Infant Circumcision

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DSenette
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Re: Infant Circumcision

Postby DSenette » Tue Sep 04, 2012 6:11 pm UTC

Izawwlgood wrote:
DSenette wrote:well, all of the language in any of the links that i've looked at are referencing infection rates, so i can only assume that they mean new infections by that.

I'm pretty sure the wikipedia entry you linked showed HIV cases per capita, not new HIV cases? It lists prevalence, not 'new cases'.

DSenette wrote:"if the US circumcision rates were to be at the rate of european circumcision rates, you would see STI-X infection rates rise by 20%"(paraphrasing so i don't have to go look through links again, but it was in the NPR article i think). which sounds like a pretty solid statement that SHOULD mean that STI-X infection rates in europe are 20% higher than those in the US. is that the case?

They're looking at rates of new HIV infection, and saying that if America had less circumcision, the infection RATE (which is different from what you linked) would be higher.

could you point to something that i linked to on wikipedia again? i'm fairly certain you'll find that was someone else.

i havent' actually linked to anything with regards to statistics, or hell, any of these articles. i've mentioned my confusion with them, and asked questions.

to the actual pont that's being made there.

IF they're looking at new rates of HIV, and claiming that circumcision has the effect they're predicting, then shouldn't we actually see the difference in infection rates in europe?

i.e. if a doctor says "if the US circumcision rates were the same as that in europe, then HIV infection rates would increase by 20%". so unless i'm reading that wrong, then given that europe's circumcision rates are already at the rates of circumcision in europe, then their HIV infection rates SHOULD BE 20% higher than the US correct? IS that actually the case?

Izawwlgood wrote:
DSenette wrote:i'm really asking the question, is that the case? i'm not a statistics wizard, and i really get gummed up with predictive analasys that try to illustrate the concept of "percentages of things that have never existed or would never exist".

I too am asking the question; what social factors (circumcision among them) account for America having a higher HIV prevalence than Europe?
IF europe has a lower HIV prevalance than the US, AND a lower circumcision prevalance than america, what does that mean to the calculations?

Izawwlgood wrote:
DSenette wrote:is there any difference in infection rates when you're comparing circumcised+condom vs. uncircumcised+condom?

Good question. My guess is that because condom use includes improper use (penetration before putting on the condom), that this stat will still be somewhat muddied.
which basically means if you're accounting for improper use, then you can't actually make an accurate prediction?

Izawwlgood wrote:
DSenette wrote:i mean, if you could actually say that the tissue is in fact more "amenable" to viral infection (by a statistically important value) than ANY other part of the male genetalia, then it might be useful information.

Right, to be clear, I'm not saying 'because foreskin is used in tissue culture, it MUST mean that uncircumcised men are riddled with sexually transmitted viruses.
And, well, no one cultures shaft foreskin fibroblasts. So, take that for what it's worth.
which is not much in the current discussion?

Izawwlgood wrote:
DSenette wrote:but, of course, we've got another analog to this concept. human breast tissue. it's the only thing that can get breast cancer right? wouldn't we be able to eliminate an entire type of cancer if we just removed the tissue before it got cancer?

A somewhat flawed analogy, insofar as breast cancer is not a transferable disease like STIs; cancer cannot be eliminated from the world, like, say, smallpox.

But to use the analogy; say we lived in region where breast cancer was ridiculously high, like hypothetically, 95 of 100 women were BRCA carriers. Breast cancer rates are so high, that it is not uncommon to perform mastectomies on infants (i'm not even sure this is possible?), removing all breast tissue early on. Your thoughts?
transferability is a moot point. IF the only tissue that a specific type of cancer could be present in was never present in a human being for the cancer to develop, then you could in fact eliminate that form of cancer. you cannot have pancreatic cancer without a pancrease right? you can't have appendecitus without an appendix right? but even that's not the point of the analogy, the point of the analogy are about the profylactic application of circumcision. you would actually have a BETTER argument for profylactic mastectomies because you would reduce the chances of getting breast tissue cancer to 0%.

your hypothetical numbers are outside of the scale required here. get back to numbers analagous to the protection afforded by circumcision.

if a double mastectomy performed at infancy reduced the chances of an individual from possibly getting breast cancer (again, remember we're not even talking about probabilities here, these are possibilities. none of the metrics on circumcision are about probabilities of any one person contracting a disease. it's about possibilities and feasabilities) when they were an adult to the same scale as the projected reduction afforded by circumcision, should we then advocate for infant mastectomies?

to use your version, with 95-100% infection rates, IF 95 to 100% of men were infected with HIV (or the other STIs that are being mentioned) and circumcision reduced the transmission rate to 0%, then shit yes everyone should be circumcised
Izawwlgood wrote:
DSenette wrote:i mean let's really actually get to the deal here. is anyone suggesting that circumcision is a better sollution to condom use, hygene education, sexual education, et al?

No, no one is saying that; Enuja said it quite clearly, that no matter how good sex education is, people are flawed and will engage in imperfect sexual practices. In such a circumstance, the added safety of circumcision may be a good thing.

Which again though, is quite besides the point.

not sure how it's beside any point, but whatever.
the proposed added safety isn't effective untill the child is sexually active, which is far away from when the child is an infant. which completely reduces the urgency of the procedure. there is no pressing medical need to force the procedure on an infant. the procedure can be done roughly the same on a child that's 10ish (or about to start puberty) as it can on an infant, with roughly the same consequences in either direction. with the same benefits with regards to STIs, assuming the child isn't sexually active already. so, why not wait till you can have a reasoned discussion with the child about it.

remember, i'm not arguing against circumcision. i'm arguing against INFANT circumcision. anyone who can make an informed opinion about the procedure should surely be allowed to get one
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Re: Infant Circumcision

Postby The Great Hippo » Tue Sep 04, 2012 6:25 pm UTC

DSenette wrote:the proposed added safety isn't effective untill the child is sexually active, which is far away from when the child is an infant.
But it is many, many magnitudes easier to convince parents to circumcise their infants than it is to convince people to circumcise themselves. In fact, this difference is so enormous that, were you to possess the means to convince people to circumcise themselves, you'd probably be better off using those means to convince them to engage in responsible sex instead.

When dealing with public health issues, things like that are important, and depending on what's at stake--and what the benefits are--it may shape how we approach the issue.

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Re: Infant Circumcision

Postby DSenette » Tue Sep 04, 2012 7:19 pm UTC

The Great Hippo wrote:
DSenette wrote:the proposed added safety isn't effective untill the child is sexually active, which is far away from when the child is an infant.
But it is many, many magnitudes easier to convince parents to circumcise their infants than it is to convince people to circumcise themselves. In fact, this difference is so enormous that, were you to possess the means to convince people to circumcise themselves, you'd probably be better off using those means to convince them to engage in responsible sex instead.

When dealing with public health issues, things like that are important, and depending on what's at stake--and what the benefits are--it may shape how we approach the issue.

but the numbers and differences that i'm seeing aren't like you're making a massive difference in public health. especially compared to safe sex education and the effectiveness of the other means.

unless i'm reading them all wrong. which is COMPLETLEY possible. but as far as i can tell, they studies seem to be representing individual infection possibilities, not probabilities.

so, while the general concept is a lot similar to childhood vaccination, the percentages that are trying to be countered don't seem to be on the same scale. i dunno, they might be. but as far as i'm understanding the percentages and the numbers, we're not talking about the same thing as allowing for a measles outbreak by not vaccinating your kids.
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Re: Infant Circumcision

Postby Izawwlgood » Tue Sep 04, 2012 7:47 pm UTC

DSenette wrote:could you point to something that i linked to on wikipedia again? i'm fairly certain you'll find that was someone else.

You linked this data in response to Europe having a lower circumcision rate and a lower HIV prevalence;
On HIV infection rates around the world, from WIKI. :-/
http://en.wikipedia.org/wiki/List_of_co ... lence_rate

Prevalence in adults, 15-49.

USA, 0.6%
Germany, 0.1%
France, 0.4%
UK, 0.2%

And that wiki links to prevalence, not rate of new infections. The above bolding is yours, and I'm suggesting, not with 100% confidence, that the reason we see this discrepency is because 'prevalence of HIV' != 'rate of new HIV infection'

DSenette wrote:IF europe has a lower HIV prevalance than the US, AND a lower circumcision prevalance than america, what does that mean to the calculations?

It can mean that the US has a lower rate of new HIV infections than a comparable country with a similar pool of HIV+ individuals, due to the relatively high rate of circumcision.
DSenette wrote:[Breast Cancer analogy]

Well, the transferability is actually quite the point; one reason circumcision may be useful is that it can reduce the rate of disease acquisition, and thus potentially eliminate a disease, whereas mastectomies aren't going to have a long term affect on reducing the rate of breast cancers (indeed, might even increase it, as BRCA is no longer selected against). But, like I said, it's an analogy, so it's not perfect, which doesn't invalidate it's purpose as an analogy. And yes, the numbers I gave were ~50% too high for even the worst case environments where circumcision would be useful (some parts of Africa have as high as a 60% HIV infection rate).

I'm pleased and somewhat befuddled by your instant and more or less non-waffling willingness to say that yes, circumcision should be performed in such a situation. So, even in such a scenario where alternative learned practices are possible, if there is MEDICAL value to improving life, consent of the child is not required (presumably this falls under 'best interest of the child', yes?). But if a parent places value on a procedure, it is immoral to perform the procedure if the procedure has no clear and obvious medical benefit? I'm just clarifying your position for my own sake.

