picking on words; it is essentially zero which means no practical value. I hammer it because it's important that people know that in Western contexts circumcision is not a useful or supported intervention in the vast majority of cases. Or do you not want people to be fully informed?

And again I wouldn't/don't support RIC in Africa. Unfortunately, medical ethics are important to me therefore they should allow individual men to make the decision for themselves. Even the ethics aside, it's a more practical approach if they really wish to reduce the risk of HIV.



Third, your 0.2% figure (which is still higher than the .00001% of measles you're so uptight over) excludes homo anal sex, and the publication you cite states there are studies, not yet peer reviewed, showing that circ. reduces transmission rates from anal sex. Frankly, this makes 100% sense. Circ. reduces the penis vulnerability to HIV in the vagina, so it should reduce its vulnerability in the anus as well. There's no reason why it shouldn't.

So once you factor in the protection for gays, you're starting to get more significant benefits from circ.

It is two hundredths of a percent (0.02%) not 0.2%. And Measles is more critical because it is an airborne disease which is highly infectious. Really, I shouldn't have to explain that to someone.

Since that sheet was published, there has been no demonstrated protection for MSM. That lack of demonstrated benefit is not through lack of trying; it's been looked at several times in the last two years. Here are some more studies for you, three of at least six that I am aware of:

Circumcision status and HIV infection among MSM: reanalysis of a Phase II HIV vaccine clinical trial. Gust DA, Wiegand RE, Kretsinger K, Sansom S, Kimarx PH, Bartholow BN, Chen RT. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. AIDS Feb 2010


Controlling for demographic characteristics and risk behaviors, in the model that included unprotected insertive anal sex, being uncircumcised was not associated with incident HIV infection.Millett G et al. Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men: a meta-analysis. Journal of the American Medical Association 300(14):1674-1684, 2008. <- This study involved 53,000 men.

Millett GA et al. Circumcision status and HIV infection among Black and Latino men who have sex with men in 3 US cities. JAIDS 46 (5): 643-650, 2007.

Temptleton DJ et al. Circumcision status and risk of HIV seroconversion in the HIM cohort of homosexually active men in Sydney. Fourth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, abstract WEAC103, Sydney, 2007.

Never fear though Gana, I am sure they'll eventually find some combination that demonstrates protection. As has been said, "If your results are bad, ask the computer to go back and see if any particular subgroups behaved differently. You might find that your drug works very well in Chinese women aged fifty-two to sixty-one."



I said the UN studies were good because they had large sample sizes. You responded with a study coming to opposite conclusions from the UN. I asked you if this large study of yours was self-reporting, because self-reporting results on STIs are inherently unreliable because many people don't know what they have.

You failed to respond to my question. I wonder why? I googled this study, found it on cirp.org. It turns out this large study relied completely on self-reporting. So I think we can safely say your large numbers study which relies on self-reporting is inferior to and superceded by the UN studies, which have large numbers and doctor examinations.


To which I responded that some of the conclusions of the large Australian study of 10,000 were reinforced by the studies in Africa:

See:

Adult Male Circumcision Does Not Reduce the Risk of Incident Neisseria gonorrhoeae, Chlamydia trachonmatis, or Trichomonas vaginalis Infection: Results from a Randomized, Controlled Trial in Kenya.

The study you posted in support of HPV and HSV:

http://content.nejm.org/cgi/content/short/360/13/1298

also noted that:


However, no significant difference between the two study groups was observed in the incidence of syphilis.which was a result also concluded in the Australian study of over 10,000 individuals. So despite the fact that you consider it "inferior" it arrived at similar conclusions for most of the STDs both studies looked at.

To be continued.

[Fellow Traveler]

As for the other two seriological studies, I ask you, do they have large sample sizes and randomly assigned control groups? I await your answer.

Reynolds SJ, Shepherd ME, Risbud AR, et al. Male circumcision and risk of HIV-1 and other sexually transmitted disease in India. Lancet 2004

Looked at a clinic population in India and tested serologically I can't remember the size of the sample, it's been a long time since I've dug that one up.

Dickson, Nigel MB, FAFPHM; van Roode, Thea MSc; Paul, Charlotte MB, PhD Hepes Simplex Virus Type 2 Status at Age 26 Is Not Related to Early Circumcision in a Birth Cohort Sexually Transmitted Diseases: August 2005 - Volume 32 - Issue 8 - pp 517-519

A cohort study of 400 individuals over more than 26 years. They noted that their (Dickson's) results are in line with the following large cross-sectional:

Richters J, Smith AMA, de Visser RO, et al.
Circumcision in Australia: prevalence and effects on sexual health. Int J STD AIDS 2006

Laumann EO, Masi CM, Zuckerman EW.
Circumcision in the United States: prevalence, prophylactic effects, and sexual practice.
JAMA 1997

Dave SS, Johnson AM, Fenton KA, et al. Male Circumcision in Britain: findings from a national probability sample survey. Sex Trans Infect 2003;79:499-500.

These studies involved over >15,000 men. And while the question of 'self-report' is important, the larger the numbers the more accurate the results become. In a subsequent paper on this issue, Circumcision and Risk of Sexually Transmitted Infections in a Birth Cohort Nigel P. Dickson, FRACP, Thea Van Roode, MSC, Peter Herbison, MSC, and Charlotte Paul, PhD J Pediatr 2008;152:383-7. DOI: 10.1016/ j.jpeds. 2007.07.044, Dickson noted:


Self reports of STIs were used [for the large studies just mentioned], which could have resulted in an underestimate of total rates. For self-reporting to hide a protective effect of circumcision, the men who were uncircumcised would have to have had a higher proportion of STIs unrecognized or unreported. Although unlikely, we explored the possibility with our data on herpes simplex virus-2 seroprevalence at age 32 years and responses to a question asked at age 32 years about whether they had ever had genital herpes. Men who were uncircumcised did not have a higher proportion of unrecognized infections; 60% of the circumcised men and 56% of the uncircumcised men with serologic evidence of herpes simplex virus-2 infection did not report a past infection.So while self-report can result in under reporting, to hide a protective effect both groups would have to under report. That doesn't seem to be the case with the Dickson cohort and there is no reason to believe that would be the case with any of these larger studies. And there are some more studies beyond the ones listed. As far as I know studies that show a small protective effect include the one you posted, one cross-sectional, one cohort, and possibly one nested case control study. This is still an open question but it seems that if there is any effect, it's a small one.



I'm not here to knock the vaccine. But if I remember right there are hundreds of variations of HPV, Gardasil directly protects 4 and is pretty good for 10 others. That's not bad, but it's not perfect. As I'm sure you know, prevnar was supposed to wipe out certain types of pneumonia. Instead, new strains became more prevalent so now there's prevnar-13. Maybe 10 years from nohttp://www.bubhub.com.au/community/forums/newreply.php?do=newreply&p=4662986w there will be prevnar-65.

There are hundreds of variations but only about a dozen are considered oncological. If you actually knew something about HPV you might know that. There is also no evidence or reason to believe that one strain will take the place of another. Both of these questions are addressed here (http://www.medscape.com/viewarticle/563089).


Dr. Brown expressed skepticism: "When one looks at situations where there has been replacement or niche filling, these have been pathogens in which mutation is frequent and likely to occur, for example, streptococcus," he said. "In contrast, HPV has a very stable genome and replicates at about the same rate as the human genome.Finally, for strains that are not directly covered by this version of Gardasil, Merck (http://www.merck.com/newsroom/news-release-archive/financial/2008_1209.html) already has a Phase III clinical trial in progress for a supplemental vaccine which would cover HPV-31, -33, -45, -52 and -58. They expect to license it by 2012.



The point, which you should admit, is that Gardasil + circ >>> Gardasil alone.

The problem here is that the term 'circ' provides little additional protection. That term is simply very small.

