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Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

blog.practicalethics.ox.ac.uk

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Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#31

Post by valtism »

ivank wrote: post #3

http://webcache.googleusercontent.com/search?q=cache:blog.pr... Bill Gates doesn't seem to care that that science behind the project is terrible. It must have been pointed out to him, yet he was still promoting the project in 2015: https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=HFtSt862sKY - how much informed consent do you think was involved here? A lawsuit against PSI Zimbabwe, al…

I've heard from people inside WHO that Gates' mentality is that he wants solutions NOW and doesn't concern himself much with potential issues around the solutions. I've heard that they would rather not have his money than be forced to put out vaccines that have questionable manufacturing practices.

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#32

Post by notahacker »

nostromo wrote: post #20

This article is FUD. If the article raised some questions about the (multiple) studies that show the effect, I would just shrug and let it go. But then to go on and say it "may increase it" is irresponsible. There is zero evidence for this -- and in fact a lot of evidence to the contrary. [1] Yes, every study has limitations. The fact that you can't do a blind study or a placebo control with circumcision is just a fa…

> Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing.

I don't think the evidence bases are exactly comparable (even acknowledging that the study you've linked to doesn't sound quite as appallingly constructed as the one described by the blog). And people argue about whether recommendations with thin justifications around stuff like diets have counterproductive side effects all the time, especially when the recommendations are pretty drastic.

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#33

Post by Retra »

telchar wrote: post #18
Theodores wrote: post #10

There is also the aspect of who has a dog in the fight and skin in the game. When you have Americans telling Africans to get themselves circumcised you do have to wonder what is really going on, particularly when there is this dubious level of 'science'. In the U.S. there is always the profit motive. Hence male circumcision is sold to parents as hygienic and beneficial, they go along with it and the hospital makes so…

You can add to that a large part of why circumcision was promoted in the US originally was to control men's sexuality (see: Dr. Kellogg[1] - incidentally he also promoted using acid to circumcise girls). You can bet that the idea of desexualizing African men appeals to a certain subset of fearful white Americans. That may be an inflammatory statement but if one looks at some of the more extreme corners of internet op…

You are attributing to malice what could easily be attributed to stupidity.

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#34

Post by nostromo »

notahacker wrote: post #32
nostromo wrote: post #20

This article is FUD. If the article raised some questions about the (multiple) studies that show the effect, I would just shrug and let it go. But then to go on and say it "may increase it" is irresponsible. There is zero evidence for this -- and in fact a lot of evidence to the contrary. [1] Yes, every study has limitations. The fact that you can't do a blind study or a placebo control with circumcision is just a fa…

> Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing. I don't think the evidence bases are exactly comparable (even acknowledging that the study you've linked to doesn't sound quite as appallingly constructed as the one described by the blog). And peo…

The article is very old now, so that was a fair point... when it was published.

But in 2018 we have a lot of evidence that show the effect on transmission is real -- and we also have evidence that circumcised people do not engage in more risky behavior. [1]

So that's why I think this is similar to denying climate change or claiming vaccines cause autism. It could have a real impact on public health.

I suspect I'm getting downvoted because some people are passionately anti-circumcision. And that's fine! Nobody is going to make you get circumcised. But the science doesn't care about one's personal views regarding circumcision.

1. https://www.fhi360.org/sites/default/files/media/documents/M...

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#35

Post by gumby »

gus_massa wrote: post #29
gumby wrote: post #19

Earlier quoted context omitted.

My kid was born in a US hospital and the woman who did the circumcisions was very pushy that we should get it done ASAP. We said we'd let him decide when he became an adult and she said "but if you let him decide he'll decide not to do it" which seemed like a pretty good argument to me! I did hear from the staff that she got peed on pretty much every time.

It's seams like a very bad argument for me. What about tonsil removal ASAP? He may decide not to do that. What about a lobotomy ASAP?

Her argument was very convincing against her position.

However now you mention lobotomy...that might have made child rearing much simpler. A bit late for me, but you might consider proselytizing this issue for the good of parents everywhere...