DSenette wrote:the procedure can be done roughly the same on a child that's 10ish (or about to start puberty) as it can on an infant, with roughly the same consequences in either direction

Well, I don't think this is entirely true; Enuja pointed out that infants recover from the procedure faster and don't have the same length of pain memory associated with it. For perhaps a similar reason one wouldn't wait to operate on, say a cleft palate in a child until they were ~10, but would tackle the procedure ASAP.
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Re: Infant Circumcision

Postby DSenette » Tue Sep 04, 2012 8:36 pm UTC

Izawwlgood wrote:
DSenette wrote:could you point to something that i linked to on wikipedia again? i'm fairly certain you'll find that was someone else.

You linked this data in response to Europe having a lower circumcision rate and a lower HIV prevalence;
On HIV infection rates around the world, from WIKI. :-/
http://en.wikipedia.org/wiki/List_of_co ... lence_rate

Prevalence in adults, 15-49.

USA, 0.6%
Germany, 0.1%
France, 0.4%
UK, 0.2%

And that wiki links to prevalence, not rate of new infections. The above bolding is yours, and I'm suggesting, not with 100% confidence, that the reason we see this discrepency is because 'prevalence of HIV' != 'rate of new HIV infection'
i most certainly did not. and the fact that your "quote" of whatever that is doesn't include my name would seem to back my assertion up. (hint, i know who did post that information...and i did in fact quote the information that was posted, and asked some questions based on those numbers WITH questions about whether those were the numbers in use)


Izawwlgood wrote:
DSenette wrote:IF europe has a lower HIV prevalance than the US, AND a lower circumcision prevalance than america, what does that mean to the calculations?

It can mean that the US has a lower rate of new HIV infections than a comparable country with a similar pool of HIV+ individuals, due to the relatively high rate of circumcision.


i'd really like to keep the context with this because you seem to be losing a lot of it

DSenette wrote:if the US circumcision rates were to be at the rate of european circumcision rates, you would see STI-X infection rates rise by 20%"(paraphrasing so i don't have to go look through links again, but it was in the NPR article i think). which sounds like a pretty solid statement that SHOULD mean that STI-X infection rates in europe are 20% higher than those in the US. is that the case?

so, that's where i asked the question, based on the NPR article (which again, just like the wikipedia one...i didn't link to). The scientist in question made a statement about infection rates. i asked a question based on the way i'm interpreting the statement.

the basic assumption: IF the us circumcision rate was the same as the circumcision rate in europe then the HIV infection rate in the US would increase by 20%
so, to check that assumption you could either decrease the circumcision rate in the US. OR look at the HIV infection rate in europe. IF the assumption is correct, then the HIV infection rate in europe should be 20% higher than that of the US. correct?

am i framing that correctly given the assumption?

which is where the following part (which really had no business being separated from the other part..but, well you decided to)

DSenette wrote:
Izawwlgood wrote:
DSenette wrote:i'm really asking the question, is that the case? i'm not a statistics wizard, and i really get gummed up with predictive analasys that try to illustrate the concept of "percentages of things that have never existed or would never exist".


I too am asking the question; what social factors (circumcision among them) account for America having a higher HIV prevalence than Europe?IF europe has a lower HIV prevalance than the US, AND a lower circumcision prevalance than america, what does that mean to the calculations?

your statement seems to suggest taht it's your understanding that america, which has a higher circumcision rate, has a higher HIV prevalance than that of europe correct? which again, i'm still assuming isn't the same thing as infection rate...which, was, what i was asking about in the above quoted question

my question is, how does that jive with the circumcision data? like really, IS there data that shows that europeans are 20% more likely to contract HIV?


Izawwlgood wrote:
DSenette wrote:[Breast Cancer analogy]

Well, the transferability is actually quite the point; one reason circumcision may be useful is that it can reduce the rate of disease acquisition, and thus potentially eliminate a disease, whereas mastectomies aren't going to have a long term affect on reducing the rate of breast cancers (indeed, might even increase it, as BRCA is no longer selected against). But, like I said, it's an analogy, so it's not perfect, which doesn't invalidate it's purpose as an analogy. And yes, the numbers I gave were ~50% too high for even the worst case environments where circumcision would be useful (some parts of Africa have as high as a 60% HIV infection rate).
pardon? in the example you would completely elliminate breast cancer from the face of the earth. if no one were to exit infancy with breast tissue to develop cancer in, you would wipe breast cancer from the face of the earth for as long as you retained the practice of removing breast tissue.

50%? where are we seeing data that has actually shown a 45% reduction in infection rates anywhere? as far as i'm reading the data they're still talking about possibility reductions in individuals. as in you could possibly reduce the possibility of contracting HIV by 20% for an individual. which isn't the same as reducing probability of contracting HIV. and it's not the same as a large scale sociatal reduction


Izawwlgood wrote:I'm pleased and somewhat befuddled by your instant and more or less non-waffling willingness to say that yes, circumcision should be performed in such a situation. So, even in such a scenario where alternative learned practices are possible, if there is MEDICAL value to improving life, consent of the child is not required (presumably this falls under 'best interest of the child', yes?). But if a parent places value on a procedure, it is immoral to perform the procedure if the procedure has no clear and obvious medical benefit? I'm just clarifying your position for my own sake.

IF the reduction rate were anywhere near 100% you could effectively reference the procedure as a CURE to a dissease. just like giving medicine would represent a cure to a disease if it reduces the chances of infection by 100%. anyone with half a brain can understand the difference between the application of a cure to an infectious dissease, and a 10% reduction in possible infection some time down the line, perhaps, maybe, and of course, that's a 10% reduction that only really comes in to play IF you're not using one of the other proven methods of infection prevention while participating in sexual activity with an infection+ partner.

i've also, not really ever made that many claims about anything being immoral. ever. in this thread. again i'm fairly certain you're arguing against someone else. my argument is against society placing any intrensic value on the circumcision status on a child. IF the decision IS ever to be made, it should be made based on the medical merits of the procedure since it's, you know...a medical procedure. there should be absolutely no social component to it.

that in no way states that people who have placed social weight on the procedure are in any way immoral. i just don't agree with it.

Izawwlgood wrote:
DSenette wrote:the procedure can be done roughly the same on a child that's 10ish (or about to start puberty) as it can on an infant, with roughly the same consequences in either direction

Well, I don't think this is entirely true; Enuja pointed out that infants recover from the procedure faster and don't have the same length of pain memory associated with it. For perhaps a similar reason one wouldn't wait to operate on, say a cleft palate in a child until they were ~10, but would tackle the procedure ASAP.
[/quote]
the difference in recovery time isn't like the difference between 1 day of healing time, and 2 months of healing time. children at the age of puberty and just before share a lot of the same quick healing benefits as infants to most degrees.

do you have any studdies showing the difference between healing times of circumcisions performed on infants vs 10 year olds?

"pain memory" isn't a metric that i'd put too much value on in a scenario where someone isn't being forced to participate in the procedure. you remembering that a decision you made caused you pain or discomfort isn't really something anyone else should care about.

let's not start the cleft palate bullshit again please.
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Re: Infant Circumcision

Postby Izawwlgood » Tue Sep 04, 2012 9:10 pm UTC

DSenette wrote:i most certainly did not.

Ah! You are absolutely correct; BattleMoose posted that, not you. Apologies.

DSenette wrote:i'd really like to keep the context with this because you seem to be losing a lot of it

Elaborate? We're spitballing about possible reasons circumcision can lower rates of HIV transmission, but the US can still have a higher prevalence of HIV+ individuals.

DSenette wrote:so, to check that assumption you could either decrease the circumcision rate in the US. OR look at the HIV infection rate in europe. IF the assumption is correct, then the HIV infection rate in europe should be 20% higher than that of the US. correct?

Yes? I think? Like I said, circumcision might not be the only variable; circumcision may simply be a measure of, say, socioeconomic status, which may be a stronger predictor. Or, for example, (hypothetical here) 80% of the US population may be circumcised, and there may be more HIV+ individuals in the US, but in the US, new cases of HIV are predominately in uncircumcised men. That doesn't mean that circumcision has no affect on HIV transmission, it just means you're not looking at your data properly.

DSenette wrote:in the example you would completely elliminate breast cancer from the face of the earth. if no one were to exit infancy with breast tissue to develop cancer in, you would wipe breast cancer from the face of the earth for as long as you retained the practice of removing breast tissue.

You would eliminate breast cancer from the face of the Earth in people who undergo the procedure. Like I said, you would then be selecting for a population that is more resilient to being carriers of the BRCA gene, which is a bad thing. This is why your analogy is flawed, because if you, say, circumcise everyone, and this (and presumably other factors) eliminates HIV from the face of the Earth, you could then go back to not circumcising ANYONE, and never see HIV again. This is why transferability of the disease in question is somewhat pertinent.
But like I acknowledged, the specifics of this analogy are irrelevant, it as an analogy, doesn't have to fit perfectly.

DSenette wrote:50%? where are we seeing data that has actually shown a 45% reduction in infection rates anywhere? as far as i'm reading the data they're still talking about possibility reductions in individuals. as in you could possibly reduce the possibility of contracting HIV by 20% for an individual. which isn't the same as reducing probability of contracting HIV. and it's not the same as a large scale sociatal reduction

Yeah, I fail at reading stats again; 60% of the worlds HIV cases are found in Africa, with the highest country infection rate being Swaziland at ~26%. My error was misreading that as 'the highest countries infection rate is 60%' and then throwing out a '90-95% disease rate' as being too high by a factor of 50%. Lets back up, because me taking your breast cancer analogy fitted with my terrible ability to use statistics is only muddying the discussion

DSenette wrote:children at the age of puberty and just before share a lot of the same quick healing benefits as infants to most degrees.