[Fellow Traveler]

I want to address this point because I think fellowtraveler is oversimplifying a complex issue because he doesn't understand it.

In an earlier post, you said that female to male HIV transmission rate is 2000 to 1, which is absolutely ludicrous given the rate that AIDS has spread in Africa through heterosexual activity. You later changed it to 1,000 to 1 as you apparently realized how ludicrous 2,000 to is, but you're still way off.


It's not ludicrous I've provided you with two references that have studied this, go back and check them. I have seen a range of values from about 1/1000 to 1/2500 in most literature. Tell me if HIV spreads so fast in Africa and that is your reason for believing that HIV is much more infectious than I, and much literature state, then why is the prevalence of HIV in Australia 0.2%, in most of Europe between 0.1% and 0.3% and in the US 0.6%? Why has it not spread in any other part of the world the way it has spread there?



In Africa, where there's a high rate of herpes, other diseases, other STIs (basically a lot of confounding factors), the rate of HIV transmission through hetero sex is going to be very high, especially since AIDS is so prevalent in Africa.

Post some figures on the rates of herpes in sub-Saharan Africa please.



Australia already has a high rate of herpes. Fortunately we don't have a high rate of HIV as in Africa. But if HIV ever gets a foothold here, then with the huge number of herpes cases which is growing ever larger, the rate of transmission of HIV through hetero sex is not going to be 1,000 to 1, it'll be a much higher rate of transmission.


HIV has been circulating for well over 30 years, there is not likely to be any kind of a heterosexual epidemic outside Africa. It would have developed by now. In fact, last year a report (http://www.independent.co.uk/life-style/health-and-families/health-news/threat-of-world-aids-pandemic-among-heterosexuals-is-over-report-admits-842478.html) was issued saying as much.


Dr De ****, an epidemiologist who has spent much of his career leading the battle against the disease, said understanding of the threat posed by the virus had changed. Whereas once it was seen as a risk to populations everywhere, it was now recognised that, outside sub-Saharan Africa, it was confined to high-risk groups including men who have sex with men, injecting drug users, and sex workers and their clients. Dr De **** said: "It is very unlikely there will be a heterosexual epidemic in other countries."




doesn't that make communicating safesex, condoms, abstinence message much harder, and argue for RIC which does not incur communication barriers?


No because you could people could misinterpret the very limited protection circumcision may offer them. Better to develop programs to give them the correct information in their own language at the appropriate age.



Well if you're worried about prison sex, you cited an article which said circ. lowers HIV transmission through homo anal sex.

So you're basically making an argument for circ. for blacks and hispanics.

Actually go back and read my previous post, there has been no demonstrated efficiency in MSM. Prisons have many times the rate of HIV that the general population has too.

[Fellow Traveler]

you highlighted Africa as if UNAIDS only supports circ. in Africa. that's actually not true. if you had read the link, it says that circ. should be universal.


Here is what they say regarding places like Australia:


In settings with lower HIV prevalence in the general population, including where HIV infection is concentrated in specific populations at higher risk of HIV exposure, such as sex workers, injecting drug users or men who have sex with men, limited public health benefit would result from promoting male circumcision in the general population. However, there may be individual benefit for men at higher risk of heterosexually acquired HIV infection such as men in sero-discordant partnerships and clients presenting at clinics for the management of sexually transmitted infections.So no, they don't say circumcision should be universal, Gana you're lying.



do you really think i'm not at all informed :rolleyes:


Yes.



the UNAIDS pages mention all 3 african studies repeatedly endorsing them. your studies, on the other hand, are never mentioned by UNAIDS. the results of your studies are explicitly rejected.


If it doesn't say so in the text Gana, they didn't explicitly reject it.



You are wrong again and again. You have every right to advocate your position, but it's wrong to lie to people tricking them. The statement of UNAIDS is not equivocal, it is not limited to Africa. Here's their exact words.


I am not wrong see quote above.



you're wrong again. RACP says parents choice. UNAIDS favors RIC as shown above.


As cowardly nod to religion but they also state there are no medical reasons for routine circumcision.



I think it's a pity you think it's OK to affect people's lives, decisions and health with deception.

I have not deceived anyone. I encourage them to verify my information with their doctor and that is that there are no practical reasons to circumcise healthy children. Nearly all come back telling me the doctor confirmed the information I gave them.

[Guest]

Gana,
I think calling people liars for posting credible information is quite offensive to anyone who chooses not to circumcise based on relevant information.
You are very much into your own studies, but there are studies that contradict these also. You should aknowledge that and understand there are pros and cons and it depends on you which you choose to look at more.
Saying you will raise your children to look at the truth, the truth is what ‘you’ believe it to be. You yourself have admitted you circed yourself as an adult. You had that previledge to decide for yourself what the right thing was to do. And only after you did, you’ve also said you started to research medical benefits, your reasons for circing your self weren’t based on any study you are posting but for your own personal hygeine. You also have given yourself the dignity to research what is best for yourself and are giving your views to your children. However, I believe children grow up to be adults and have their own ideas and belief systems, they to will have the tools to know what the right thing is for them. You are taking away that choice and applying your beliefs on your children. This is fine, however, it invloves their body, a body they have a right to, and a right to decide what and how it should ‘look’ and whether they want to permamentl modify it based on the information out there. You had that previledge, why can’t all children have the same previledge?
Your reasons so far have been because it hurts alot more when your an adult, and are assuming it’s easier when your a baby and this is a common reason if not the only eason to do it in infancy and not when they’re older. But this does not change the fact that you are instilling your beliefs on what is best for their anatomy before they get the chance to decide for themselves what is best. This is something that is permanently modifying their body, alot of men who aren’t circed are quite happy to leave themselves intact and don’t have a problem. How do you know your sons won’t feel the same way, your assuming they will think and feel the way you do, but they will be their own person, not an image of you completely. You also post alot of assumptions, like all men who aren’t circed have problems and men who are circed don’t, you yourself have said you’ve based this knoweldge on what family and friends tell you, too many assumptions and self beliefs to justify your pov and why you circumcised yourself after the fact.
All the studies you post are relevant to adults, not babies. So an adult should have the dignity to decide for themselves if they believe in this or not and research it for themselves as you do. Perhaps they would choose to circumcise anyway, perhaps not, but I believe all people should have a right to their body, not just because mum and dad think I should have this permanent procedure done. This is not a medical decision your making based on neccesity, only preventative (which are shown in this country to be small) or its easier when they’re babies or if they aren’t circed they will ‘definately’ have a problem or be unclean.
All the studies you post about African studies are not relevant in Australia, and this is clearly stated by Australian medical bodies. This is not a lie. Basing studies and information on benefits and these benefits having no relevance to this country or to children is extreme. There are different factors invloved in their continent and ours and why it may help them, but have no basis here, unless you are anticipating to live there, it’s irrelevlant to men living here. We have hygeine, access to medicine and education.
This is an Australian Parenting Website and any benefits listed are relevant to adults, not children so therefore it should be adults who should decide what is best for themselves.

[Father]

above post



The fact is. The Australian medical bodies ackowledge that there are benefits and ackowledge that parents CAN choose for their children. They might not recommend it "routinely", but the option is there. An option that parents have a right to choose if THEY think it is in their child's best interest. Fortunately, we live in a country where we still have choices.

[Father]

My point is MyBabyLeo. You can't have your cake If you respect the RACP's 'recommendation' in regard to ROUTINE circumcision, then you should also respect their stance that the parent can still choose if they deem it in their child's best interest.

You say that no 'medical association' recommends it routinely. I say that no 'medical association' says that parents can't choose it.

I am happy with both of those statements. It seems that you are only happy with half of their view.

[gana]

You have posted a single link, the same statement. Nobody is disagreeing with that unfortunate decision but it applies only to sub-Saharan Africa.