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#36

Post by loeg »

nostromo wrote: post #27
robotbikes wrote: post #2

Basically I agree with this sentiment "So what should we conclude? Green et al. get it right: “Before circumcising millions of men in regions with high prevalences of HIV infection, it is important to consider alternatives. A comparison of male circumcision to condom use concluded that supplying free condoms is 95 times more cost effective.”"

That's as silly as focusing on teaching abstinence. Sure, it'd work... in theory. In practice, people don't like condoms and HIV rates would be largely unchanged. The best hope we have is to work on many fronts at the same time: education, condoms, voluntary circumcision, etc.

People don't like condoms in western countries too but they don't seem to have the same sky-high HIV rates. I don't see how making condoms available for free would hurt.

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#37

Post by xkcd-sucks »

valtism wrote: post #31
ivank wrote: post #3

http://webcache.googleusercontent.com/search?q=cache:blog.pr... Bill Gates doesn't seem to care that that science behind the project is terrible. It must have been pointed out to him, yet he was still promoting the project in 2015: https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=HFtSt862sKY - how much informed consent do you think was involved here? A lawsuit against PSI Zimbabwe, al…

I've heard from people inside WHO that Gates' mentality is that he wants solutions NOW and doesn't concern himself much with potential issues around the solutions. I've heard that they would rather not have his money than be forced to put out vaccines that have questionable manufacturing practices.

Well yeah he probably wants to see results before he dies

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#38

Post by nostromo »

valtism wrote: post #31
ivank wrote: post #3

http://webcache.googleusercontent.com/search?q=cache:blog.pr... Bill Gates doesn't seem to care that that science behind the project is terrible. It must have been pointed out to him, yet he was still promoting the project in 2015: https://www.youtube.com/watch?v=_ovf8GYfNbw&t=40s https://www.youtube.com/watch?v=HFtSt862sKY - how much informed consent do you think was involved here? A lawsuit against PSI Zimbabwe, al…

I've heard from people inside WHO that Gates' mentality is that he wants solutions NOW and doesn't concern himself much with potential issues around the solutions. I've heard that they would rather not have his money than be forced to put out vaccines that have questionable manufacturing practices.

A million people die from HIV every year -- a sense of urgency is warranted.

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#39

Post by m0llusk »

xkcd-sucks wrote: post #37
valtism wrote: post #31

Earlier quoted context omitted.

I've heard from people inside WHO that Gates' mentality is that he wants solutions NOW and doesn't concern himself much with potential issues around the solutions. I've heard that they would rather not have his money than be forced to put out vaccines that have questionable manufacturing practices.

Well yeah he probably wants to see results before he dies

Do gooders tend to cause harm Thu do not intend. That Gates has good intentions means little if he makes things worse by pushing non solutions that happen to harmonize with his dick chopping ideology.

Re: Why the “circumcision solution” to the AIDS epidemic in Africa may increase it

#40

Post by defen »

nostromo wrote: post #34
notahacker wrote: post #32

Earlier quoted context omitted.

> Can you imagine the outrage if the author published a paper questioning the effect of smoking on lung cancer, and then wondered if smoking actually reduces your chances for lung cancer? That's what this article is doing. I don't think the evidence bases are exactly comparable (even acknowledging that the study you've linked to doesn't sound quite as appallingly constructed as the one described by the blog). And peo…

The article is very old now, so that was a fair point... when it was published. But in 2018 we have a lot of evidence that show the effect on transmission is real -- and we also have evidence that circumcised people do not engage in more risky behavior. [1] So that's why I think this is similar to denying climate change or claiming vaccines cause autism. It could have a real impact on public health. I suspect I'm get…

> I suspect I'm getting downvoted because some people are passionately anti-circumcision. And that's fine! Nobody is going to make you get circumcised.

Yeah, the problem is that this "science" is inevitably used to justify performing an invasive, unnecessary procedure on babies because in 15+ years it will reduce his risk of acquiring HIV during unprotected sex with an HIV-positive woman from 4/10,000 to 2.4/10,000.

Maybe that's worthwhile in certain cultures experiencing pandemic levels of HIV, but in the USA it's borderline medical malpractice. There are only about 250,000 women in the entire country with HIV.

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