Er, I call bullshit if you're going to make the previous as well as the following statements;
DSenette wrote:do you have any studdies showing the difference between healing times of circumcisions performed on infants vs 10 year olds?


DSenette wrote:"pain memory" isn't a metric that i'd put too much value on in a scenario where someone isn't being forced to participate in the procedure. you remembering that a decision you made caused you pain or discomfort isn't really something anyone else should care about.

No, but as parents concerned with our childrens well being, if we are subjecting them to something, we should subject them to it in such a manner as to maximize pain reduction. Such as eliminating the pain memory to the best of our ability.

EDIT: Also, and this is not the first time I've said this to you in this thread, curb your fucking attitude.
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Re: Infant Circumcision

Postby DSenette » Tue Sep 04, 2012 9:25 pm UTC

Izawwlgood wrote:
DSenette wrote:i most certainly did not.

Ah! You are absolutely correct; BattleMoose posted that, not you. Apologies.
glad we got that out of the way

Izawwlgood wrote:
DSenette wrote:i'd really like to keep the context with this because you seem to be losing a lot of it

Elaborate? We're spitballing about possible reasons circumcision can lower rates of HIV transmission, but the US can still have a higher prevalence of HIV+ individuals.
the context is getting lost because you're splitting of quotes and then responding to them without the original question attached...just like the stuff that was previously with the quote you just completely removed, and then tried to address. i'm fairly certain it's close to quote sniping.

Izawwlgood wrote:
DSenette wrote:so, to check that assumption you could either decrease the circumcision rate in the US. OR look at the HIV infection rate in europe. IF the assumption is correct, then the HIV infection rate in europe should be 20% higher than that of the US. correct?

Yes? I think? Like I said, circumcision might not be the only variable; circumcision may simply be a measure of, say, socioeconomic status, which may be a stronger predictor. Or, for example, (hypothetical here) 80% of the US population may be circumcised, and there may be more HIV+ individuals in the US, but in the US, new cases of HIV are predominately in uncircumcised men. That doesn't mean that circumcision has no affect on HIV transmission, it just means you're not looking at your data properly.
if circumcision is a measure of socieoeconomic status, and the socioeconomic status is what's reducing the infection rates, then how does circumcision have anything to do with infection rates?

i don't quite understand the second bit. like, fundamentally i don't understand what you're saying in respect to the context of the question that you're responding to. the specific doctor in question said, if the us circumcision rates dropped, we would see a 20% increase in HIV infections. how does taht jive with what you're saying?

Izawwlgood wrote:
DSenette wrote:in the example you would completely elliminate breast cancer from the face of the earth. if no one were to exit infancy with breast tissue to develop cancer in, you would wipe breast cancer from the face of the earth for as long as you retained the practice of removing breast tissue.

You would eliminate breast cancer from the face of the Earth in people who undergo the procedure. Like I said, you would then be selecting for a population that is more resilient to being carriers of the BRCA gene, which is a bad thing. This is why your analogy is flawed, because if you, say, circumcise everyone, and this (and presumably other factors) eliminates HIV from the face of the Earth, you could then go back to not circumcising ANYONE, and never see HIV again. This is why transferability of the disease in question is somewhat pertinent.
But like I acknowledged, the specifics of this analogy are irrelevant, it as an analogy, doesn't have to fit perfectly.
well, to even get remotely close to saying that circumcision could eliminate HIV, or even play a large enough factor that it would be cited as a reason for HIV to be eradicated it would have to have much larger effect than any of the studies i read suggest it does. you'd basically have to be able to say "well, even with the other methods of prevention, if we don't add circumcision it's never going to happen"

Izawwlgood wrote:
DSenette wrote:50%? where are we seeing data that has actually shown a 45% reduction in infection rates anywhere? as far as i'm reading the data they're still talking about possibility reductions in individuals. as in you could possibly reduce the possibility of contracting HIV by 20% for an individual. which isn't the same as reducing probability of contracting HIV. and it's not the same as a large scale sociatal reduction

Yeah, I fail at reading stats again; 60% of the worlds HIV cases are found in Africa, with the highest country infection rate being Swaziland at ~26%. My error was misreading that as 'the highest countries infection rate is 60%' and then throwing out a '90-95% disease rate' as being too high by a factor of 50%. Lets back up, because me taking your breast cancer analogy fitted with my terrible ability to use statistics is only muddying the discussion
fine

Izawwlgood wrote:
DSenette wrote:children at the age of puberty and just before share a lot of the same quick healing benefits as infants to most degrees.

Er, I call bullshit if you're going to make the previous as well as the following statements;
DSenette wrote:do you have any studdies showing the difference between healing times of circumcisions performed on infants vs 10 year olds?

why? do you not agree that the younger you are, the quicker you heal from a wound....in general?
you seemed to be suggesting that there was some drastic difference between the healing times of an infant getting circucmised and a ten year old. i'd like to see that data

Izawwlgood wrote:
DSenette wrote:"pain memory" isn't a metric that i'd put too much value on in a scenario where someone isn't being forced to participate in the procedure. you remembering that a decision you made caused you pain or discomfort isn't really something anyone else should care about.

No, but as parents concerned with our childrens well being, if we are subjecting them to something, we should subject them to it in such a manner as to maximize pain reduction. Such as eliminating the pain memory to the best of our ability.



but you can do things other than doing the procedure in infancy to reduce or eliminate the pain, like perhaps use a local anasthetic? which would quite probably remove the concept of pain memory to begin with?

why can't you preserve the kids right to make an informed decision AND reduce their pain if they decide to do the procedure? i mean, shit, if i decided today to go get circumcised i would definitely ask them for a local, and some kind of topical analgesic to take home for the healing process. why wouldn't you do that with your kid if they chose to do the same?
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Re: Infant Circumcision

Postby Izawwlgood » Tue Sep 04, 2012 10:05 pm UTC

DSenette wrote:if circumcision is a measure of socieoeconomic status, and the socioeconomic status is what's reducing the infection rates, then how does circumcision have anything to do with infection rates?

i don't quite understand the second bit. like, fundamentally i don't understand what you're saying in respect to the context of the question that you're responding to. the specific doctor in question said, if the us circumcision rates dropped, we would see a 20% increase in HIV infections. how does taht jive with what you're saying?

I'm not necessarily agreeing with the doctors assessment about US HIV rates. Because;
Izawwlgood wrote:circumcision might not be the only variable; circumcision may simply be a measure of, say, socioeconomic status, which may be a stronger predictor. Or, for example, (hypothetical here) 80% of the US population may be circumcised, and there may be more HIV+ individuals in the US, but in the US, new cases of HIV are predominately in uncircumcised men. That doesn't mean that circumcision has no affect on HIV transmission, it just means you're not looking at your data properly.

What I'm saying is that to better understand how circumcision is affecting the rate of new cases of HIV in America vs Europe, you'd have to look at (presumably in both populations, meaning that US/Europe isn't even the variable here) the %'age of men who are newly presenting as HIV+ who are circumcised annually per capita. The variable here being 'are they circumcised' with an additional variable of 'prevalence of HIV in this region'.

Insofar as how this jives with what I'm saying, it may not; the fact of the matter may be that circumcision does nothing to HIV transmission rates, and there are other factors that DO, such as, say, socioeconomic status/education/etc.

DSenette wrote:well, to even get remotely close to saying that circumcision could eliminate HIV, or even play a large enough factor that it would be cited as a reason for HIV to be eradicated it would have to have much larger effect than any of the studies i read suggest it does. you'd basically have to be able to say "well, even with the other methods of prevention, if we don't add circumcision it's never going to happen"

Well, not necessarily; for example, to eliminate Malaria from the US in the 20s (30s? I can't remember when this movement happened), they sprayed neighborhoods, drained swamps, encouraged the purchasing of window and door screens, and encouraged the spiking of standing water with gasoline/oil. Any one of these things would have reduced mosquito populations and malaria infection rates, but it took all of them in tandem to fully drive the disease pool to zero in the US. As analogies go, my point is only that perhaps to eliminate HIV entirely, you need the tandem effort of a number of different tactics, one of which may be circumcising ALL boys.

If the US decided eliminating HIV was an important undertaking, and circumcising proved to be one of the means for doing so, I guess we'd have a generation or two or boys who are circumcised and could reassess after? I dunno, that'd be an interesting situation to assess from.

DSenette wrote:why? do you not agree that the younger you are, the quicker you heal from a wound....in general?
you seemed to be suggesting that there was some drastic difference between the healing times of an infant getting circucmised and a ten year old. i'd like to see that data

Are we considering 10 year olds capable of giving consent now?
But yes, I'm suggesting that an infant will in fact heal faster from a minor surgery than a 10 year old. I find it funny that you question whether or not a 10 year old will heal more slowly than an infant, given the above bolded.

DSenette wrote:but you can do things other than doing the procedure in infancy to reduce or eliminate the pain, like perhaps use a local anasthetic? which would quite probably remove the concept of pain memory to begin with?

Sure; why not both?
DSenette wrote:why can't you preserve the kids right to make an informed decision AND reduce their pain if they decide to do the procedure?

Crux of the debate we keep circling around, year after year;
You believe that a child maintains, always, the right to consent. I believe that parents act as custodians of a child's rights, and make the best decisions they can. Children don't have a right of consent.
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Re: Infant Circumcision

Postby DSenette » Wed Sep 05, 2012 12:27 pm UTC

Izawwlgood wrote:
DSenette wrote:if circumcision is a measure of socieoeconomic status, and the socioeconomic status is what's reducing the infection rates, then how does circumcision have anything to do with infection rates?

i don't quite understand the second bit. like, fundamentally i don't understand what you're saying in respect to the context of the question that you're responding to. the specific doctor in question said, if the us circumcision rates dropped, we would see a 20% increase in HIV infections. how does taht jive with what you're saying?