Here is the relevant statement (http://www.google.com/url?sa=t&source=web&ct=res&cd=2&ved=0CAwQFjAB&url=http%3A%2F%2Fwww.who.int%2Fhiv%2Fmediacentre%2 FMCrecommendations_en.pdf&rct=j&q=%22In+settings+with+lower+HIV+prevalence+in+the+ general+population%2C+including+where+HIV%22&ei=N7O_S_6bCYKC8gaTnPniDg&usg=AFQjCNG-qPXGIp-6Fyhr2ekotm7lyMfuBg):

you cut out one paragraph, leaving it in isolation to imply that UNAIDS does not endorse circ. in low prevalence AIDS countries, consistent with your general practice of providing half-truths to trick people into adopting your position.

what UNAIDS is advocating is rollout of circ. programs worldwide, prioritizing men of sexually active age in high risk areas first, followed by everyone else.

the document you cite is actually a blueprint for circ. rollout setting forth priorities, standards, emphasizing education on abstinence, safe sex, training for med workers on how to conduct circ. in safe and sterile settings.

here are some paragraphs you omitted, which refute your attempt to imply that UNAIDS is anti-circ in low risk areas.

"Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men."

"Global, regional and national level communication strategies need to ensure that clear and consistent messages are disseminated and that male circumcision is promoted within the context of comprehensive HIV prevention strategies."

"Parents who are responsible for providing consent, including for the circumcision of male infants, should be given sufficient information regarding the benefits and risks of the procedure in order to determine what is in the best interests of the child."

"Countries with other HIV epidemic situations [meaning non-hyperendemic] should carefully consider the potential impact that promoting male circumcision and expanding safe circumcision services will have on their HIV epidemic."


Here is what the French National Council on AIDS (http://www.cns.sante.fr/IMG/pdf/2007-05-24_rap_en_politique_internationale.pdf) said about this issue:

And once again your very own AFAO (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf) not to be out done:

So the bottom line here is that there is no practical value to those outside of some very specific contexts. There is no endorsement or recommendation for circumcision outside of Sub-Saharan Africa.

no, you are once again taking words out of context. WHO has recommended comprehensive programs for rollout of circ. in Africa. The French paper estimates the costs of such rollouts to be $22 billion. When the French paper says the "same measures are not applicable to Northern countries" they are saying it's not necessary to rollout a $22 billion circ. program. They're not saying circ. or RIC should be rejected out of hand.

You quote the AFO as rejecting an "intervention like a generalized circumcision programs" is again not a rejection of circ., it's a rejection of comprehensive circ. rollout/intervention. It's not a rejection of circ. or RIC, like you're trying to imply.

Nobody here has said first world countries should implement expensive interventionist, generalized circ rollouts. It's obviously a ridiculous return on investment.

These professional organizations put out carefully worded, nuanced, and balanced messages. You have to read them more carefully before you post. It hurts your already low credibility when you post obviously flawed interpretations of published position papers.


I am glad you brought up UTIs; in the RACP's last statement (http://www.racp.edu.au/index.cfm?objectid=B5606813-F174-8FA9-0522EE1FC3053078) they noted:

They noted that while there is a slightly reduced risk of UTI, after reviewing about 12 studies concluded that their review did not support the routine circumcision of normal boys with standard risk in order to prevent UTI and suggested that circumcision of boys with higher than normal risk of UTI should be considered.

I said circ. is useful for UTI. The studies you post agree with that. I'm not sure the point you're trying to prove on UTIs.


We already know how rare HIV infection is among heterosexual in Australia and we know that penile cancer is also extremely rare and will become more so with the introduction of Gardasil.

and it'll be even more rare with circ.


They note there are potential benefits but the benefits are trivial in most cases and don't outweigh the risk. That is what they say.

that's not what he said. this is what he said in the link you provided:

"The Colleges’ recent statement is not anti-circumcision, but clearly states that parents should be informed of risks and benefits, and then supported in their decision."


I don't know, you said: "and its effects wear off over time." Please provided evidence of this if you have it.

http://www.thehpvtest.com/About-HPV/HPV-Vaccine-FAQs.html

this link says it's only proven to last 5 years. if you have to get a booster every 5 years at the prices they charge, i'm sorry but it's not going to be a very successful vaccine.

and that's one of the advantages of circ. vaccines effectiveness can wear out, but circ is permanent protecton.

anyway, i'm not trying to knock gardasil. i'm just saying it's not perfect protection, it is expensive, it may wear out and that circ + gardasil is better.


You can still get it if you're over 26. The only reason they have a cut off is that it is believed it is a bit less effective if you've already been exposed. However for the vast majority of people exposure to HPV causes no problems anyway. This can be an option for anyone willing to pay for it at the end of the day. And while that might be a good excuse for you it's not for a child born today.

no thanks. it's got no effectiveness unless it's taken before you become sexually active. plus i don't really worry about penile cancer as a circ'd man


Nobody is doubting the results and it's not a question of "picking against" them. I don't doubt that the Yellow Fever vaccine (http://en.wikipedia.org/wiki/Yellow_fever_vaccine) is >90% effective but we don't get the Yellow Fever vaccine in the west because we don't need it. Likewise we shouldn't do circumcision in the west because it is equally pointless.

how can extra 35% protection against herpes in Australia or US be pointless? and really, in terms of diseases it's really important to avoid, AIDS ranks way up there. someone with AIDS is a modern day leper. there's nothing wrong with extra protection, nothing at all. plus the convenience and hygiene benefits are well worth it.


It is critical and the number who've refuses has fortunately not been that large (in most places). Those fears of autism were clearly unfounded to anyone paying attention.

i think you're wrong. MMR vaccination rates have dropped a lot. google it


Not my prediction, public health officials' prediction.

you were howling loud and clear in the chorus of wolf criers.


It's not clear to me that you do know what negligible means. Once again though, you confuse the issue. I'll try and make it as simple as I can for you:

If vaccination rates drop by more than five or 10 percent in the US or Australia, a disease like measles would become endemic again.

you tell me, what is the reduction in MMR vaccination rate due to the autism scare in Australia and US? so far, the only thing you told me is 16 sick kids in Cali so I'm not going to lose sleep over it.

i realize there is a tipping point on decreased vaccination rates at which point the disease makes a comeback. but even in england where the vaccination rate on MMR is real low, there haven't been that many deaths or serious disability as a percentage of the population, in fact I think it's close to 0. You do the research, it's your issue.

Also, I think this is an important lesson for you. This is what happens in the real world when people don't "do as they should" like you do. This is what happens when people follow the advice of unqualified quacks who dispense cruddy "expert" advice. This is what happens when people believe in questionable studies that are not endorsed by top experts, instead of rigorous studies conducted and peer reviewed by top experts. This is what happens when people don't listen to WHO, UNAIDS, and other top medical organizations.

And that's the beauty of circ. Even if my son doesn't do what he should and has unprotected sex with the wrong girls, he has a 60% shot of dodging a fatal HIV bullet and a 35% shot of not getting herpes.


If circumcision became rare in the US and finally snuffed out in Australia, HIV would not become endemic in the population, just like it's not endemic in Australia.

the speed at which HIV spreads depends on multiple confounding factors, one of which (herpes) is endemic in US and prevalent in Australia, is rapidly spreading, and is currently incurable. i read somewhere 50% of american black girls have herpes, 40% of american black men have herpes and AIDS is sky high in that portion of your population. that is a ticking AIDS time bomb in US.

it's easy for a guy like you who does what he should to play russian roulette with other people's lives by denying them the tools they need to save themselves. but i think it's irresponsible.


And again I wouldn't/don't support RIC in Africa. Unfortunately, medical ethics are important to me therefore they should allow individual men to make the decision for themselves. Even the ethics aside, it's a more practical approach if they really wish to reduce the risk of HIV.

well now you're going against the expert advice of UNAIDS and WHO. you're really no different than the unqualified quack who scared up the autism controversy on MMR. the expert advice is geared to save lives. you've already seen what happens when expert advice is not followed on measles, so why are you opposing expert advice on circ in Africa?


