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The Lobby

  • The CDC/AAP Project
    STILL ONLINE
  • The Brian Morris Project
    Offline - this page remains offline for now.
  • The Daniel Halperin Project
    Offline - this page remains offline for now.
  • The Robert Bailey Project
    Offline - this page remains offline for now.

About

  • Male Circumcision and HIV provides a place for a public health policy debate on the linking of male circumcision and HIV/AIDS. It seeks to address questions of cost versus benefit, the effectiveness of circumcision in the fight against HIV/AIDS in real world settings, and the differing points of view of researchers, the media, and all contributors to the policy discussion.

Weekly Video Commentary

Contributors

  • David Wilton

    David Wilton is a lawyer by training. He has a long-standing interest in issues of body integrity and HIV/AIDS. He maintains this site and blogs from San Francisco, California. His primary interests outside of nurturing a debate on the controversial measure of removing sexual tissue to reduce the spread of HIV are in the areas of international relations, languages, and journalism.
  • Adrienne Soti
    Adrienne Soti has provided research and monitoring of the media for Male Circumcision and HIV. A native of Hungary who came to the US in 1990, she lives with her husband and two small children in New Jersey. She has a B.A. in Psychology and Philosophy from Rutgers University. She lists biology and medicine among her many interests and is particularly interested in bio-ethical issues. The circumcision controversy came to her attention after the birth of her son in 2005.
  • Joe
    Joe is a long time reader who has made many very helpful suggestions along the way. He has also been very active in pointing out overlooked stories. In fact, he has been so helpful that I offered him a job (sadly unpaid). He now posts occasionally to these pages. At his request, he remains anonymous. Welcome aboard and thanks for your work, Joe. - DW

Contact

  • Please note new contact email
    Circumcisionandhiv.com
    PO Box 40312
    San Francisco, CA 94140
    wilton31@gmail.com
    [Please put CIRCUMCISIONANDHIV in the subject line.]

Relevant Reference Works

DVDs

  • Cut:
    Slicing Through the Myths of Circumcision
    A Film by Eliyahu Ungar-Sargon
    Buy Now
    See the Trailer

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Saturday, July 04, 2009

AFRICA: Uganda to outlaw female circumcision

The irony continues to pour forth from Africa ...

Uganda to outlaw female circumcision

AFP Fri Jul 3, 7:45 am ET KAMPALA (AFP) – Uganda will pass a law banning female genital mutilation, which is rampant among pastoralist tribes in the country's eastern region, the president said in a statement Friday.

"The way God made it, there is no part of a human body that is useless," President Yoweri Museveni told a gathering in the eastern Karamoja district.

"Now you people interfere with God's work. Some say it is culture. Yes, I support culture but you must support culture that is useful and based on scientific information," he added.

Last year, the United Nations passed a resolution that called female genital mutilation a violation of the rights of women and said it constituted "irreparable, irreversible abuse."

The resolution also said female circumcision increases the risk of HIV transmission, as well as maternal and infant mortality. The UN estimates that between 100 million to 140 million worldwide have undergone the practice.

Link: Uganda to outlaw female circumcision - Yahoo! News.

Monday, June 29, 2009

We must all "come out of the closet" for genital integrity

The Bay Area Intactivists Group, sponsored by MGMBill.org, marched again this year in the San Francisco Gay Pride Parade. The organizers chose the slogan "The Audacity of Pride" to reflect how gay activism has, through sheer will, persevered to the point of making marriage available for all - and to remind us there is still much work to be done.

James Loewen, a Vancouver-based photographer and videographer, came to San Francisco this year to document the experiences of many activists who oppose infant circumcision (intactivists) and their yearly participation in the pride parade. We agreed to work together during the parade and afterwards to document the experience.

You never know what may happen in activism as in life. And so out of the crowd came an audacious supporter indeed. The self-proclaimed "Lady Miss Saigon" jumped the rails and grabbed a sign, hoisting it aloft and walked three blocks or more with us to the end in 4 inch heels.

Apart from the excellent footage James got of her, official media of all sorts, many with actual press passes jumped in the mix and started shooting, reminding me and hopefully us all that we must come out of the closet for genital integrity no matter who or where we are

Interestingly, it was at this point that a monitor came over and asked for my press pass. I showed him my t-shirt to persuade him I was part of the group. I was flattered. There are many more photos, perhaps 250 in all, which will be made available shortly for various projects.

Click on the photos to enlarge.

DSC_0318

DSC_0321

DSC_0048

Thursday, June 25, 2009

PlusNews Global | SOUTHERN AFRICA: Male circumcision - what's the latest on roll out?

JOHANNESBURG, 23 June 2009 (PlusNews) - It has been two years since the World Health Organization recommended male circumcision (MC) as an HIV prevention measure, and countries in Southern Africa - the region hardest-hit by AIDS - have been slowly gearing up to provide widespread access to the procedure. IRIN/PlusNews has compiled a list of the progress made so far in eight southern African countries.

Click the link below for a country by country report of the extent that the HIV/AIDS community is wasting massive amounts of time and effort.