I'm not necessarily agreeing with the doctors assessment about US HIV rates. Because;
Izawwlgood wrote:circumcision might not be the only variable; circumcision may simply be a measure of, say, socioeconomic status, which may be a stronger predictor. Or, for example, (hypothetical here) 80% of the US population may be circumcised, and there may be more HIV+ individuals in the US, but in the US, new cases of HIV are predominately in uncircumcised men. That doesn't mean that circumcision has no affect on HIV transmission, it just means you're not looking at your data properly.

What I'm saying is that to better understand how circumcision is affecting the rate of new cases of HIV in America vs Europe, you'd have to look at (presumably in both populations, meaning that US/Europe isn't even the variable here) the %'age of men who are newly presenting as HIV+ who are circumcised annually per capita. The variable here being 'are they circumcised' with an additional variable of 'prevalence of HIV in this region'.

Insofar as how this jives with what I'm saying, it may not; the fact of the matter may be that circumcision does nothing to HIV transmission rates, and there are other factors that DO, such as, say, socioeconomic status/education/etc.
which goes back to not understanding the studdies/evidence currently being presented (by me. perhaps you, i dunno). if "we" aren't certain of the methodology or the implications of the studdies being cited, then how are they being used as evidence that circumcision should be getting done?

Izawwlgood wrote:
DSenette wrote:well, to even get remotely close to saying that circumcision could eliminate HIV, or even play a large enough factor that it would be cited as a reason for HIV to be eradicated it would have to have much larger effect than any of the studies i read suggest it does. you'd basically have to be able to say "well, even with the other methods of prevention, if we don't add circumcision it's never going to happen"

Well, not necessarily; for example, to eliminate Malaria from the US in the 20s (30s? I can't remember when this movement happened), they sprayed neighborhoods, drained swamps, encouraged the purchasing of window and door screens, and encouraged the spiking of standing water with gasoline/oil. Any one of these things would have reduced mosquito populations and malaria infection rates, but it took all of them in tandem to fully drive the disease pool to zero in the US. As analogies go, my point is only that perhaps to eliminate HIV entirely, you need the tandem effort of a number of different tactics, one of which may be circumcising ALL boys.

If the US decided eliminating HIV was an important undertaking, and circumcising proved to be one of the means for doing so, I guess we'd have a generation or two or boys who are circumcised and could reassess after? I dunno, that'd be an interesting situation to assess from.
except that there's concrete evidence that all of those items would reduce mosquito populations. like 100% evidence that doing all of those things would kill the fuck out of mosquitos.

that doesn't exist with circumcision as far as i'm reading (again, i'm not a statistician or a doctor so if someone can actually show me the numbers and help explain them so that i can understand i'd be more than happy to do so), it's not a causal connection.

also, with the mosquitos they only took those actions in places where mosquitoes were a possible threat/issue. granted, that's pretty much fucking everywhere. but, it's similar to the fact that the sexual "benefits" of circumcision aren't provided to the kid till they become sexually active, so, why not wait?


Izawwlgood wrote:
DSenette wrote:why? do you not agree that the younger you are, the quicker you heal from a wound....in general?
you seemed to be suggesting that there was some drastic difference between the healing times of an infant getting circucmised and a ten year old. i'd like to see that data

Are we considering 10 year olds capable of giving consent now?
But yes, I'm suggesting that an infant will in fact heal faster from a minor surgery than a 10 year old. I find it funny that you question whether or not a 10 year old will heal more slowly than an infant, given the above bolded.
i am. always have been in this discussion. i'm not talking about legal consent, i'm talking about having a frank conversation with your parents, getting real unbiased information, and making a decision about your body. i don't see why that would have to have anything to do with the legal definition of age of consent. children should be able to make informed decisions about their bodies. especially in these types of situations.

absolutely they will heal faster than a 10 year old, but is it at a scale that we should actually give a shit about? all of the anecdotal or medical evidence that i've seen that argues for infant circumcision based on healing time and pain is comparing infant circumcision (where you can't accurately measure pain since the infant's pain response is pretty much the same for almost all levels of pain) to adult circumcision....which is pretty far off as comparisons go. i'd like to know if there would be a functional difference between an infant and a 10 year old

my limited anecdotal evidence from the friend of mine's brother that got circumcised when he was around 10 suggests that getting circumcised when you're 10 isn't the end of the world. he reported some discomfort after the procedure, because, you know...someone cut his dick. but it wasn't something that he listed as horrible.

Izawwlgood wrote:
DSenette wrote:but you can do things other than doing the procedure in infancy to reduce or eliminate the pain, like perhaps use a local anasthetic? which would quite probably remove the concept of pain memory to begin with?

Sure; why not both?

why not both what? anesthetic AND infant?

because, why infant? if you can get the same benefits of the "infant" part, without requiring the child to be an infant, then why not do it the way that gives the kid a choice?

Izawwlgood wrote:
DSenette wrote:why can't you preserve the kids right to make an informed decision AND reduce their pain if they decide to do the procedure?

Crux of the debate we keep circling around, year after year;
You believe that a child maintains, always, the right to consent. I believe that parents act as custodians of a child's rights, and make the best decisions they can. Children don't have a right of consent.

correction, i believe they SHOULD have a right to consent. especially in matters of bodily autonomy that aren't actually life or death (or of other medical necessity).

to say that i believe they DO, suggests that i also believe that you're a horrible person if you decide to violate those rights (which, TBH in certain situations i do believe some parents are horrible people), i'm fully aware that other people disagree, and that i'm not the parent of their children.
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Re: Infant Circumcision

Postby The Great Hippo » Wed Sep 05, 2012 1:24 pm UTC

DSenette wrote:correction, i believe they SHOULD have a right to consent. especially in matters of bodily autonomy that aren't actually life or death (or of other medical necessity).
Or of a socially catastrophic facial deformity; you've agreed that this is a situation where it's okay to violate their right of consent, too.

You think children should have a right of consent except when having it clearly doesn't serve their best interests, and that parents are the ones who determine their best interests (but we should have laws to make sure idiotic parents don't make idiotic decisions). But what's the functional difference between this and a model where we just act in the child's best interests? Delaying decisions that 'violate' their bodily autonomy (and carry no significant positive gains for that violation when done now, rather than later) is just another way of serving their interests (people tend to be happier when we leave the big decisions for them to make). You want to add an additional step to this process--one which apparently does nothing. Why?

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Re: Infant Circumcision

Postby Izawwlgood » Wed Sep 05, 2012 1:28 pm UTC

DSenette wrote:which goes back to not understanding the studdies/evidence currently being presented (by me. perhaps you, i dunno). if "we" aren't certain of the methodology or the implications of the studdies being cited, then how are they being used as evidence that circumcision should be getting done?

I'm proffering alternative theories that could explain why the US has both a circumcision and higher HIV prevalence than Europe. I'm not suggesting the African studies that claim circumcision reduces HIV transfer are wrong.

DSenette wrote:except that there's concrete evidence that all of those items would reduce mosquito populations. like 100% evidence that doing all of those things would kill the fuck out of mosquitos.

that doesn't exist with circumcision as far as i'm reading (again, i'm not a statistician or a doctor so if someone can actually show me the numbers and help explain them so that i can understand i'd be more than happy to do so), it's not a causal connection.

also, with the mosquitos they only took those actions in places where mosquitoes were a possible threat/issue. granted, that's pretty much fucking everywhere. but, it's similar to the fact that the sexual "benefits" of circumcision aren't provided to the kid till they become sexually active, so, why not wait?

You misunderstood my point; my point wasn't that any one of these things is proven to reduce mosquito populations, but that all of them were required to eliminate malaria. Similarly, as Enuja pointed out, if circumcision provides a a solid reduction in HIV transmission, then it could be a powerful tool, a tool required in tandem with other tools, to effectively eliminate HIV from a given population.
As to 'why not wait', this is addressed later in the 'because kids heal faster and enjoy reduced rates of complication line of things'.

DSenette wrote:i am. always have been in this discussion. i'm not talking about legal consent, i'm talking about having a frank conversation with your parents, getting real unbiased information, and making a decision about your body. i don't see why that would have to have anything to do with the legal definition of age of consent. children should be able to make informed decisions about their bodies. especially in these types of situations.

I don't think 10 year olds can make a decision. I think you're placing an unrealistic expectation of what constitutes a 'frank conversation, with unbiased information'. Most 10 year olds lack the maturity to be trusted with a kitchen stove, let alone weigh the facts and make life long decisions for themselves.

DSenette wrote:absolutely they will heal faster than a 10 year old, but is it at a scale that we should actually give a shit about? all of the anecdotal or medical evidence that i've seen that argues for infant circumcision based on healing time and pain is comparing infant circumcision (where you can't accurately measure pain since the infant's pain response is pretty much the same for almost all levels of pain) to adult circumcision....which is pretty far off as comparisons go. i'd like to know if there would be a functional difference between an infant and a 10 year old

You cede that infants will heal faster; why not minimize the recovery time required?

DSenette wrote:why not both what? anesthetic AND infant?

because, why infant? if you can get the same benefits of the "infant" part, without requiring the child to be an infant, then why not do it the way that gives the kid a choice?

Because infant circumcision bears; maximized healing time and forgotten pain memory.
DSenette wrote:correction, i believe they SHOULD have a right to consent. especially in matters of bodily autonomy that aren't actually life or death (or of other medical necessity).