And Measles is more critical because it is an airborne disease which is highly infectious. Really, I shouldn't have to explain that to someone.

lives are lives. does it matter if they're save by MMR vaccine uptake or circ? i don't subscribe to your philosophy of save some lives and dump others.


Since that sheet was published, there has been no demonstrated protection for MSM. That lack of demonstrated benefit is not through lack of trying; it's been looked at several times in the last two years. Here are some more studies for you, three of at least six that I am aware of:

i don't know what you're talking about on MSM. it looks like you're referring to gay sex/circ studies. no thanks. if UNAIDS hasn't taken a position it means they're not sure yet, probably there are mixed results.

certainly the fake autism controversy has taught me to be wary of studies not endorsed by expert orgs like UNAIDS. hopefully, you too have learned this valuable lesson.


Never fear though Gana, I am sure they'll eventually find some combination that demonstrates protection. As has been said, "If your results are bad, ask the computer to go back and see if any particular subgroups behaved differently. You might find that your drug works very well in Chinese women aged fifty-two to sixty-one."

please don't lump me with people like yourself who twist and misrepresent studies and position papers to support their preconceived beliefs.

i am only interested in facts. i just want studies staffed by experts whose interest is to find the information they need to save lives. i want those studies to have plenty of funding so that doctors can be paid to monitor patients instead of unreliable self-reporting. i want those studies to have randomly assigned control group.

whatever information in those studies should be reviewed by top experts at top organizations. whatever the conclusion of the top experts on these studies, i want it published in an unbiased, factual manner.


To which I responded that some of the conclusions of the large Australian study of 10,000 were reinforced by the studies in Africa:

See:

Adult Male Circumcision Does Not Reduce the Risk of Incident Neisseria gonorrhoeae, Chlamydia trachonmatis, or Trichomonas vaginalis Infection: Results from a Randomized, Controlled Trial in Kenya.

The study you posted in support of HPV and HSV:

http://content.nejm.org/cgi/content/short/360/13/1298

also noted that:

which was a result also concluded in the Australian study of over 10,000 individuals. So despite the fact that you consider it "inferior" it arrived at similar conclusions for most of the STDs both studies looked at.

please pay attention. I NEVER SAID THE AFRICAN TRIALS FOUND CIRC TO PREVENT CHLAMYDIA OR GONORRHEA.

Furthermore, please stop comparing your inferior studies which are never cited by UNAIDS or WHO to the african trials, which have been deemed conclusive by everyone but you.

[gana]

These studies involved over >15,000 men. And while the question of 'self-report' is important, the larger the numbers the more accurate the results become.

I agree larger numbers are better. but I think you are underestimating how unreliable self-reporting on STDs is. This article on US herpes rates says 80% of herpes infected victims don't even know they have it. (http://www.cnn.com/2010/HEALTH/03/10/genital.herpes/index.html).


So while self-report can result in under reporting, to hide a protective effect both groups would have to under report. That doesn't seem to be the case with the Dickson cohort and there is no reason to believe that would be the case with any of these larger studies. And there are some more studies beyond the ones listed. As far as I know studies that show a small protective effect include the one you posted, one cross-sectional, one cohort, and possibly one nested case control study. This is still an open question but it seems that if there is any effect, it's a small one.

come on, you can't fudge data to correct 80% error factor.

i just don't see how these studies can be relied upon, especially now that the african trials, which don't have this problem are around.



There are hundreds of variations but only about a dozen are considered oncological. If you actually knew something about HPV you might know that. There is also no evidence or reason to believe that one strain will take the place of another. Both of these questions are addressed here (http://www.medscape.com/viewarticle/563089).

It seems like there's millions of flu strains. There's updated Prevnar for strains that are now becoming more prevalent. They can't make AIDS vaccines because it mutates so fast.

In light of all that, I'm supposed to believe you that Gardasil is just about 100% effective (even though it directly covers only 4 strains) and will remain 100% effective because no new strains will develop (contrary to evolutionary theory) when you've already admitted you're looking for anyway possible to undermine justification for circ?

I know you backed up your words by linking a study or article (which I can't access), but you also linked me a study that relied on self-reporting STIs which, in the case of herpes, has 80% error factor.

Furthermore, which among the hundreds of non-oncological strains cause genital warts, which concern me as much as cancer causing variation.

Honestly, I'd rather not worry about such things for me and my son. 30% from circ without having to get vaccine shots or pay for them is nice to have. Plus gardasil won't help me anyway, I'm too old and sexually experienced. Also, for me HPV protection is just icing on the cake as a benefit for circ.


Finally, for strains that are not directly covered by this version of Gardasil, Merck (http://www.merck.com/newsroom/news-release-archive/financial/2008_1209.html) already has a Phase III clinical trial in progress for a supplemental vaccine which would cover HPV-31, -33, -45, -52 and -58. They expect to license it by 2012.

that's good. so they'll cover 9 out hundreds of strains, leaving some oncological strains uncovered and who knows how many other genital wart causing strains.

still gardasil + supp. + circ >>> gardasil + supp.


The problem here is that the term 'circ' provides little additional protection. That term is simply very small.

what's the problem? it's still better. and HPV protection is just icing on the cake for herpes and HIV protection, for which there are no vaccines.

[gana]

Here is what they say regarding places like Australia:

So no, they don't say circumcision should be universal, Gana you're lying.

No FellowTraveler, my earlier post directly quotes several passages from the UNAIDS paper, which you cited, proving me correct. And you wrong.

Position papers by top orgs staffed by real experts on controversial issues are ALWAYS going to straddle both sides of the fence. They're going to toss out facts on studies that meet scientific standards for reliability, and then they're going to say individuals/countries choose. They are not going to expose themselves by making a choice for you.


Yes.

Then I'm the one eyed man in the land of the blind, because I've documented several inaccuracies in studies and position papers you've cited.


If it doesn't say so in the text Gana, they didn't explicitly reject it.

I said UNAIDS has rejected the "results" of the studies you cited.


I have not deceived anyone. I encourage them to verify my information with their doctor and that is that there are no practical reasons to circumcise healthy children. Nearly all come back telling me the doctor confirmed the information I gave them.

You have cited studies that disagree with the African trials, which are endorsed by all respected organizations, and failed to mention the severe methodological flaws in your studies, namely they are self-reporting on STIs.

You have claimed that various respected orgs, like RACP, WHO, UNAIDS are anti-RIC in first world countries, but when I read the ENTIRE statement, I find you selectively took out one sentence/paragraph ignoring the rest which completely contradicts your point.

Everything you and I have said is posted. Anyone can double check what has been said and confirm your numerous errors. If I am wrong, then anyone can check that as well and post it.

In any case, I hope to keep a civil and honest discussion with you. I am well aware that my knowledge is limited and my understanding of the science and math behind this is at very low, sucky level. I admit looking at real studies and scientific paper gives me a headache and I hate doing it. It's why I try to stick to parroting trusted experts who know more and are multiple standard deviations higher in IQ. It's why I cite newspaper articles. I don't mind my mistakes being pointed out. I'm happy to retract anything that is wrong. Accurate information for people reading this board is more important by far than my ego. But I don't like feeling that you are always trying to pull a fast one on me. I ask you respectfully and courteously to try to be more accurate and careful in what you post. Thanks.

[gana]

Gana you have put up some relevant and incredible arguements. Thanks for your arguements for all others may I suggest you stop refering to literature and speak to a doctor, someone that professionally understands if it needs to be done or not or is it just an incredible thing to do as a preventative measure.

Thanks for the kind words. I really appreciate it.


Personally I do not like the idea of RIC but I do think it needs to be done before he can decide for himself especially to prevent a situation where there is a problem that he is not able to talk about it and also the penis can not be any better off for having a foreskin that is a ridiculous notion if I have ever heard one.

