It's official -- it's best to get cut, boys

[Asher]

Originally posted by lord of the mark
Yes, but their conclusion is NOT to avoid marketing circumcision, but to do so as part of an integrated strategy.

I dunno ace, it sounds to me like it was a caution...

Hmm. Come to think of it, I guess that's what I said?

The quote says circumcision "most effective" at preventing HIV with condom use, true, but that's not the same as saying it should be marketed as a solution. Comprende?

[lord of the mark]

"Adult male circumcision will be most effective when integrated into a comprehensive prevention strategy which includes the ABCs (Abstinence, Be Faithful, and Condoms) of HIV prevention."

Its a caution to use it as part of an integrated strategy. Not a caution against encouraging it at all.

If all youre saying is that it shouldnt be used apart from an integrated strategy, and that experts caution that it shouldnt be used apart from an integrated strategy, I heartily agree with you.

[Asher]

Originally posted by lord of the mark
Its a caution to use it as part of an integrated strategy. Not a caution against encouraging it at all.

If all youre saying is that it shouldnt be used apart from an integrated strategy, and that experts caution that it shouldnt be used apart from an integrated strategy, I heartily agree with you.

You are, once again, missing the point. The point is if you start telling people circumcision reduces HIV transmission rates, fewer people are going to be motivated to use a condom every time. It's a simple fact of humanity, mentioned in my above quote.

Then when you take into account the fact that when using a condom the HIV transmission rates are extremely remote to the man anyway, the benefits of such a procedure are extremely slim in real terms, and are offset by the chance of complications.

[lord of the mark]

Originally posted by Asher

I dunno ace, it sounds to me like it was a caution...

Hmm. Come to think of it, I guess that's what I said?

The quote says circumcision "most effective" at preventing HIV with condom use, true, but that's not the same as saying it should be marketed as a solution. Comprende?

"Adult male circumcision will be most effective when integrated into a comprehensive prevention strategy "

If you read "strategy" as an individuals strategy, then yes. If you read "Strategy" as referring to a public health strategy, than it would imply that AMC will be effective as part of a public health strategy, which to me would mean promoting it in some fashion.

At most I will admit the statement is ambiguous. We will have to await fuller info, I suppose.

But if AMC is bad, cause it disincents condom use, why did the researchers feel it was ethically incumbent to end the research? After all, the uncirced guys were SAFER, since they had the incentive to use condoms.

[lord of the mark]

Originally posted by Asher

You are, once again, missing the point. The point is if you start telling people circumcision reduces HIV transmission rates, fewer people are going to be motivated to use a condom every time. It's a simple fact of humanity, mentioned in my above quote.

Then why did they stop the study? Why did uncirced guys in the study contract HIV? The reality is that plenty of African men DONT use condoms, and many who do so incorrectly, and that (as DR SL here has said) education campaigns dont generate universal condom use, and that has to be weighed against the speculated disincentive effect.

[Asher]

Originally posted by lord of the mark

"Adult male circumcision will be most effective when integrated into a comprehensive prevention strategy "

If you read "strategy" as an individuals strategy, then yes. If you read "Strategy" as referring to a public health strategy, than it would imply that AMC will be effective as part of a public health strategy, which to me would mean promoting it in some fashion.

This is a case of you reading your wishes into a statement that says no thing.

It's saying circumcision alone is not a good prevention of HIV, and that it must be used with other methods (well, duh).

But if AMC is bad, cause it disincents condom use, why did the researchers feel it was ethically incumbent to end the research? After all, the uncirced guys were SAFER, since they had the incentive to use condoms.

Your tendancy for strawmen is grating. No one said it is SAFER. In fact I believe I have said about a dozen times in this thread that with condom use, there's no real difference.

People can get their dicks crippled if they want. The problem I have is when we have authority figures (parents, or government) deciding to do this to other people's bodies. I further have a problem with it when people keep championing this practice as a way to realistically prevent HIV. Here's a very important reminder: You still have a VERY good chance of getting HIV while circumcised and having unsafe sex. But, this is what is happening anyway in Africa.

You may be okay with spending TONS of money to give Africans operations by shady people in shady clinics, but to me it's just one more reason for these people to not use a condom -- and they have a hard enough time knowing to use them anyway.

And as for why they decided to end the research, I'd imagine it has to do with the amount of unprotected sex going on among their subjects which alters the situation considerably.

[Asher]

Originally posted by lord of the mark
Then why did they stop the study? Why did uncirced guys in the study contract HIV?

You seem to imply that circumcised people didn't, which is VERY false.

