An Interesting Australian Study

[Fellow Traveler]

The news blurb of a new from the Australian and New Zealand Journal of Public Health:

http://www.6minutes.com.au/articles/....asp?id=515210

Circumcision does not seem to be justified in the Australian context because it has no protective effect against STIs and does not reduce sexual difficulties, a major new study has found.

Thoughts?

[Father]

I would have to read the entire study. But that doesn't seem to be out.
It is self-reporting, which is a big limitation.

They say findings from a previous Australian survey that showed higher rates of sexual difficulties among uncircumcised men had been used in support of the procedure. However, the new study showed no such differences.

I wonder why???

author Dr Juliet Richters

I guess this is why. She is a vocal intactivist. Obviously her 'study' is going to point in the direction of her opinion. If you doubt her 'bias'. here is a quote of hers:

Yet circumcision can be seen rather as a sociocultural intervention with post hoc medical justification. As a form of body modification, it serves to exaggerate the visual difference between male and female. Reducing the ambiguity and untidiness of the penis turns it into a neat phallus more specifically fitted for what is seen as its purpose in a gendered sexual culture focused on coitus.

From her article "Circumcision and the Socially Imagined Sexual Body".

Using only the abstract, this statement screams issues:

reported lifetime experience of selected sexually transmissible infections (STIs)

Apparently, the study didn't even include HPV! Enough said.

[sockstealingpoltergeist]

Father innactivist is a non term. Fail.

It is the most laughable term used by pro cicers.

Try again.

[Fellow Traveler]

I would have to read the entire study. But that doesn't seem to be out.

It is available through the article.

It is self-reporting, which is a big limitation.

It is self reporting, and that can be a limitation but that would mean that either:

1. Individuals lied about an STD and receiving treatment.
2. Not realize they were infected and thus not reported it.
3. Misreport the infection they had.

1 could certainly happen but since it is over the phone I suspect it would be less likely than a face to face interview. 2 is not very likely most of these STDs make themselves known though some don't which is why men can't report on HPV. 3 is also possible, perhaps more than any other. For all of these things to hide a protective effect one population would have to do much more of lying, not recognizing, and misreporting. I find it difficult to believe that this would be the case. But it is true that there are limitations to self reporting.

On the other hand, it was a very large study. Not as large as the 10,000 man study in 2006 which made similar conclusions but respectable.

I wonder why???

Good question, any ideas?

I guess this is why. She is a vocal intactivist. Obviously her 'study' is going to point in the direction of her opinion. If you doubt her 'bias'. here is a quote of hers:

And Father would never accept research or read the websites of those with bias opinions on circumcision.

From her article "Circumcision and the Socially Imagined Sexual Body".

That was very insightful and it's one I've never read. I'll have to check it out.

Using only the abstract, this statement screams issues:

To save you the suspense they were:
Genital Warts, Chlamydia, Genital herpes, Gonorrhea, non-specific urethritis, Penile candidiasis, and pubic lice. Not sure what issue there is there.

Apparently, the study didn't even include HPV! Enough said.

Why is that, enough said? What do you mean?

[Father]

To save you the suspense they were:
Genital Warts, Chlamydia, Genital herpes, Gonorrhea, non-specific urethritis, Penile candidiasis, and pubic lice. Not sure what issue there is there.

Thanks for providing that.

Great selection. Lets go through them:

Warts - no argument
Chlamydia - no argument
Herpes - has been some argument, but not much in it
Gonorrhea - no argument
NSU - yep, less likely in the uncircumcised
Candidiasis - yep, less likely in the circumcised
Pubic lice - whatever. Glad they researched that one

It seems like a bit of a waste of those 4300 blokes time if you ask me. All the information was out there already. eg. this meta-analyses
http://www.ncbi.nlm.nih.gov/pubmed/16581731

This first systematic review of male circumcision and ulcerative STI strongly indicates that circumcised men are at lower risk of chancroid and syphilis. There is less association with HSV-2. Potential male circumcision interventions to reduce HIV in high risk populations may provide additional benefit by protecting against other STI.

So my point. They have chosen STI's that suit their ant-circ argument. I am surprised that they included candidiasis though.

Since you obviously have faith in this study, I guess then you will acknowledge their conclusion:

Circumcision was unrelated to any of the sexual difficulties we asked about (after adjusting for age) except that circumcised men were somewhat less likely to have worried during sex about whether their bodies looked unattractive (OR=0.77, p=0.04). No association between lack of circumcision and erection difficulties was detected.

This destroys some regular anti-circ comments that are thrown around here. I'm sure Opinionated won't agree with their conclusion.

[MotherNurture]

Apparently, the study didn't even include HPV! Enough said.

Um, if genital warts are included it *did* address HPV; Genital warts are caused by HPV.

[Fellow Traveler]

Thanks for providing that.

Great selection. Lets go through them:

Warts - no argument
Chlamydia - no argument
Herpes - has been some argument, but not much in it
Gonorrhea - no argument
NSU - yep, less likely in the uncircumcised
Candidiasis - yep, less likely in the circumcised
Pubic lice - whatever. Glad they researched that one

Ok. I am surprised they got to P.L. first though.

It seems like a bit of a waste of those 4300 blokes time if you ask me. All the information was out there already. eg. this meta-analyses
http://www.ncbi.nlm.nih.gov/pubmed/16581731

So my point. They have chosen STI's that suit their ant-circ argument. I am surprised that they included candidiasis though.

So which additional ones were you looking for that would not satisfy their argument? I am sure they could have ask about Chancroid. They did look at syphilis and HIV but found to few respondents; those diseases are too rare among heterosexuals. We do know that one of the "big" trials from Africa found no significant difference in rates of syphilis, it was rare there too. I am not surprised about candidiasis though, why wouldn't they include it?

Since you obviously have faith in this study, I guess then you will acknowledge their conclusion:

This destroys some regular anti-circ comments that are thrown around here. I'm sure Opinionated won't agree with their conclusion.

That sure is one of their conclusions but their most important conclusion is that there is no practical health benefit for Australians, and in all likelihood any first world country. And if there is no benefit of substance how can one justify it ethically?

I'll reiterate my previous question since you missed it, why is not including HPV a "big" deal?

[Fellow Traveler]

Um, if genital warts are included it *did* address HPV; Genital warts are caused by HPV.

Good pick up MotherNurture.

[MummaBear03]

There's such a thing as pubic lice???

[Father]

Um, if genital warts are included it *did* address HPV; Genital warts are caused by HPV.

A random google link for you:

http://www.cancerhelp.org.uk/type/ce...sks-and-causes

Some HPV types are called the ‘wart virus’ or ‘genital wart virus’ as they cause genital warts. The types of this virus that cause warts are not the same types that increase the risk of cervical cancer. But some types of HPV are considered 'high risk' for cancer of the cervix - they include types 16 and 18. If you have persistent or frequent infections with these 'high risk' types, you are more at risk of developing pre-cancerous cervical cells or cervical cancer than people who have not had these infections.

I'll reiterate my previous question since you missed it, why is not including HPV a "big" deal?

Because all their statements talked about STI's in a generic sense as though they studied them all......when they did not look at the most commonly transmitted STI. Rather convenient coming from an intactivist.