I think it would be interesting to see what people think are benefits of the foreskin. Certainly I never got any benefit from mine.

[Father]

Hats off Gana.

You put together a very convincing argument.

[gana]

It's not ludicrous I've provided you with two references that have studied this, go back and check them. I have seen a range of values from about 1/1000 to 1/2500 in most literature. Tell me if HIV spreads so fast in Africa and that is your reason for believing that HIV is much more infectious than I, and much literature state, then why is the prevalence of HIV in Australia 0.2%, in most of Europe between 0.1% and 0.3% and in the US 0.6%? Why has it not spread in any other part of the world the way it has spread there?

Maybe I didn't word this right. Sorry on that.

What I mean is that any fixed figure for the rate of AIDS transmission is inappropriate. The reason is that hetero AIDS transmission seems to rely on so many factors, and many of these factors interconnect with each other in ways that accelerate the rate of transmission.

For example, imagine country A, everyone is healthy, everyone is hetero, everyone is circ'd, no one has HIV. If you introduce one hetero HIV infected woman to this country, she's not going to do a lot of damage. Maybe 1 of 1,000 hetero sexual encounters with this girl will cause AIDS.

Now imagine country B, everyone has herpes, everyone is hetero, everyone is circ'd, no one has HIV. If you introduce an HIV infected woman, she's going to do much more damage because herpes makes you far more vulnerable to HIV infection. Let's say 1 in 150.

Now imagine country C, everyone has herpes, everyone is bisexual, everyone is circ'd, no one has HIV. If you introduce HIV infected woman, she's going to infect a bunch of bisexual men thru hetero sex, and those bisexual men are going to infect other men at a higher rate thru gay sex, and those newly infected men will infect more women. herpes and bi-sex combine to transmit HIV far faster than either one would alone. Let's say transmission there is 1 in 60.

Now imagine country D, same as C, except nobody is circ'd. D will be, say, 1 in 10.

The point is the hetero transmission rates depend on how many confounding variables are present, how large the variable is, how tightly linked those variables are.

Africa has a lot more confounding variables in larger numbers and more tightly linked. So I agree the hetero transmission rates in Australia aren't going to be anywhere near Africa. But I would point out that we have 2 major confounding variables here which do make us more vulnerable, which is high herpes rate and low circ. rate.


Post some figures on the rates of herpes in sub-Saharan Africa please.

82% of women, 52% of men according to wiki (http://en.wikipedia.org/wiki/Epidemiology_of_herpes_simplex#Sub-Saharan_Africa)

this article says 30 to 70% of HIV infecteds have herpes, and 50 to 90% of African HIV infecteds have herpes (http://content.nejm.org/cgi/content/full/356/8/854)


HIV has been circulating for well over 30 years, there is not likely to be any kind of a heterosexual epidemic outside Africa. It would have developed by now. In fact, last year a report (http://www.independent.co.uk/life-style/health-and-families/health-news/threat-of-world-aids-pandemic-among-heterosexuals-is-over-report-admits-842478.html) was issued saying as much.

thanks for this excellent article. it's a good find. a lot of this article talks about how many variables are needed to up the rate of hetero AIDS transmission including circ. and herpes.

"'It is the question we are asked most often – why is the situation so bad in sub-Saharan Africa? It is a combination of factors – more commercial sex workers, more ulcerative sexually transmitted diseases, a young population and concurrent sexual partnerships.'

'Sexual behaviour is obviously important but it doesn't seem to explain [all] the differences between populations. Even if the total number of sexual partners [in sub-Saharan Africa] is no greater than in the UK, there seems to be a higher frequency of overlapping sexual partnerships creating sexual networks that, from an epidemiological point of view, are more efficient at spreading infection.'


Low rates of circumcision, which is protective, and high rates of genital herpes, which causes ulcers on the genitals through which the virus can enter the body, also contributed to Africa's heterosexual epidemic."


No because you could people could misinterpret the very limited protection circumcision may offer them. Better to develop programs to give them the correct information in their own language at the appropriate age.

so why can't you circ them AND give them appropriate instruction in their language?

Also, you know the article you linked says this:

"Critics of the global Aids strategy complain that vast sums are being spent educating people about the disease who are not at risk, when a far bigger impact could be achieved by targeting high-risk groups and focusing on interventions known to work, such as circumcision, which cuts the risk of infection by 60 per cent, and reducing the number of sexual partners."


Actually go back and read my previous post, there has been no demonstrated efficiency in MSM. Prisons have many times the rate of HIV that the general population has too.

I'm still not sure what you mean by MSM and I don't get the argument.

[Fellow Traveler]

you cut out one paragraph, leaving it in isolation to imply that UNAIDS does not endorse circ. in low prevalence AIDS countries, consistent with your general practice of providing half-truths to trick people into adopting your position.

what UNAIDS is advocating is rollout of circ. programs worldwide, prioritizing men of sexually active age in high risk areas first, followed by everyone else.


That is not an advocacy for world wide roll out of anything. They clearly said and the the situation in low prevalence countries is entirely different. And by not pointing that out and noting that the top HIV and pediatricians' organization in your country stated that the impact of circumcision on their population is and will be negligible (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf), you are the one who is lying.



"Countries with other HIV epidemic situations [meaning non-hyperendemic] should carefully consider the potential impact that promoting male circumcision and expanding safe circumcision services will have on their HIV epidemic."


And your country did do this Gana. As did the French, the British and many others. And you know what they said? They said in our countries circumcision would not provided a significant additional benefit (http://www.afao.org.au/library_docs/policy/BP09_Circumcision.pdf) to make it worth being promoted or the trouble.




You quote the AFO as rejecting an "intervention like a generalized circumcision programs" is again not a rejection of circ., it's a rejection of comprehensive circ. rollout/intervention. It's not a rejection of circ. or RIC, like you're trying to imply.


In those countries where HIV is not endemic and exists in specific populations, they reject promoting it as general practice and note that for most people any potential HIV benefit is marginal. That is what they say. The bottom line is that if (unfortunately) a parent circumcises, they shouldn't think it's going to change their son's risk more than a sliver; the benefit in the Australian context is negligible. Or said in another way, one should not circumcise in Australia thinking it's going to change their son's risk of HIV in any meaningful way.



Nobody here has said first world countries should implement expensive interventionist, generalized circ rollouts. It's obviously a ridiculous return on investment.

These professional organizations put out carefully worded, nuanced, and balanced messages. You have to read them more carefully before you post. It hurts your already low credibility when you post obviously flawed interpretations of published position papers.


I've read all those documents several times over the years. I know what they say and I know what they don't say. And they basically say there is no value with regard to HIV in promoting circumcision outside of some specific situations.


I said circ. is useful for UTI. The studies you post agree with that. I'm not sure the point you're trying to prove on UTIs.

They said it potentially reduces but for boys with standard risk there is no justification to circumcise the UTI benefit is marginal at best.



and it'll be even more rare with circ.

that's not what he said. this is what he said in the link you provided:

"The Colleges’ recent statement is not anti-circumcision, but clearly states that parents should be informed of risks and benefits, and then supported in their decision."


So then you agree that parents should be told that the college, and other researchers, have shown that while there may be a slight UTI benefit it is not enough to justify circumcision of boys with standard risk. Correct?

So then you agree that it is correct to point out that while some third world study has shown an HIV benefit, the medical authorities in Australia have deemed the benefit to be of negligible value to Australians. Correct?



http://www.thehpvtest.com/About-HPV/HPV-Vaccine-FAQs.html

this link says it's only proven to last 5 years. if you have to get a booster every 5 years at the prices they charge, i'm sorry but it's not going to be a very successful vaccine.

and that's one of the advantages of circ. vaccines effectiveness can wear out, but circ is permanent protecton.


