Don't Get Stuck With HIV

Protect yourself from HIV during healthcare and cosmetic services

Circumcise? An absurd response to HIV epidemics driven by unsafe healthcare

[This introductory page links to other pages: Intact men have less HIV in many African countries! — Circ’ing and HIV outside Africa – Observed new HIV infections in intact vs. circumcised men – Critique of 3 trials of circ to protect men – Boys and men harmed by circ’ing — Impact of male circumcision on women’s HIV risk — Some anti-circ resources — Plans to circ millions, achievements falling short. But if you want to get circ’dhere’s how to ensure you don’t get HIV from the procedure.]

Bloodborne transmission drives Africa’s HIV epidemics

For more than 33 years, beginning with the first tests for HIV in Africa, evidence shows that healthcare likely infects as many or more Africans as does sex.[1,2] Public health agencies from WHO to Africa’s ministries of health have chosen to ignore the evidence, have not cleaned up health care, and have instead accused HIV-positive people of sexual misbehavior. As healthcare facilities continued to infect patients, Africa’s generalized epidemics raged on. Sexual transmission, is there, of course, but it is derivative; people who get HIV from unsafe healthcare can pass it to their sexual partners.

Africa’s continuing nosocomial epidemics opened the door to proposed solutions, even ones that made no sense. Circ’ing men is one such senseless response.

The US wants to circumcise millions of men in Africa

In 2007, WHO and UNAIDS recommended circumcising men in Africa to prevent HIV.[3] The US leads the charge. WHO’s and UNAIDS’ 2012 “joint strategic” plan to circ men in 14 African countries lists 11 “stakeholders”: four US government agencies (Department of Defense, USAID, CDC, and the State Department’s global AIDS czar), the Gates Foundation, and three international organizations in which the US is the major funder (World Bank, UNAIDS, and WHO).  No other government or organization in Europe or elsewhere signed the plan.[4]

Why are so many US elected officials and health managers so excited  to pay to circumcise men in Africa? At least part of the answer may be the unusual popularity of circumcision in the US. Across 35 rich countries (ie, OECD member countries), the average (median) percentage of circ’d men is 6%. Aside from Israel and Turkey, where religion promotes circ’ing, no other rich country has more than 33% of men circ’d – except the US (71%) and South Korea (77%).[5]

Why circumcise? Relying on selected evidence from unethical trials

Outside Africa, less than one man in 1,000 gets HIV through their penis, and most men are intact (uncircumcised). Within Africa, intact men are less likely to be HIV-positive compared to circ’d men in more than half of the countries with available data, including 4 of 14 countries where the US targets men for foreskin removal.

The main excuse for circ’ing men in Africa – the excuse the US uses — comes from three partially reported and unethical trials that are widely believed to show that circumcision reduces men’s risk to get HIV from sex by about 60%. Even the reported evidence from these trials undermines that claim; and why did study teams withhold so much other relevant evidence?

Circ’ing millions of men

As a response to a nosocomial epidemic, circ’ing millions of men is dangerous. Circ’ing has been promoted with insufficient care — putting men at risk to get HIV, hepatitis B, hepatitis C, and other infections. These dangers are coming to the fore with recent reports of adverse events, including deaths from tetanus. Thankfully, the numbers circ’d have fallen far short of targets, but ambitious targets remain.

References

1. Gisselquist D, Potterat JJ, Brody S, Vachon F. Let it be sexual: how health care transmission of AIDS in Africa was ignored. Int J STD AIDS. 2003; 14: 148-161. Available at: http://www.cirp.org/library/disease/HIV/gisselquist1/gisselquist1.pdf (accessed 18 April 2018).

2. Gisselquist D. Randomized controlled trials for HIV/AIDS prevention among men and women in Africa: untraced infections, unasked questions, and unreported data. Social Science Research Network 2011. Available at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1940999 (accessed 21 May 2017).

3. WHO, UNAIDS. New data on male circumcision and HIV prevention: policy and programme implications. Geneva, WHO: 2007. Available at: http://apps.who.int/iris/bitstream/handle/10665/43751/9789241595988_eng.pdf;jsessionid=FBAEAFE7FB9E7D69C17004CF4BE9801E?sequence=1 (accessed 17 April 2018).

4. WHO, UNAIDS. Joint strategic action framework to accelerate the scale-up of voluntary medical male circumcision for HIV prevention in Eastern and Southern Africa. Geneva: WHO, 2012. Available at: http://www.who.int/hiv/pub/strategic_action2012_2016/en/ (accessed 17 April 2018).’

5. Morris BJ, et al. Estimation of country-specific and global prevalence of male circumcision. Pop Health Metrics 2016; 14: DOI 10.1186/s12963-016-0073-5. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772313/pdf/12963_2016_Article_73.pdf (accessed 17 April 2018).

13 responses to “Circumcise? An absurd response to HIV epidemics driven by unsafe healthcare

  1. Pingback: Circumcision is a Joke to Some Researchers, but Do they Know the Risks Involved? « Don't Get Stuck With HIV

  2. Pingback: Scarification and Male Circumcision Associated with HIV Infection in Children « Don't Get Stuck With HIV

  3. Pingback: Denied, withheld, and uncollected evidence and unethical research cloud what really happened during three key trials of circumcision to protect men « Don't Get Stuck With HIV

  4. Me March 11, 2012 at 5:34 am

    There still is not a single concrete piece of evidence that circumcision actually reduce the chance of contracting HIV or any other STD. People should be very vigilent with pseudo-researches promoting unconfirmed claims. Do not forget that circumcision also has its risks as well.

    The best way to avoid getting HIV or an SDT is very simple: do not engage in unprotected sex intercourses. Abstinence is also a solution.

  5. Pingback: The African Circumcision Experiment: Donor Driven? « Don't Get Stuck With HIV

  6. Pingback: Have we ignored a very simple procedure that could significantly reduce the risk of sexual transmission of HIV to men from women? « Don't Get Stuck With HIV

  7. Pingback: Wait and wipe, don’t cut « Don't Get Stuck With HIV

  8. Anonymous October 21, 2012 at 6:03 pm

    Only today did I finally come to appreciate the extent of David Gisselquist’s careful work on the bad science underlying the alleged causal connection between foreskin and HIV positivity. This alleged causal connection formed a major part of the “evidence” invoked by the AAP’s Task Force on routine infant circumcision, in support of its conclusion that the “benefits of RIC exceed the risks.” I warmly agree that the African clinical trials, and the subsequent campaigns to circumcise millions of African young men, are a scientific scandal on the order of the Tuskegee and Guatemala syphilis experiments.

  9. Pingback: What Happens when an ‘Activist’ Site is Bought off by the Multinationals? | Don't Get Stuck With HIV

  10. Pingback: Uganda: Mystery About Effectiveness of Circumcision Against HIV | Don't Get Stuck With HIV

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  12. Pingback: Circumcision: Digital Manipulation May Lead to Reduced Vision | Don't Get Stuck With HIV

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