I have commented about this issue previously. By now you may have heard that researchers have found that circumcised men end up getting the HIV virus half as often as uncircumcised men.
Now comes this article in the New York Times:
Last month, scientists invented the AIDS vaccine. Missed it? Perhaps that’s because you were still seeking the vaccine fantasy: the magic bullet, the impenetrable shield that finally pitches this disease into the trash bin, the shot that will end not only the AIDS epidemic but our anxiety about the AIDS epidemic as well.
[…]The vaccine that arrived last month was not actually a vaccine. It was, instead, a confirmation of what scientists had long suspected: circumcision helps protect men from AIDS infection. For years, AIDS researchers have observed that many African tribes that circumcise boys or young men had lower AIDS rates than those that don’t, and that Africa’s Muslim nations, where circumcision is near universal, had far fewer AIDS cases than predominantly Christian ones. The first research proof came in 2005, when a study in South Africa was stopped early in the face of evidence that the men who had been randomly assigned to be circumcised were getting 60 percent fewer H.I.V. infections than the men assigned to the control group. Last month, ethics boards halted two similar studies, in Uganda and Kenya, when they found similar results. In both, the circumcised men caught the AIDS virus half as often as the uncircumcised control group.
I don’t have a problem with the results of the research itself, besides the obvious ethical questions, such as letting men have unprotected sex with HIV-positive women: if it is no biggie, then why didn’t the researchers try this little experiment somewhere in the U.S.? Ethics rule #1: if an Institutional Review Board (IRB, the one that regulates all research in every institution) would object to a certain experiment in your country, it is probably unethical to do so in another country as well. In layman’s terms, such research would never be allowed in the U.S.
But I digress. I don’t have a problem with the results of the studies. My problem is that because of these results, some people think that cutting part of their wiener is all it takes to fight AIDS. Thankfully, the New York Times article does tackle those issues, such as:
1) Will knowledge of circumcision’s protective status increase dangerous and ill-informed sexual behavior in men?
2) Does this protective status extend to the women circumcised men have sex with?
3) Will it increase or decrease research efforts for an AIDS vaccine?
4) How on Earth are we going to mass circumcise men in Africa? (really, what the hell do people think circumcision is?)
5) Who will train the medical personal?
You have to keep in mind that Africa’s health systems are very delicate – sometimes there is no sterilized equipment, or no autoclave machine, or surgical kits, or for that matter, very few medical personnel – and just cutting wieners left and right is not going to help in fighting AIDS.
Circumcision is a surgical procedure, however, and in the hands of traditional ritual circumcisers, it has a high rate of infection and mishap. The solution is to train these circumcisers and give them decent tools, and at the same time encourage men to come to clinics. Since men in studies say that cost is the biggest reason they are not circumcised, the operation must be free. Countries will also have to equip these clinics and train counselors and medical circumcisers, who don’t have to be doctors.
As you can gather, I oppose circumcision. It is a barbaric practice of ancient times, and you won’t see many docs offering circumcisions (unless you are Jewish). Here is another question for you: are we going to mass circumcise African children now? I really, really don’t want a religious crackpot to dictate that all those poor African children must be circumcised to prevent HIV.
You can read the rest of the article here. The article compares circumcision to a vaccine, and even though it is clear to make the distinctions, I don’t like it one bit. The best way to prevent HIV/AIDS is through education. Education, education, education! Not prayer, certainly not wishful thinking – education.
Either you don’t have sex (you’re not going to last long in this group), you use condoms and protect yourself and your partner, or are faithful to your partner (once you have an honest dialogue, both are faithful to each other, and of course none of them have HIV). That’s the foolproof method. You need to be educated about your own body, and respectful of your partner(s).
Of course, the biggest question to me is that while circumcision is protective only 50%, perhaps 60%, of HIV in each sexual encounter the individual has, you are out of luck the other half of the time. You really are going to take your chances? Who is going to protect you the other 50% of the time? It’s basic statistics – in this case, almost like a coin toss. And it’s also common sense – a condom, or a circumcision? Thanks but no thanks Mohel, you can keep your Metzitzah b’peh to yourself. You can cut part of your wiener, but if you have unprotected sex with someone who has HIV/AIDS, trust me, you will eventually get HIV.