Your link is out of date. As I've shown (http://www.medscape.com/viewarticle/716166) we're up to 6.4 years and going strong.



anyway, i'm not trying to knock gardasil. i'm just saying it's not perfect protection, it is expensive, it may wear out and that circ + gardasil is better.

...

no thanks. it's got no effectiveness unless it's taken before you become sexually active. plus i don't really worry about penile cancer as a circ'd man


Please do not lie Gana; it has less effectiveness not no effectiveness. And if I remember correctly even having less effectiveness, it was still more effective than circumcision.

And you should worry about penile cancer, circumcised men do get penile cancer see:

Outcome of Penile Cancer in Circumcised Men
The Journal of Urology, Volume 175, Issue 2, Pages 557-561 R. Seyam, N. Bissada, A. Mokhtar, W. Mourad, M. Aslam, N. Elkum, S. Kattan, K. Hanash

to start. Further, they are now looking at other cancers that Gardasil may provide protection for in both sexes. So I don't know why you wouldn't consider it, I mean wasn't it you who kept saying:


that circ + gardasil is better.

Surely that means it would be better for you too, so what are you waiting for?



how can extra 35% protection against herpes in Australia or US be pointless? and really, in terms of diseases it's really important to avoid, AIDS ranks way up there. someone with AIDS is a modern day leper. there's nothing wrong with extra protection, nothing at all. plus the convenience and hygiene benefits are well worth it.


You are lying again Gana. Please recall from the paper you sited that they measured only a 25% protective effect. The papers I cited have said no effect.

Further, if there is nothing wrong with extra protection, when are you going to get your Gardasil shot? Your Yellow Fever shot? Your Anthrax shot? Is extra protection only good for a body modification you had the dignity to choose for yourself and then took from your son?



Also, I think this is an important lesson for you. This is what happens in the real world when people don't "do as they should" like you do. This is what happens when people follow the advice of unqualified quacks who dispense cruddy "expert" advice. This is what happens when people believe in questionable studies that are not endorsed by top experts, instead of rigorous studies conducted and peer reviewed by top experts. This is what happens when people don't listen to WHO, UNAIDS, and other top medical organizations.


Gana, here is what your top experts have said for Australia.


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.

And that's the beauty of circ. Even if my son doesn't do what he should and has unprotected sex with the wrong girls, he has a 60% shot of dodging a fatal HIV bullet and a 35% shot of not getting herpes.

That isn't how it works. His odds are about 60% less than what they might have been. And 25% less than what they might have been. For example taking the figure from the AFAO you've might have decreased his lifetime odds of HIV by about one one-hundredths of a percent (0.01%). That is a trivial decrease, he is more likely to die in a plane crash.


men have herpes and AIDS is sky high in that portion of your population. that is a ticking AIDS time bomb in US.

But according to most experts there is no longer a concern for a generalized epidemic in most countries first world countries, or really those outside of Africa.



it's easy for a guy like you who does what he should to play russian roulette with other people's lives by denying them the tools they need to save themselves. but i think it's irresponsible.


I don't play Russian Roulette. I give people the true odds just like I gave you. The difference in HIV risk (according to your HIV organization) is negligible. Do you not believe in providing the facts from your top experts?



so why are you opposing expert advice on circ in Africa?


I oppose RIC. Adults can do what they like. They might find the risk reduction in Africa compelling. Similarly, you can tell an adult Australian that the reduction in HIV risk is on the order of hundredths or thousandths of a percent. Then they can decide.



i don't know what you're talking about on MSM. it looks like you're referring to gay sex/circ studies. no thanks. if UNAIDS hasn't taken a position it means they're not sure yet, probably there are mixed results.


The results aren't that mixed. They've had no less than six large studies in the last 2 years and all have pointed firmly and unequivocally to no benefit.



please don't lump me with people like yourself who twist and misrepresent studies and position papers to support their preconceived beliefs.

I haven't manipulated anything I've provided factual information particularly regarding the fact that the use of circumcision is not endorsed by top HIV/AIDS officials for the Australian population. They have weighed the evidence and found it not to be in anyway necessary.



i am only interested in facts. i just want studies staffed by experts whose interest is to find the information they need to save lives. i want those studies to have plenty of funding so that doctors can be paid to monitor patients instead of unreliable self-reporting. i want those studies to have randomly assigned control group.

whatever information in those studies should be reviewed by top experts at top organizations. whatever the conclusion of the top experts on these studies, i want it published in an unbiased, factual manner.


The top experts in Australia have said the circumcision is of little practical value in Australia.



please pay attention. I NEVER SAID THE AFRICAN TRIALS FOUND CIRC TO PREVENT CHLAMYDIA OR GONORRHEA.

Furthermore, please stop comparing your inferior studies which are never cited by UNAIDS or WHO to the african trials, which have been deemed conclusive by everyone but you.


A few things:

First, I don't care what you mentioned. I am going to point out all the things that circumcision can and can't do whether you've brought it up yet or not. Because at some point someone like yourself will try to do that.

Second, I will bring to bare whatever studies are available on the issue. I don't care what you think since I think people should be fully informed.

Third the 2007 policy you cite is based on the results of the three HIV trials and nothing more. The NEJM study you cite is from 2009 and the cohort study I site is from 2008 there is no firm position taken on effectiveness against any other STD and people should know that too.

Fourth, and let's not forget no protection for syphilis.

[Fellow Traveler]

No FellowTraveler, my earlier post directly quotes several passages from the UNAIDS paper, which you cited, proving me correct. And you wrong.


No, I am not wrong. There is nothing that states circumcision would be universally recommended and they explicitly state that the impact in low prevalence countries would be minimal.



Position papers by top orgs staffed by real experts on controversial issues are ALWAYS going to straddle both sides of the fence. They're going to toss out facts on studies that meet scientific standards for reliability, and then they're going to say individuals/countries choose. They are not going to expose themselves by making a choice for you.


The AFAO position didn't seem to me to be too fence sitting.



Then I'm the one eyed man in the land of the blind, because I've documented several inaccuracies in studies and position papers you've cited.


If you say so. :rolleyes:



I said UNAIDS has rejected the "results" of the studies you cited.

You have cited studies that disagree with the African trials, which are endorsed by all respected organizations, and failed to mention the severe methodological flaws in your studies, namely they are self-reporting on STIs.

And if you read the studies you would find that they were:

A. Not all are self-reporting, at least two tested seriologically.
B. The results of even the "self-reporting" studies have matched up with studies that you cite in Africa on several points.
C. Admittedly, none of those studies (that I recall) looked at HIV because its prevalence was too low to measure.



You have claimed that various respected orgs, like RACP, WHO, UNAIDS are anti-RIC in first world countries, but when I read the ENTIRE statement, I find you selectively took out one sentence/paragraph ignoring the rest which completely contradicts your point.


The RACP has stated that routine infant circumcision is not necessary. Which means there is insufficient evidence to promote it generally like say a vaccination.



Everything you and I have said is posted. Anyone can double check what has been said and confirm your numerous errors. If I am wrong, then anyone can check that as well and post it.

That's fine by me I have been nothing but accurate.



In any case, I hope to keep a civil and honest discussion with you. I am well aware that my knowledge is limited and my understanding of the science and math behind this is at very low, sucky level. I admit looking at real studies and scientific paper gives me a headache and I hate doing it. It's why I try to stick to parroting trusted experts who know more and are multiple standard deviations higher in IQ. It's why I cite newspaper articles. I don't mind my mistakes being pointed out. I'm happy to retract anything that is wrong. Accurate information for people reading this board is more important by far than my ego. But I don't like feeling that you are always trying to pull a fast one on me. I ask you respectfully and courteously to try to be more accurate and careful in what you post. Thanks.