Yeah. I don't. I also think your definition of 'medical necessity' is flawed, based on previous discussions we've had.
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Re: Infant Circumcision

Postby BattleMoose » Wed Sep 05, 2012 2:19 pm UTC

Izawwlgood wrote:
DSenette wrote:which goes back to not understanding the studdies/evidence currently being presented (by me. perhaps you, i dunno). if "we" aren't certain of the methodology or the implications of the studdies being cited, then how are they being used as evidence that circumcision should be getting done?

I'm proffering alternative theories that could explain why the US has both a circumcision and higher HIV prevalence than Europe. I'm not suggesting the African studies that claim circumcision reduces HIV transfer are wrong.


How about the obvious, of all the myriad of factors that effect HIV prevalence and infection rates, circumcision is very low on the list. And would have no effect if combined with proper condom usage, which, I would hazard is best practice in Europe and I would expect, most parts of the USA.

Current infection rates are probably strongly linked to how governments responded initially to the AIDS epidemic back in the 80's. Availability of condoms, free needles, education and communication, et cetera.

Also, no medical body, recommends routine infant male circumcision.

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Re: Infant Circumcision

Postby Izawwlgood » Wed Sep 05, 2012 2:24 pm UTC

BattleMoose wrote:How about the obvious, of all the myriad of factors that effect HIV prevalence and infection rates, circumcision is very low on the list. And would have no effect if combined with proper condom usage, which, I would hazard is best practice in Europe and I would expect, most parts of the USA.

Possible. Might be worth looking into.
BattleMoose wrote:Current infection rates are probably strongly linked to how governments responded initially to the AIDS epidemic back in the 80's. Availability of condoms, free needles, education and communication, et cetera.

Right, which would suggest that the higher prevalence of HIV in America isn't a valid counter point to the notion that circumcision reduces the transfer of the virus.
BattleMoose wrote:Also, no medical body, recommends routine infant male circumcision.

Yes, and?
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Re: Infant Circumcision

Postby BattleMoose » Wed Sep 05, 2012 2:46 pm UTC

Izawwlgood wrote:
BattleMoose wrote:Current infection rates are probably strongly linked to how governments responded initially to the AIDS epidemic back in the 80's. Availability of condoms, free needles, education and communication, et cetera.

Right, which would suggest that the higher prevalence of HIV in America isn't a valid counter point to the notion that circumcision reduces the transfer of the virus.


I don't think anyone has actually made that argument. One would have to somehow account for all the strategies that other nations have taken and try and account for their efficacy, its just feels like far too much hard work.

Although I do think the impenetrable barrier that one places over ones cock during intercourse does reduce the efficacy of circumcision to prevent transmission to zero.

To put it another way. If the suggestion is that we should circumcise infant males, in order to reduce STIs, then the onus is on those making that argument to provide evidence that it would firstly actually even be effective.

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Re: Infant Circumcision

Postby Izawwlgood » Wed Sep 05, 2012 3:04 pm UTC

BattleMoose wrote:Although I do think the impenetrable barrier that one places over ones cock during intercourse does reduce the efficacy of circumcision to prevent transmission to zero.

Learn new things time! Condoms include a 'rate of success' that includes improper use. Go back and reread Enuja's post.
BattleMoose wrote:To put it another way. If the suggestion is that we should circumcise infant males, in order to reduce STIs, then the onus is on those making that argument to provide evidence that it would firstly actually even be effective.

I think the number of African studies showed that it is.
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Re: Infant Circumcision

Postby Enuja » Wed Sep 05, 2012 3:05 pm UTC

To chose one place DSenette stated this question:
DSenette wrote:the basic assumption: IF the us circumcision rate was the same as the circumcision rate in europe then the HIV infection rate in the US would increase by 20%
so, to check that assumption you could either decrease the circumcision rate in the US. OR look at the HIV infection rate in europe. IF the assumption is correct, then the HIV infection rate in europe should be 20% higher than that of the US. correct?

am i framing that correctly given the assumption?


To answer the question: Hell Fucking No!

To explain: There are other variables that determine both the HIV incidence & prevalence rates. It is true that, all other things being equal, "IF the us circumcision rate was the same as the circumcision rate in europe then the HIV infection rate in the US would increase by 20% ... then the HIV infection rate in europe should be 20% higher than that of the US." However, all other things are not equal. I don't know the actual differences between the US and Europe (I've read about the US and Africa, and not much about Europe), but other important variables that determine incidence rate (the chance to be infected) include prevalence rate (it doesn't matter how risky your behavior is, if your partners don't have the infection, you're not going to get it from them), condom usage, and average number of concurrent sexual partners.

Confounding variables are extremely difficult to control for in studies that look at existing populations. One extremely awesome way to get rid of confounding variables is to do a randomized controlled trail: take a group, divide them randomly, give one treatment to one half of the group and another treatment to other half of the group. This has been done three times in Africa with adult circumcision. The results were stunning: adult male circumcision reduced the chance of these men getting HIV by 51% to 60%. (It's easy to have big swings in chances: if you go from a 1% chance of getting HIV in the next year to a 2% chance, you've increased your risk by 100%. I don't remember what the actual risks where, or which countries these studies were done in, and all I'm finding with quick google searches are review articles.)

I know the above is not actually about infant circumcision, but it's about statistics and adult STI transmission, which I think are necessary background to talking about infant circumcision.

The Great Hippo wrote:(people tend to be happier when we leave the big decisions for them to make).
Do you have any evidence for that statement, both in general and in this particular case? From my limited understanding of psychology and circumcision, I suspect you've got it exactly backwards. Of course, there are some specific big decisions where you're right, but I doubt it's general or true for circumcision (whether circumcision is a big or small decision: I think of it as a relatively small decision).

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Re: Infant Circumcision

Postby The Great Hippo » Wed Sep 05, 2012 3:22 pm UTC

Enuja wrote:
The Great Hippo wrote:(people tend to be happier when we leave the big decisions for them to make).
Do you have any evidence for that statement, both in general and in this particular case? From my limited understanding of psychology and circumcision, I suspect you've got it exactly backwards. Of course, there are some specific big decisions where you're right, but I doubt it's general or true for circumcision (whether circumcision is a big or small decision: I think of it as a relatively small decision).
No evidence that I can think, but I'm thinking in very broad terms, and deriving my position from the notion that, except for obvious stuff, we're actually not that good at figuring out what makes other people happy without their input.

We know that, in general, people prefer to be healthy rather than sick; we know that, in general, people prefer to be considered attractive rather than ugly. But we can't answer questions like 'would you rather identify as a boy or girl?' or 'would you rather have a cleft chin or a smooth chin?' accurately without your input--and so from that, I derive the notion that people are happier when we let them make those decisions themselves--rather than making them for them. For that reason, I tend toward reserving the 'big decisions' for people to make on their own when reserving them carries no significant consequence. At the very least, if you make the wrong decision yourself, it can be a learning experience--but if I make the wrong decision for you, there's nothing to gain.

I would expect there are lot of decisions that people would prefer we make for them, but I also expect the majority of those decisions fall under things like health and social acceptance.

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Re: Infant Circumcision

Postby leady » Wed Sep 05, 2012 4:27 pm UTC

If you are going to argue on the basis of health then a few relevent stats

"It’s a topic that doctors aren’t eagerly discussing, but the rate of transmitting HIV is low during heterosexual intercourse- estimates are from about 1 in 1,000 to as low as 1 in 10,000"

“There is a large Uganda study that showed it was much more equal. The number that is quoted is 2-to-1; in other words, male to female is twice as efficient or more likely to transmit HIV, as female to male.”

source: http://thechart.blogs.cnn.com/2010/08/1 ... nsmission/

so a 1 in 2000 chance altered to 1 in 1800, and you have to find the 0.6 person in a 100 with HIV in the first place.

You can play around with the numbers, but you are well outside the chop off body parts risk vs reward threshold

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Re: Infant Circumcision

Postby DSenette » Wed Sep 05, 2012 5:53 pm UTC

Enuja wrote:To chose one place DSenette stated this question:
DSenette wrote:the basic assumption: IF the us circumcision rate was the same as the circumcision rate in europe then the HIV infection rate in the US would increase by 20%
so, to check that assumption you could either decrease the circumcision rate in the US. OR look at the HIV infection rate in europe. IF the assumption is correct, then the HIV infection rate in europe should be 20% higher than that of the US. correct?

am i framing that correctly given the assumption?


To answer the question: Hell Fucking No!

To explain: There are other variables that determine both the HIV incidence & prevalence rates. It is true that, all other things being equal, "IF the us circumcision rate was the same as the circumcision rate in europe then the HIV infection rate in the US would increase by 20% ... then the HIV infection rate in europe should be 20% higher than that of the US." However, all other things are not equal. I don't know the actual differences between the US and Europe (I've read about the US and Africa, and not much about Europe), but other important variables that determine incidence rate (the chance to be infected) include prevalence rate (it doesn't matter how risky your behavior is, if your partners don't have the infection, you're not going to get it from them), condom usage, and average number of concurrent sexual partners.

Confounding variables are extremely difficult to control for in studies that look at existing populations. One extremely awesome way to get rid of confounding variables is to do a randomized controlled trail: take a group, divide them randomly, give one treatment to one half of the group and another treatment to other half of the group. This has been done three times in Africa with adult circumcision. The results were stunning: adult male circumcision reduced the chance of these men getting HIV by 51% to 60%. (It's easy to have big swings in chances: if you go from a 1% chance of getting HIV in the next year to a 2% chance, you've increased your risk by 100%. I don't remember what the actual risks where, or which countries these studies were done in, and all I'm finding with quick google searches are review articles.)