The reality is that plenty of African men DONT use condoms, and many who do so incorrectly, and that (as DR SL here has said) education campaigns dont generate universal condom use, and that has to be weighed against the speculated disincentive effect.

YES. Very good!

Africans are not using condoms enough as they should. But if these people are having regular unprotected sex, circumcision or not they're going to contract HIV eventually in Africa. That's a simple fact.

As such, marketing circumcision as a way to prevent HIV is one more thing that these people will weigh in their mind against using a condom. After all, part of the reason condoms aren't used is the lack of sensation.

Do you really think after you remove most of the nerve endings in the penis that produce sensation, these men are going to still want to throw a layer of latex on top of it? That reduces the sensation even farther.

I really don't care what some lab rat scientist thinks about this, from a sociological perspective it's just a bad idea to market this as a way to prevent HIV.

[lord of the mark]

Originally posted by Asher

And as for why they decided to end the research, I'd imagine it has to do with the amount of unprotected sex going on among their subjects which alters the situation considerably.

They didnt end the study when they found out unprotected sex was going on, but when they found that circ made a diff. IF circ incents unsafe sex, then the uncirced guys will practive even MORE unsafe sex after being circed, and so will be LESS safe after being circed. Ergo, there should have been no reason to end the study. I mean circ is either a net increase in safety, after accounting for incentive effects, or a net decrease. Why would it be a net increase for this group, but a net decrease for the broader population?

[Asher]

Originally posted by lord of the mark
They didnt end the study when they found out unprotected sex was going on, but when they found that circ made a diff. IF circ incents unsafe sex, then the uncirced guys will practive even MORE unsafe sex after being circed, and so will be LESS safe after being circed. Ergo, there should have been no reason to end the study. I mean circ is either a net increase in safety, after accounting for incentive effects, or a net decrease. Why would it be a net increase for this group, but a net decrease for the broader population?

Because this group of people was given many lectures on safe sex and are far more educated on the matter than most Africans.

[lord of the mark]

[QUOTE] Originally posted by Asher

You seem to imply that circumcised people didn't, which is VERY false.

LOTM, no Im implying that circed men do so cause of the incentive effect, but that uncirced men, who have no such incentive effect, should not be. Obviously thats a straw man, but its to indicate the implications of what youre saying. That promoting circ is bad cause condoms eliminate the threat from HIV - they dont, cause the reality is that UNCIRCED as well as circed men in africa dont use them close to universally.


YES. Very good!

"Africans are not using condoms enough as they should. But if these people are having regular unprotected sex, circumcision or not they're going to contract HIV eventually in Africa. That's a simple fact. "

Depends on how often. Its a crap shoot each time.

"As such, marketing circumcision as a way to prevent HIV is one more thing that these people will weigh in their mind against using a condom. After all, part of the reason condoms aren't used is the lack of sensation.

Do you really think after you remove most of the nerve endings in the penis that produce sensation, these men are going to still want to throw a layer of latex on top of it? That reduces the sensation even farther."

Are rates of condom usage significantly higher among uncirced than circed gay men in North America? Any studies?

"I really don't care what some lab rat scientist thinks about this, from a sociological perspective it's just a bad idea to market this as a way to prevent HIV. "

AFAICT its the public health officials too. Who presumably know the sociology at least as well you do.

[lord of the mark]

Originally posted by Asher

Because this group of people was given many lectures on safe sex and are far more educated on the matter than most Africans.

And yet still practiced unsafe sex.

[Asher]

I'm also very interested in the real numbers of this study, not percentages. I find it very curious they are not being released.

[lord of the mark]

Originally posted by Asher

Because this group of people was given many lectures on safe sex and are far more educated on the matter than most Africans.

so if you take a group that HAS been educated on safe sex, for THAT group circumcision makes them safer? That seems like an argument for an integrated approach.

[Cort Haus]

If LOTM is an Uber-Jew, does this make Asher an Uber-Gay?

[Asher]

Originally posted by lord of the mark
Are rates of condom usage significantly higher among uncirced than circed gay men in North America? Any studies?

What's important would be after circumcision. No, I don't believe there are any studies. But I do know the main complaint about not using condoms is decreased sensation.

I also know when you remove most of the sensation from the penis, men are likely to be more discouraged about using a condom to further dullen the sensation when they are comparing this to their previous experiences.

AFAICT its the public health officials too. Who presumably know the sociology at least as well you do.

Care to quote a public health official?

'cause all of the public health officials I know of do not recommend routine circumcisions, either here or in Africa. Just ask the pediatric societies of the world.