I am not pulling any fast ones I have cited accurate studies and interpreted policy correctly. And I don't see where I have been less than accurate. You should never cite newspapers because they have biased they are the worst places to get information. And you always need read the studies and to look at context because that is important.

[Fellow Traveler]

Maybe I didn't word this right. Sorry on that.

Now imagine country D, same as C, except nobody is circ'd. D will be, say, 1 in 10.

The point is the hetero transmission rates depend on how many confounding variables are present, how large the variable is, how tightly linked those variables are.


Nobody has argued that there aren't co-founders. However, the Western countries with low rates of circumcision still have consistently low rates of HIV Europe, Australia, New Zealand, and Japan and many others. There are co-founders which clearly have more force that are at work in places like Africa, otherwise we would expect to see a similar epidemic elsewhere but yet we don't. Even in countries that are as poor as those in Africa the situation is very stable.


Africa has a lot more confounding variables in larger numbers and more tightly linked. So I agree the hetero transmission rates in Australia aren't going to be anywhere near Africa. But I would point out that we have 2 major confounding variables here which do make us more vulnerable, which is high herpes rate and low circ. rate.


Nobody is predicting even a modest change in the situation. As I've pointed out, the experts agree that a heterosexual epidemic outside of Africa is very unlikely. If you really want to know the major problem in Africa I'll give you a hint. If you ever travel to Africa don't get any kind of medical treatment anywhere. If you plan to stay for a long time bring your own supplies.



so why can't you circ them AND give them appropriate instruction in their language?


You can, if they're adults. But the order of operations should be give them the information and then let them decide if circumcision is right for them. If you wanted to do it ethically.



Also, you know the article you linked says this:

"Critics of the global Aids strategy complain that vast sums are being spent educating people about the disease who are not at risk, when a far bigger impact could be achieved by targeting high-risk groups and focusing on interventions known to work, such as circumcision, which cuts the risk of infection by 60 per cent, and reducing the number of sexual partners."


I would agree. Since infants aren't at risk, we should identify high risk adults and provide them the information and allow them to make an informed choice. In Australia that would be: MSMs and some heterosexuals who are in serodiscordant relationships. For MSMs you would have to say there is no benefit to circumcision demonstrated and someone who is married to a serodiscordant partner might want to consider it.

[susieq1969]

Personally I do not like the idea of RIC but I do think it needs to be done before he can decide for himself especially to prevent a situation where there is a problem that he is not able to talk about it and also the penis can not be any better off for having a foreskin that is a ridiculous notion if I have ever heard one.

I'm sorry but I completely disagree with this post!!! :no:

Male human beings were created with that foreskin, therefore it's there for a reason. How can you possibly say it's not!!!

And how many infants do you know walk around having sex!! Hmmmmm???

[Father]

The AFAO position didn't seem to me to be too fence sitting.


You do rely on the AFAO position a fair bit your argument.

When I read that document, the word that stands out at me is "consensus".
The word is used 3 times in the paper. They use it every time they make a statement on their stance on circumcision.

"On the basis of limited evidence there is no consensus to support the use of circumcision as a prevention strategy in the Australian epidemic."

"On the basis of limited, and potentially conflicting, evidence there is no consensus to support the use of circumcision as a prevention strategy in the Australian epidemic."

"This view is not currently supported by a consensus or statement from any organisation currently involved in Australia’s HIV partnership."

It seems to me the AFAO don't really know where they stand. They are still argueing internally and can't reach a consensus. So, in the meantime (due to conflicting evidence and debate) they can't support circumcision for HIV prevention.

This is a far cry from the way you read the paper. You are stating that they "don't support circumcision". This is not the case. They just can't reach a consensus to support circumcision.

[Leeee]

That has absolutely been said. They (intact) are "dirty", "strange looking"

lol i personally think all penises look strange, clean, dirty,circed or not.
i would like to point out one page within circinfo.net titled why are human males born with a foreskin:

"The foreskin plays a role during embryogenesis and development of the distal end of the penis, including the head (glans) and anterior aspect of the urethra [Schoen, 2007e]. Separation of the prepuce from the glans during development is completed in the 5th month of gestation [Diebert, 1933]. The foreskin has no role after birth. "

it goes on to speculate about possible (note- speculate about possible) uses, but scientific stuff-wise no use.

so if it's not gonna do anything and you can reduce risk of infection with a quick easy procedure while they're too young to have an objection, why not?

awesome thread btw. i would be in this section a lot more if it weren't so bloodthirsty and judgemental.

[kribby]

awesome thread btw. i would be in this section a lot more if it weren't so bloodthirsty and judgemental.

:laughing: :iagree:

[Guest]

lol i personally think all penises look strange, clean, dirty,circed or not.
i would like to point out one page within circinfo.net titled why are human males born with a foreskin:

"The foreskin plays a role during embryogenesis and development of the distal end of the penis, including the head (glans) and anterior aspect of the urethra [Schoen, 2007e]. Separation of the prepuce from the glans during development is completed in the 5th month of gestation [Diebert, 1933]. The foreskin has no role after birth. "

it goes on to speculate about possible (note- speculate about possible) uses, but scientific stuff-wise no use.

so if it's not gonna do anything and you can reduce risk of infection with a quick easy procedure while they're too young to have an objection, why not?

awesome thread btw. i would be in this section a lot more if it weren't so bloodthirsty and judgemental.
Circinfo.net is a pro circ website with alot of biased info. I wouldn't base an opinion on everything you read from there without researching other sources.

[Fellow Traveler]

You do rely on the AFAO position a fair bit your argument.

When I read that document, the word that stands out at me is "consensus".
The word is used 3 times in the paper. They use it every time they make a statement on their stance on circumcision.


Well they are the relevant agency in Australia, aren't they? On their front page they note that:


AFAO is the peak non-government organisation representing Australia's community-based response to HIV/AIDS.In any case, I think if you read the paper, you'll see why they actually took the trouble to publish it. It was because of the recent newspaper article (http://www.theaustralian.com.au/news/health-science/circumcision-can-curb-hiv-rates/story-e6frg8y6-1111118520896) by Wodak who was misrepresenting the situation in Australia regarding HIV. This statement was in direct response to that article as was this reply (http://www.theaustralian.com.au/news/health-science/circumcision-no-barrier-to-hiv/story-e6frg8y6-1111119114985) which gives a comprehensive break down. I found especially interesting that the average age of infection for heterosexual men was 46. Anyway the AFAO's original statement was here (http://www.afao.org.au/library_docs/policy/Circumcision07.pdf).


"On the basis of limited evidence there is no consensus to support the use of circumcision as a prevention strategy in the Australian epidemic."

"On the basis of limited, and potentially conflicting, evidence there is no consensus to support the use of circumcision as a prevention strategy in the Australian epidemic."


You'll note that these refer to the question of MSM. I'll add in the last 2 years there have been at least five reasonably large studies on this issue the results of which have been consistent and unidirectional. I've listed some of them earlier.



"This view is not currently supported by a consensus or statement from any organisation currently involved in Australia’s HIV partnership."


That is true, I suppose this view could change if they found that MSM could reduce their risk via circumcision. But after four or five fairly large studies, one that looked at data from about 53,000 men, it doesn't seem that this will be the case. If it was then the appropriate policy change would be to consider offering circumcision for men in those risk groups. I don't see how it would impact infants.



It seems to me the AFAO don't really know where they stand. They are still argueing internally and can't reach a consensus. So, in the meantime (due to conflicting evidence and debate) they can't support circumcision for HIV prevention.

This is a far cry from the way you read the paper. You are stating that they "don't support circumcision". This is not the case. They just can't reach a consensus to support circumcision.

I disagree it seems pretty clear to me where they stand on this issue if you're heterosexual, non-vi drug using male; I am not sure why you read it as you do. I do agree that they may not have decided on the MSM issue but even if they decide in favor of it, that doesn't affect infant boys. If they grow up to be homosexual and the AFAO says that homosexuals should consider circumcision then the individual can make that choice at that time.