I know the above is not actually about infant circumcision, but it's about statistics and adult STI transmission, which I think are necessary background to talking about infant circumcision.

which is actually why i asked. i didn't make up that statement. a person involved in making the recomendation that infant males should be circumcised made that statement (the bit about circumcision rates vs hiv infection rates). the statement was (give or take a space or a letter) as i presented it, he said that if the circumcision rates in the US dropped, the HIV rates would increase, and he gave things that we should be able to measure against. no one came back and said "hey that guy's a dumbass" so i was asking about the reality of the statement.
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Re: Infant Circumcision

Postby Enuja » Wed Sep 05, 2012 9:33 pm UTC

That guy's not a dumbass. His part of the statement is (probably: I haven't done the research) right. Your part of the statement (his statement has got to be wrong, because US HIV prevalence is higher than European HIV prevalence) is the problem. He's using the HIV rate in Europe as a number to give people a ballpark idea of the effect size of circumcision in the United States: he's talking about a situation in which "all other things remain equal," you're trying to check his statement with one in which all other things are not equal, so it does not work.

The Great Hippo wrote:I would expect there are lot of decisions that people would prefer we make for them, but I also expect the majority of those decisions fall under things like health and social acceptance.
Like circumcision does, right? The main health issues are infant UTIs and adult STIs, and the social acceptance is what your partners think about your penis, or maybe what culture as a whole things of your penis. While there is the sexual pleasure question, circumcision reduces sensitivity, not (necessarily) resultant sexual pleasure. Many adult men who had circumcision say it increases their sexual pleasure, because they were too sensitive before, and now enjoy sex more.

Even though I'm currently pro-circumcision, a big part of me wants to be anti-circumcision, and not just because I prefer to play with uncircumcised penises. The vagina and the ass are sensitive, vulnerable tissues involved in sex. This isn't going to change. If "men" also have more sensitive, vulnerable tissues as part of their specifically "man" parts, then the sexes are more equal, the risks are more equal, society as a whole is more physiologically sensitive, which would hopefully lead to more thoughtful, safe, respectful, egalitarian behavior and psychology, and less of an assumed "biological" difference between "sexes."

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Re: Infant Circumcision

Postby BattleMoose » Wed Sep 05, 2012 11:41 pm UTC

Izawwlgood wrote:
BattleMoose wrote:Although I do think the impenetrable barrier that one places over ones cock during intercourse does reduce the efficacy of circumcision to prevent transmission to zero.

Learn new things time! Condoms include a 'rate of success' that includes improper use. Go back and reread Enuja's post.


I am aware of this. Which is why education on correct on proper condom usage is a very good idea. And if a condom does fail, then its PEP time for both individuals, lucky them! And if you think you don't have to go on PEP because you are circumcised, then, well, moron.

So, lets get condoms freely available, lets educate people on how to use them and also make PEP readily available as well, like, 4am from the emergency room available.


Izawwlgood wrote:
BattleMoose wrote:To put it another way. If the suggestion is that we should circumcise infant males, in order to reduce STIs, then the onus is on those making that argument to provide evidence that it would firstly actually even be effective.

I think the number of African studies showed that it is.


I am aware of the African studies. I am also aware that condom usage in Africa is very very very low. Doing a such a study in an environment where condoms are largely not used, and then applying that data to a context where condoms are largely used is just very bad science.

The question is, does circumcision provide any protection above and beyond correct condom usage, with available PEP?

If yes, give the data. If no, then stop supporting male infant circumcision.

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Re: Infant Circumcision

Postby DSenette » Thu Sep 06, 2012 12:20 pm UTC

Enuja wrote:That guy's not a dumbass. His part of the statement is (probably: I haven't done the research) right. Your part of the statement (his statement has got to be wrong, because US HIV prevalence is higher than European HIV prevalence) is the problem. He's using the HIV rate in Europe as a number to give people a ballpark idea of the effect size of circumcision in the United States: he's talking about a situation in which "all other things remain equal," you're trying to check his statement with one in which all other things are not equal, so it does not work.


the guy did not say "if all things are equal", he said "if the circumcision rates in america were to drop to the rates found in europe, HIV infection rates in the US would increase by 20%".

i also didn't say he was wrong. i asked several questions and didn't get answers. IF his statement is actually correct, then we should expect to see a 20% higher rate of infection in europe right? do we? i'm actually asking if we do, because i don't know.

i, in fact, never said a thing about US HIV prevalance, or listed any numbers, or cited any of that stuff because i don't actually know the answer, every time i've done anything with regards to any of this, i've asked a question to get information. i haven't made any statements of probability, or listed any numbers or percentages or anything unless it was in a quote from someone else.

so if you could PLEASE not attribute things to me that i haven't said, it would be MUCH appreciated.
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Re: Infant Circumcision

Postby TheGrammarBolshevik » Thu Sep 06, 2012 12:45 pm UTC

DSenette wrote:IF his statement is actually correct, then we should expect to see a 20% higher rate of infection in europe right?

No, that isn't right. There are a number of factors that might cause Europe's infection rate to be higher or lower, independent of circumcision rate. For example, what if Europeans use condoms more consistently than Americans do?
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Re: Infant Circumcision

Postby DSenette » Thu Sep 06, 2012 12:58 pm UTC

TheGrammarBolshevik wrote:
DSenette wrote:IF his statement is actually correct, then we should expect to see a 20% higher rate of infection in europe right?

No, that isn't right. There are a number of factors that might cause Europe's infection rate to be higher or lower, independent of circumcision rate. For example, what if Europeans use condoms more consistently than Americans do?

which has FUCK all to do with the statement that i'm quoting. so, either the guy that i'm quoting is wrong, or he misspoke. WHICH IS FINE, but say that he's wrong, or find a place where he said he misspoke, don't keep saying "well, his statement is correct, but you have to take into account all of the compounding factors"...because his statement didn't take those into account. his statement was basically that circumcision rate was the only thing making a difference in the HIV infection rates between europe and the US, period. so, again, like i asked the first time i quoted it......is that correct? can we actually observe that his claim is true?

your answer is obviously "no, no it's not true, circumcision isn't anywhere near the only thing separating the HIV infection rates between the US and europe". which is fine, and would have been nice to have 2 or 3 pages ago.

so the question is NOW, what ARE the things separating the HIV infection rates between the US and europe? and HOW big of a factor is circumcision rate?

because if you're looking at the studies in africa that are just looking at circumcision, and then you attempt to apply the findings to either the US or Europe, you're not going to be getting the same numbers.

i'm not defending the statements that i'm quoting either. it was a quantifiable statement that a professional made with regards to circumcision, in an article about recomending circumcision.
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Re: Infant Circumcision

Postby TheGrammarBolshevik » Thu Sep 06, 2012 1:55 pm UTC

DSenette wrote:his statement was basically that circumcision rate was the only thing making a difference in the HIV infection rates between europe and the US, period.

Could you quote exactly which statement you are talking about? I don't recall seeing a statement that says this.
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Re: Infant Circumcision

Postby DSenette » Thu Sep 06, 2012 2:07 pm UTC

http://www.hopkinsmedicine.org/news/media/releases/declining_rates_of_us_infant_male_circumcision_could_add_billions_to_health_care_costs_experts_warn wrote:According to the team’s analysis, if U.S. male circumcision rates among men born in the same year dropped to European rates, there would be an expected 12 percent increase in men infected with HIV (or 4,843); 29 percent more men infected with human papillomavirus (57,124); a 19 percent increase in men infected with herpes simplex virus (124,767); and a 211 percent jump in the number of infant male urinary tract infections (26,876). Among their female sex partners, there would be 50 percent more cases each of bacterial vaginosis (538,865) and trichomoniasis (64,585). The number of new infections with the high-risk form of human papillomavirus, which is closely linked to cervical cancer in women, would increase by 18 percent (33,148 more infections).


http://www.futurity.org/health-medicine/fewer-circumcisions-could-cost-billions/?utm_source=Futurity+Today&utm_campaign=627a28e183-August_218_21_2012&utm_medium=email wrote:According to the analysis, if circumcision among men born in the same year dropped to European rates, there would be an expected 12 percent increase in men infected with HIV, 29 percent more men infected with human papillomavirus, a 19 percent increase in men infected with herpes simplex virus, and a 211 percent jump in the number of infant male urinary tract infections.

Among their female sex partners, there would be 50 percent more cases each of bacterial vaginosis and trichomoniasis. The number of new infections with the high-risk form of human papillomavirus, which is closely linked to cervical cancer in women, would increase by 18 percent.


i'm looking for whatever convinced me that these parts were attributed to an actual human being speaking, but, whatever, i said i was paraphrasing before. but, the point stays the same. the statement being made is that if you were just to circumcise the same amount of people in the US as they do in europe, HIV infection rates would increase.

right? that's what's being said above right?
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Re: Infant Circumcision

Postby Enuja » Thu Sep 06, 2012 2:19 pm UTC

DSenette wrote: IF his statement is actually correct, then we should expect to see a 20% higher rate of infection in europe right? do we? i'm actually asking if we do, because i don't know.

i, in fact, never said a thing about US HIV prevalance, or listed any numbers, or cited any of that stuff because i don't actually know the answer, every time i've done anything with regards to any of this, i've asked a question to get information. i haven't made any statements of probability, or listed any numbers or percentages or anything unless it was in a quote from someone else.

so if you could PLEASE not attribute things to me that i haven't said, it would be MUCH appreciated.
The results of the study are extremely plausible, and what you're saying (if the paper is correct, Europe should have a 20% higher HIV infection rate 12% higher HIV infection rate in men than the US) is still wrong. I'm not trying to put any words in your mouth and I'm not quoting you for saying things you didn't say. Apparently, I am using words you don't understand, and I am not being clear enough. Let's try this again.

