AIDS and Circumcision–The Bronze Bullet?
January 17, 2007 by Liz Lewis
Filed under Media, Sex, Technology, Treatment
Silver Bullet cures in medicine are as rare as clichés that aren’t over–used. But that hasn’t stopped the pharmaceutical industry from charging after them like a fat kid going after cake. Where’s all this tongue-in-cheek talk leading to? Right to the tip of your penis or one close to you, anyway.
The AIDS vaccine that researchers would give their eye-teeth for simply isn’t coming in 3 to 5 years like we are all told every, oh, 3 to 5 years. (The truth is that 3 to 5 years is how long most research grants can last without coming up with results.)
When/if it does ever get here it won’t be nearly as good as we think. Education, circumcision and other boring methods are the real answer to controling this virus. At least that’s what Tina Rosenberg, New York Times contributer, thinks, and I tend to agree with her.
The vaccine that arrived last month was not actually a vaccine. It was, instead, a confirmation of what scientists had long suspected: circumcision helps protect men from AIDS infection. For years, AIDS researchers have observed that many African tribes that circumcise boys or young men had lower AIDS rates than those that don’t, and that Africa’s Muslim nations, where circumcision is near universal, had far fewer AIDS cases than predominantly Christian ones. The first research proof came in 2005, when a study in South Africa was stopped early in the face of evidence that the men who had been randomly assigned to be circumcised were getting 60 percent fewer H.I.V. infections than the men assigned to the control group. Last month, ethics boards halted two similar studies, in Uganda and Kenya, when they found similar results. In both, the circumcised men caught the AIDS virus half as often as the uncircumcised control group…
…An efficacy rate of 50 to 60 percent is actually a lot better than it sounds, because of herd immunity. We get AIDS from one another. Every time a person is rendered less infectious, the chance of an uninfected person catching H.I.V. from each sexual contact drops, and in a virtuous circle, the whole community becomes progressively safer. A vaccine of 50 to 60 percent efficacy might come close to wiping out the epidemic in places with low AIDS rates. In high-prevalence areas, it could reduce the epidemic and save millions of lives.
A Real–World AIDS Vaccine – NYT
There are many studies and circumstatances suggesting circumcision is not even a bronze, but a paper bullet against HIV/AIDS. The latest studies have not yet been published in peer-reviewed journals and thoroughly critiqued before the authors have raced to the media. The effect of surgery itself curtalling sex during studies that were all themselves cut short has not been properly corrected for. The danger of circumcised men thinking they are immune has not been properly measured. Male circumcision provides no protection to women, who are in much greater danger of infection in Africa. In some of the countries with higher HIV rates, circumcision is already near-universal.
There are many confounding factors, such as widow inheritance (often involving ceremonial unprotected sex with male relations, when the husband died of AIDS complications, then the abandonment of the widow, who is forced into prostitution), “dry sex” (herbs in the vagina, creating microscopic abrasions), unknown rates of same-sex activity, and the sharing of needles and instruments in medical procedures.
Circumcision has been a “cure” looking for a disease for nearly 150 years. It was inevitable that it should latch on to HIV/AIDS. Let men who want part of their penis cut off try that if they wish, but it is still a human rights abuse of babies.
Yeah, but I found the absolute perfect picture for the post, right?
But seriously…
It’s been looking for a cure a lot longer than 150 years unless the copyright on my old testament is all wrong.
You raise a lot of good points which are almost all addressed in the original article. That’s why I linked to it.
As for the cultural, er, complications of the disease spreading (Your widow situation), that’s where the education part comes in.
I was distinguishing ancient ritual from modern medicine: we know cave men drilled holes in their skulls, but we don’t call it brain surgery.
The NYT article is uncritical advocacy. Circumcision has markedly failed to prevent HIV in the US (compared to uncircumcising Europe) and in Ghana, Cameroon, Rwanda, Lesotho, Tanzania and Malawi, where higher proportions of circumcised than intact men have HIV. At the very least, more work needs to be done.
Telling men “circumcision protects men against AIDS, but it won’t protect *you* so keep on using the condoms [if they can be obtained, because X church says they're sinful]” is about as mixed a message as you could imagine, the reverse of education. And it is going to make women less able to refuse (unprotected) sex, disempowering them.