And I don't just have to rely on their statement. As also noted by the French (http://www.cns.sante.fr/IMG/pdf/2007-05-24_rap_en_politique_internationale.pdf) and others who even bother to publish a statement.


The same measures are not applicable to the Northern countries. The recommendations of the WHO state that this strategy is aimed at countries with high prevalence, and not at countries with low prevalence or in countries where it relates specifically to one part of the population such as in France or the United States.As has been noted before the Yellow Fever vaccine works exceptionally well. But unless you're living in a few select places in the world we don't use it. We treat vaccinations this way, why do you treat circumcision differently?

[misskittyfantastico]

lol i personally think all penises look strange, clean, dirty,circed or not.
i would like to point out one page within circinfo.net titled why are human males born with a foreskin:

"The foreskin plays a role during embryogenesis and development of the distal end of the penis, including the head (glans) and anterior aspect of the urethra [Schoen, 2007e]. Separation of the prepuce from the glans during development is completed in the 5th month of gestation [Diebert, 1933]. The foreskin has no role after birth. "

it goes on to speculate about possible (note- speculate about possible) uses, but scientific stuff-wise no use.

so if it's not gonna do anything and you can reduce risk of infection with a quick easy procedure while they're too young to have an objection, why not?

awesome thread btw. i would be in this section a lot more if it weren't so bloodthirsty and judgemental.

Mpeg, the site circinfo.org counters many of the pro circ arguments found on circinfo.net

I see a foreskin like an eyelid. A healthy, functioning, normal forskin aids as protection, as a lubricant (I don't want to go into tmi territory, and lubricant isn't the right word, but it aids in lessening friction.

The biggest but but(!!!) I can say, is, that if you base a childs right of objection on how old they are? That's no good.

There is realms of info as to why RIC for an infant with a normal healthy penis is totally and completely unnecessary.

[Opinionated]

The fact is. The Australian medical bodies ackowledge that there are benefits and ackowledge that parents CAN choose for their children. They might not recommend it "routinely", but the option is there. An option that parents have a right to choose if THEY think it is in their child's best interest. Fortunately, we live in a country where we still have choices.

Not everyone has choices. A circumcised man who wishes he was intact has had his choice taken away.

[Father]

Anyway the AFAO's original statement was here (http://www.afao.org.au/library_docs/policy/Circumcision07.pdf).

Well I guess you're living in the past then. The original statement dated 23 July 2007.

Do you think that it supersedes their current one dated 9 Feb 2009 - "Updated briefing on the efficacy of circumcision as an HIV prevention strategy and its relevance to the Australian epidemic.?"

They have obviously changed their opinion since 2007 haven't they? You seem to have faith in their stance - why do you feel you have to dig up old material?

[Fellow Traveler]

Well I guess you're living in the past then. The original statement dated 23 July 2007.

Do you think that it supersedes their current one dated 9 Feb 2009 - "Updated briefing on the efficacy of circumcision as an HIV prevention strategy and its relevance to the Australian epidemic.?"

They have obviously changed their opinion since 2007 haven't they? You seem to have faith in their stance - why do you feel you have to dig up old material?

I do find it interesting that they issued the latter statement for the sole purpose of addressing the misrepresentations in the Wodak article, don't you?

I don't think it was to articulate an entirely new position. If Wodak (since he is so prominently mentioned) hadn't written that article it's not clear to me that they would have issued the second statement. Further, I actually don't find them substantially different. They are curious at the role of MSM but it seems quite clear to me what their position on heterosexual transmission in Australia is in both cases.

Are you disagreeing with the notion that they put forward, that circumcision has no practical role in the heterosexual Australian context?

[Father]

That site is widely disregarded by many medical authorities (that have been mentioned many times in this thread)

That claim has been made many times on here.
Do you have some statements from these medical authorities that actually say that? It would be great if you can provide me some links so that I can read them myself.

[sockstealingpoltergeist]

Pros: it makes sense if you are into amputating healthy body parts for no reason.

Cons: it makes no sense.


:)

[Father]

Thanks for changing the wording of your statement TabouliRasta.

[serendipity22]

The Australian medical bodies ackowledge that .... parents CAN choose for their children.

The trouble with these medical statements is that they are calculated to pander to anyone.

They deliberately use the weasel word 'routine'.
routine circumcision can either mean :
(1) All infants are circumcised
(2) The parents choose

Since when is a medical body in a position to judge whether parents can subject children to unnecessary surgery? They are just supporting the status quo,

Are doctors lawyers? No
Are doctors ethicists? No
They probably should be trained in ethics but they are not
Are doctors religious leaders? No
Are doctors authorities in morality or human rights? No

Seriously, they are in a weak position to make statements about moral judgements and if they had any courage, they would omit that statement.

I read a study in the 1960s that found many doctors circumcised all baby boys *without* the consent of the parents. The decision was passed to the parents ad hoc, in response to litigation in the 1970s.

There was no ethics or morality in this passing of power.

[Guest]

Serendepity22 I'm confused by what you mean. Can you explain it abit simpler 4 me plz :D

[Father]

In regard to the pros and cons of circumcision, this website looks to be quite unbiased from a neutral source.

There are six relatively short pages in total.

http://www.medicinenet.com/circumcision_the_medical_pros_and_cons/article.htm



MedicineNet.com is an online, healthcare media publishing company. It provides easy-to-read, in-depth, authoritative medical information for consumers via its robust, user-friendly, interactive web site. Since 1996, MedicineNet.com has had a highly accomplished, uniquely experienced team of qualified executives in the fields of medicine, healthcare, Internet technology, and business to bring you the most comprehensive, sought after healthcare information anywhere. Nationally recognized, Doctor-Produced by a network of over 70 U.S. Board Certified Physicians, MedicineNet.com is the trusted source for online health and medical information. The Doctors of MedicineNet are also proud to author Webster's New World™ Medical Dictionary First, Second and Third Editions (May, 2008) John Wiley & Sons, Inc.; ISBN-10: 0470189282.

[Opinionated]

I read your link Father. I think it is slanted towards the pro-circ position. Hardly surprising really given that a) it is a US site and b) you posted the link.
It offers no alternative treatment for phimosis other than surgery when there is effective and less extreme treatments which are available to try first. One thing though that the site did state was;

There is no absolute medical indication for routine circumcision of the newborn.

[serendipity22]

Serendepity22 I'm confused by what you mean. Can you explain it abit simpler 4 me plz

I will give an example. I saw a circumcision brochure produced by a US medical body which said its ok for parents to circumcise for family, religious, traditional or social reasons.

However doctors should be sticking to whats need for medical reasons. It is not their job to decide what is ethical for 'social' reasons etc, it is not their area.

Does that explain it a bit better?

[fairystar267]

I am a mum of 3 boys all intact, To be honest i must be really naieve as i had no idea people routinely circumsised babys? I thought it was a religious or medical precedure...
My dad and my DH is intact, everyone i have been out with was, my brother is, my sons are, my dh and his brothers are etc....
and none as far as i am aware and i have asked have had any UTI,s, thrush or anything at all.
I personally dont like the look of circ at all and upon asking my 2 older sons they have told me there is no way they would cut part of their skin for no reason, despite me telling them of the 'supposodly' benefits.
Nothing i have read on here has made me want to run out either and alter my toddler.
DH said why mess with soemthing that isnt broken ;)

IMPO i think it should be a medical procedure for genuine medical reasons only and for the person to decide when older if they want to pay to have the procedure for cosmetic or preventative reasons.

If i had a child who needed it done for medical reasons i would but i wouldnt then rush to get the rest done if it wasnt necessary.

I am not a facts persona nd all the scientific stuff is beyond me so i wouldnt even attempt to but from what i have read a lot of the studies for the benefits are in africa? not sure how that is relevant here.