From a little bit of googling, it doesn't seem that the circumcision rate is measured or usually reported for "Europe" as a whole, just for specific countries in particular. But 10% looks like a good ballpark. So, it sounds to me that the paper is trying to communicate "If US circumcision rates dropped to 10%, the US HIV infection rate among men would increase by 12%." So why did the they say "dropped to rates found in Europe"? Probably because it seems plausible, given the similarities in cultures between Europe and the US, that the US circumcision rate could go that low. When you suggest one variable changing, and predict an outcome, you are assuming that all other variables will remain the same. So they plugged 10% (or whatever their average European circumcision rate was) into their models, and reported their results. The paper is not comparing HIV infection rates between the US and Europe, and doesn't address the many differences between the two regions. The results of the paper do not, in any way, imply that the current HIV infection rate is 12% higher in Europe than in the US, or that circumcision rate is the only thing making a difference in the HIV infection rates between europe and the US. Does this make sense now?

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Re: Infant Circumcision

Postby DSenette » Thu Sep 06, 2012 3:23 pm UTC

Enuja wrote:
DSenette wrote: IF his statement is actually correct, then we should expect to see a 20% higher rate of infection in europe right? do we? i'm actually asking if we do, because i don't know.

i, in fact, never said a thing about US HIV prevalance, or listed any numbers, or cited any of that stuff because i don't actually know the answer, every time i've done anything with regards to any of this, i've asked a question to get information. i haven't made any statements of probability, or listed any numbers or percentages or anything unless it was in a quote from someone else.

so if you could PLEASE not attribute things to me that i haven't said, it would be MUCH appreciated.
The results of the study are extremely plausible, and what you're saying (if the paper is correct, Europe should have a 20% higher HIV infection rate 12% higher HIV infection rate in men than the US) is still wrong. I'm not trying to put any words in your mouth and I'm not quoting you for saying things you didn't say. Apparently, I am using words you don't understand, and I am not being clear enough. Let's try this again.

From a little bit of googling, it doesn't seem that the circumcision rate is measured or usually reported for "Europe" as a whole, just for specific countries in particular. But 10% looks like a good ballpark. So, it sounds to me that the paper is trying to communicate "If US circumcision rates dropped to 10%, the US HIV infection rate among men would increase by 12%." So why did the they say "dropped to rates found in Europe"? Probably because it seems plausible, given the similarities in cultures between Europe and the US, that the US circumcision rate could go that low. When you suggest one variable changing, and predict an outcome, you are assuming that all other variables will remain the same. So they plugged 10% (or whatever their average European circumcision rate was) into their models, and reported their results. The paper is not comparing HIV infection rates between the US and Europe, and doesn't address the many differences between the two regions. The results of the paper do not, in any way, imply that the current HIV infection rate is 12% higher in Europe than in the US, or that circumcision rate is the only thing making a difference in the HIV infection rates between europe and the US. Does this make sense now?

that got it.......made the complete difference in the understanding.

IN THEORY, based on the statements, 12% of the HIV infections in the US are dependant on circumcision status (sort of)
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Re: Infant Circumcision

Postby Enuja » Thu Sep 06, 2012 9:40 pm UTC

Not quite. That 12% is not 12% of current HIV infections, it's a prediction that if the circumcision rate were to go down (to ~10%, from the current ~55%), and nothing else changed, then HIV infection rates would go up by 12%. Without a long instructional statistical tangent about incidence, prevalence, and relative risk, that I don't have the energy to write this week, I don't think I can explain this any better.


BattleMoose wrote:I am aware of this. Which is why education on correct on proper condom usage is a very good idea. And if a condom does fail, then its PEP time for both individuals, lucky them! And if you think you don't have to go on PEP because you are circumcised, then, well, moron.

So, lets get condoms freely available, lets educate people on how to use them and also make PEP readily available as well, like, 4am from the emergency room available.
...
I am aware of the African studies. I am also aware that condom usage in Africa is very very very low. Doing a such a study in an environment where condoms are largely not used, and then applying that data to a context where condoms are largely used is just very bad science.

The question is, does circumcision provide any protection above and beyond correct condom usage, with available PEP?

If yes, give the data. If no, then stop supporting male infant circumcision.
leady wrote:You can play around with the numbers, but you are well outside the chop off body parts risk vs reward threshold
The quotes DSenette included give specific predictions about increased infection rates of a variety of STIs if we lower the circumcision rate in the US. It's not just HIV that's at issue, and I'd like to ad that it's not even just known diseases. A new STI lurking around the corner will probably spread much more slowly in a population with a higher circumcision rate (all other things remaining equal, and depending on the specific biology of the new STI). Yes, for the US, the impact of circumcision on STIs is bigger for the STIs that are currently more common. That's not surprising, and it's not a convincing counter-argument for circumcision, infant or adult.

The actual rates of condom usage in the US are not particularly high: most avowedly monogamous folks don't use condoms, and many people who use condoms use them most of the time, except when they can't find one or when they're drunk. BattleMoose, I hope you're not suggesting that monogamous people should be medically treated to avoid some subset of STIs every time they chose to have sex without condoms. Yes, increasing condom usage is good, and no, people shouldn't act in more risky ways just because they're circumcised (risk compensation), but, if I recall from Tinderbox correctly, they don't, because it's not a prevention method, it's a body status. Circumcision provides a relatively small protection from STIs on the individual level, but that adds up on the population level, making everybody much safer, even if they're doing everything right.

If this were an STI thread, it would make sense to argue that circumcision is more important in the parts of Africa with high HIV prevalence than it is in the US, that reducing partner number is more important, and that increasing condom usage in the US is more important. But this isn't an STI thread. All of that is true, but none of it changes the fact that infant circumcision is also a good idea, medically, even in the US. We're not talking about infant circumcision in the US versus condom promotion in the US. We're talking about allowing infant circumcision, and having medicaid and insurance pay for it, if the parents want it, versus condemning parents as barbaric mutilators of their children if they chose to have them circumcised.

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Re: Infant Circumcision

Postby The Great Hippo » Thu Sep 06, 2012 9:53 pm UTC

Honestly, I was (mostly) against circumcision when I first entered this thread (I just disliked the quality of the arguments made against it, so often ended up criticizing my own side), but in light of the STI argument--well, if the numbers really are there, it seems hard to maintain a strong case against it.

EDIT: I can't actually speak to the numbers, though, because I absolutely blow at them. Still working my way up through higher-end maths, skipped statistics. Will probably go back and learn it soon.

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Re: Infant Circumcision

Postby Lucrece » Fri Sep 07, 2012 3:25 am UTC

I seem to recall some AIDS advocacy organizations still don't seem content with endorsing PEP usage for all HIV prevention methods. I think there might still not be consensus on the use of PEP to address HIV transmission. I don't remember if the lack of consensus is based on social worries or a risk of unwanted production of resistant strains, though.
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Re: Infant Circumcision

Postby DSenette » Fri Sep 07, 2012 12:38 pm UTC

Enuja wrote:Not quite. That 12% is not 12% of current HIV infections, it's a prediction that if the circumcision rate were to go down (to ~10%, from the current ~55%), and nothing else changed, then HIV infection rates would go up by 12%. Without a long instructional statistical tangent about incidence, prevalence, and relative risk, that I don't have the energy to write this week, I don't think I can explain this any better.
that's actually what i meant in my implication break down, just worded it wrong

you COULD (no one should, but for ease of understanding, you COULD) apply the concept retroactively JUST for illustritive purposes (not for actual number usage or as an argument). IF we had two hypothetical parallell populations of people born in 2000 containing both men and women (by parallell i mean we have two distinct universes that contain the exact same people at the exact same time, and all of the universes are exactly the same) but in one universe we circumcised 55% of the men, and in the other we only circumcised 10% of the men. in the 10% universe we should be able to reasonablly expect that 12% fewer people would have HIV (both men and women, straight or not, etc... etc...). right?

we don't really need to know the other confounding or compounding factors for that assessment because we're creating the two universes JUST to illustrate the numbers. obviously, in reality we're talking about moving forward through time in a variable universe.
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Re: Infant Circumcision

Postby bantler » Fri Sep 07, 2012 5:10 pm UTC

I’m pro for aesthetic reasons. I also like my Dobermans docked.

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Re: Infant Circumcision

Postby BattleMoose » Mon Sep 10, 2012 3:58 am UTC

On how to combat HIV:

1. Condoms, free and easily available. And easily available everywhere, public restrooms, restrooms in workplaces, every restroom on every tertiary education campus, nightclubs, bars, everywhere. And they should be absolutely everywhere in university dormitories. Tertiary education students should also particularly be strongly encouraged to carry them on their persons at all times.

2. Education, use of media, addressing the stigma and concerns about rampant condom availability. Also, on correct usage. And in some places in the world address the insanity that is the encouragement of abstinence.

3. Availability of PEP, 4am available from the emergency room kind of available.

4. Free availability of highly active antiretroviral therapy. (It reduces viral load, sometimes to undetectable level, making it much harder for these individuals to pass on the virus)

5. Testing, free, easily available and confidential. And with the promise of free treatment with a positive diagnosis.

6. Free, no questions asked, needles exchanges.

These are the things we should be doing if we want to actually combat HIV prevalence. If these things aren't happening we really ought to strongly question why and then not be surprised when HIV prevalence is high. I would hazard that if these things are being done and in every first world country they should be being done, that the effect of circumcision on new HIV infections would not even be measurable.

And if South Africa can afford to put condoms freely available just about everywhere, free testing and drugs, I expect the USA should be able to also.

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Re: Infant Circumcision

Postby The Great Hippo » Mon Sep 10, 2012 4:50 am UTC

BattleMoose wrote:These are the things we should be doing if we want to actually combat HIV prevalence. If these things aren't happening we really ought to strongly question why and then not be surprised when HIV prevalence is high. I would hazard that if these things are being done and in every first world country they should be being done, that the effect of circumcision on new HIV infections would not even be measurable.
I don't like this argument. It sounds suspiciously leaky: "We shouldn't use circumcision to combat STIs until we do all of the above. And if we do all of the above, circumcision probably won't have a positive effect anyway."

Why shouldn't we use circumcisions to combat STIs in addition to all those other excellent ideas? Why are you assuming circumcision won't have a net positive result if we put all those other ideas into effect?

The relevant point here isn't that there are other ways to reduce STI rates besides circumcision. Yes, I'm sure there are! But what's relevant is that circumcision may have a positive overall effect on STI rates, and therefore may do more good than harm.

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Re: Infant Circumcision

Postby BattleMoose » Mon Sep 10, 2012 5:13 am UTC

The Great Hippo wrote:
BattleMoose wrote:These are the things we should be doing if we want to actually combat HIV prevalence. If these things aren't happening we really ought to strongly question why and then not be surprised when HIV prevalence is high. I would hazard that if these things are being done and in every first world country they should be being done, that the effect of circumcision on new HIV infections would not even be measurable.
I don't like this argument. It sounds suspiciously leaky: "We shouldn't use circumcision to combat STIs until we do all of the above. And if we do all of the above, circumcision probably won't have a positive effect anyway."


My expectations would be that the effect would be immeasurable. I really should be asking the question, what would the effect be?

Why shouldn't we use circumcisions to combat STIs in addition to all those other excellent ideas? Why are you assuming circumcision won't have a net positive result if we put all those other ideas into effect?


I am suggesting that circumcision will have almost no effect if we do all those other things.

The instances where circumcision may have an effect are:

1. One party is infected and doesn't know. (Free and regular testing should minimize this)
AND Neither party has a condom and a condom isn't readily available. (This should never ever ever happen, we should and could have condoms just about everywhere)

2. One party is infected and doesn't know. (Free and regular testing should minimize this) AND condom failure AND no access to a hospital (Just about everyone has access to a hospital).

I am not assuming there won't be a net positive result, in terms of HIV prevention there probably will be. I just expect that it would be so incredibly small.

We should study this and find out what the benefit is before we propose circumcising to prevent HIV transmission.

The Great Hippo wrote:The relevant point here isn't that there are other ways to reduce STI rates besides circumcision. Yes, I'm sure there are! But what's relevant is that circumcision may have a positive overall effect on STI rates, and therefore may do more good than harm.


Firstly, good for who? The child or society?

And if we can address a problem without forced male genital mutilation then those other means of addressing that problem are completely relevant. Forced male genital mutilation is certainly something we should be trying to avoid. And if we don't need it to address a problem then we shouldn't be doing it.

So the question really is, if we are sensible about HIV transmission, then what will the effect of circumcision really be?

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Re: Infant Circumcision

Postby The Great Hippo » Mon Sep 10, 2012 5:39 am UTC

BattleMoose wrote:The instances where circumcision may have an effect are:
If circumcision actually reduces the transmission rate of STIs, it has impact on all instances of potential STI transmission. If I am infected and don't know, it reduces the risk. If I am infected and do know (and don't tell you, because I am terrible), it still reduces the risk. If I don't use a condom, it still reduces the risk. If I do use a condom, it still reduces the risk. If the condom fails, it still reduces the risk. If there's a hospital nearby, it still reduces the risk. If there's no hospital nearby, it still reduces the risk. If we do it while skydiving, it still reduces the risk. If we involve your sister and all her friends (and half of them are infected too!), it still reduces the risk.

That's why I find the idea kind of seductive: If this is true, it reduces the risk in all cases of intercourse involving a penis. That's... pretty great, actually.
BattleMoose wrote:And if we can address a problem without forced male genital mutilation then those other means of addressing that problem are completely relevant. Forced male genital mutilation is certainly something we should be trying to avoid. And if we don't need it to address a problem then we shouldn't be doing it.
Here's the thing: If I genuinely knew circumcision significantly reduces STI transmission rates, I would not hesitate for one second to support a campaign to mutilate the genitals of every single penis in the world. Because 'genital mutilation' is a scary sounding phrase, sure--but you know what's scarier? "You have HIV."
BattleMoose wrote:So the question really is, if we are sensible about HIV transmission, then what will the effect of circumcision really be?
Have we been sensible about HIV transmission? Have our policies toward prevention of HIV transmission largely worked? Are STIs still a big problem, and will they continue to be a big problem twenty years down the line?

Let me put it to you another way: If circumcising children right now would save a significant number of lives twenty years down the road, then we should do it.

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Re: Infant Circumcision

Postby BattleMoose » Mon Sep 10, 2012 6:05 am UTC

The Great Hippo wrote:
BattleMoose wrote:The instances where circumcision may have an effect are:
If circumcision actually reduces the transmission rate of STIs, it has impact on all instances of potential STI transmission. If I am infected and don't know, it reduces the risk. If I am infected and do know (and don't tell you, because I am terrible), it still reduces the risk. If the condom fails, it still reduces the risk. If there's a hospital nearby, it still reduces the risk. If there's no hospital nearby, it still reduces the risk. If we do it while skydiving, it still reduces the risk. If we involve your sister and all her friends (and half of them are infected too!), it still reduces the risk.

That's why I find the idea kind of seductive: If this is true, it reduces the risk in all cases of intercourse involving a penis. That's... pretty great, actually.


If a condom is used correctly, protection gained because of circumcision is zero.
If a condom fails, protection gained from circumcision compared to PEP is near zero.
Unprotected sex with an infected person on ART, protection from circumcision compared to ART, well, ART is a great deal more effective.
Unprotected sex with a stranger who doesn't know they are infected, you're a moron.

Using circumcision in conjunction with these other things, is at least an argument I can accept. I think its morally repugnant but it would be rational. But to use it instead of, is pure inanity.

BattleMoose wrote:So the question really is, if we are sensible about HIV transmission, then what will the effect of circumcision really be?
Have we been sensible about HIV transmission? Have our policies toward prevention of HIV transmission largely worked? Are STIs still a big problem, and will they continue to be a big problem twenty years down the line?[/quote]

Some countries have been sensible and the HIV prevalence in those countries are low. If a country wants to reduce infection rates, best to learn from countries which have handled the epidemic well.

The Great Hippo wrote:Let me put it to you another way: If circumcising children right now would save a significant number of lives twenty years down the road, then we should do it.


Why limit to children? Why not all adults? And then you will get a reaction appropriate to what you are suggesting.

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Re: Infant Circumcision

Postby LaserGuy » Mon Sep 10, 2012 6:30 am UTC

The Great Hippo wrote:If circumcision actually reduces the transmission rate of STIs, it has impact on all instances of potential STI transmission. If I am infected and don't know, it reduces the risk. If I am infected and do know (and don't tell you, because I am terrible), it still reduces the risk. If I don't use a condom, it still reduces the risk. If I do use a condom, it still reduces the risk. If the condom fails, it still reduces the risk. If there's a hospital nearby, it still reduces the risk. If there's no hospital nearby, it still reduces the risk. If we do it while skydiving, it still reduces the risk. If we involve your sister and all her friends (and half of them are infected too!), it still reduces the risk.


Unless people who are circumcised on these grounds then (mistakenly) believe that they are vaccinated from STIs and go on to do riskier behaviour than they would otherwise. Risk compensation of this nature is a fairly common phenomenon.

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Re: Infant Circumcision

Postby The Great Hippo » Mon Sep 10, 2012 1:42 pm UTC

BattleMoose wrote:If a condom is used correctly, protection gained because of circumcision is zero.
Unless the condom breaks. Or simply fails. Both of which are nonzero risks. Which means--if circumcision reduces STI rates--it reduces them even in cases when you use a condom correctly.
BattleMoose wrote:If a condom fails, protection gained from circumcision compared to PEP is near zero.
Unprotected sex with an infected person on ART, protection from circumcision compared to ART, well, ART is a great deal more effective.
But this isn't a race, so the efficacy of various measures in combating STIs is irrelevant. Once circumcised, you are always circumcised.
BattleMoose wrote:Unprotected sex with a stranger who doesn't know they are infected, you're a moron.
This is a breathtakingly ignorant--and ugly--sentiment. It's also irrelevant. I don't care if you're a moron. I still don't want you to get an STI.
BattleMoose wrote:Using circumcision in conjunction with these other things, is at least an argument I can accept. I think its morally repugnant but it would be rational. But to use it instead of, is pure inanity.
No one in this thread has suggested circumcision as an alternative treatment for STIs. It has only been suggested that circumcision might provide an invisible 'safety net' to reduce STI rates in conjunction with all our other measures. How are you not getting this?
BattleMoose wrote:Why limit to children? Why not all adults?
Because it's easier to convince parents to circumcise infants than convince adults to circumcise themselves.
LaserGuy wrote:Unless people who are circumcised on these grounds then (mistakenly) believe that they are vaccinated from STIs and go on to do riskier behaviour than they would otherwise. Risk compensation of this nature is a fairly common phenomenon.
The only reasonable environment I can see that happening is if, every night, when their parents tuck them in, they remind them why they're circumcised.

"Now, remember to say your prayers, Bobby. And that by circumcising your penis, we have created an INVINCIBLE CYCLOPTIC MONSTER THAT CAN DEFLECT BULLETS, CURE HERPES, AND FIGHT CRIME."


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