Link: PlusNews Global | Southern Africa | Angola Botswana Lesotho Madagascar Mauritius Malawi Mozambique Namibia Swaziland South Africa Zambia Zimbabwe | SOUTHERN AFRICA: Male circumcision - what's the latest? | HIV/AIDS (PlusNews) Prevention - PlusNews | Breaking News.

Tuesday, June 23, 2009

INTACT AMERICA LAUNCHES CAMPAIGN TO CHANGE THE WAY THE NATION THINKS ABOUT MALE CIRCUMCISION

Media Contact: Bob Liff at 917-438-4628, bliff@mrss.com
M+R Strategic Services

INTACT AMERICA LAUNCHES CAMPAIGN TO CHANGE THE WAY THE NATION THINKS ABOUT MALE CIRCUMCISION

SORAYA MIRÉ, SOMALI WOMAN WHO FIGHTS TO END FORCED FEMALE CIRCUMCISION, JOINS CAMPAIGN TO PROMOTE INTACT BODIES FOR INFANT BOYS

PAINFUL, RISKY REMOVAL OF HEALTHY FUNCTIONING TISSUE VIOLATES HUMAN RIGHTS OF BABY BOYS WHO CANNOT GIVE INFORMED CONSENT

FOR IMMEDIATE RELEASE
JUNE 22, 2009

A group of parents, pediatricians, health activists, and human rights attorneys today announced the launch of a nationwide campaign to change the way America thinks about male circumcision, arguing that painful and medically unnecessary surgery to remove healthy genital tissue from non-consenting baby boys violates medical ethics and human rights.

Intact America – which unveiled its informational and advocacy website (www.intactamerica.org) at a Manhattan press conference – was joined by Soraya Miré, the Somali filmmaker and activist who has become a global leader in the fight against forced female circumcision.

"The same universal human right to an intact body that I have fought for on behalf of women and girls must apply to boys as well, especially those who are too young to make an informed decision about the integrity of their bodies," said Miré. "We need to ask ourselves: How can it be wrong to surgically alter the genitals of a baby girl without her consent but okay to surgically alter the genitals of a baby boy?"

The Intact America campaign kickoff comes at a time when the Centers for Disease Control is reviewing studies of adult African male circumcision in the context of the HIV epidemic in Africa, with the goal of developing a recommendation to be released here in the United States.

"Studies of adult men in Africa cannot be used to justify subjecting non-consenting American baby boys to irreversible surgery that will remove healthy tissue from their genitals for the rest of their lives," said Georganne Chapin, Executive Director of Intact America. "Let young men make decisions about their own bodies, when they reach an age to make that decision for themselves."

"Before subjecting their newborn sons to painful, risky and irreversible genital surgery that is medically unnecessary, parents should ask themselves if they would do the same to their daughters," said Chapin.

Chapin was also joined at the press conference by two physicians – Dr. Robert Van Howe, a pediatrician, from Marquette, MI, and his wife Dr. Michelle Storms, a family practice physician and Assistant Professor at the Michigan State University College of Human Medicine.

"Physicians have an obligation to look after the well-being of their patients. The child is the patient, not the parent. Neonatal circumcision is definitely not in the patients' best interest," said Dr. Van Howe, noting that the surgery yields more harm than benefit for the baby boy who cannot give informed consent. "It is a violation of the child's most basic human rights, and a violation of a physician's oath to do no harm."

"As an adult, I can say yes or no based on informed consent," said Dr. Van Howe. "An infant obviously cannot do that."

Dr. Storms, who is also Research Director in the Family Medicine Residency Program at the MSU medical college, said she stopped performing circumcisions in 1988 when she could not ignore the fact that there was no medical justification for the surgery.

"I realized I was cutting off healthy tissue from a baby that couldn't say no," said Dr. Storms. "I wasn't treating or diagnosing disease. It violated my sense of ethics and everything I was taught in medical school about my obligation to heal the sick and do no harm."

"Clearly, circumcision is harming these infants," Storms said. "Physicians should just say no to neonatal circumcision."

Dean Pisani, a Texas businessman, made a $1 million commitment to assist Intact America's campaign after he and his wife, who did not know the gender of their children before their births, were pressured by his wife's obstetrician and doctors in Illinois hospitals to perform a circumcision if they had a son.

"My wife and I did our research and could find no rational or persuasive argument to subject a baby to surgery that had no medical benefit," said Pisani. "We came under pressure from doctors prior to the birth of both of our children, but none could substantiate the medical necessity to perform the surgery. The pressure from doctors was both inappropriate and indefensible."

Male circumcision is the most commonly performed surgery on infants in the nation, and one that is medically unnecessary.

The United States is the only industrialized nation (other than South Korea, which was influenced by the United States in the 1950s) that continues to circumcise a majority of baby boys for non-religious reasons, and it also has a higher rate of HIV infection than other industrialized nations.

If circumcision were an effective means to prevent potential HIV infection, logic would suggest that the U.S.'s high rate of male circumcision would yield a lower rate of HIV infection, but it does not. The only reliable means of preventing sexual transmission of HIV remains abstinence or use of a condom, not circumcision.

Approximately 75% of the men in the world are not circumcised and remain intact throughout their lives. Even in America, which continues to lead the industrialized world in male circumcision of infant boys, the rate of circumcision has dropped from 85 percent to less than 60 percent as parents learn facts that for years have gone unexamined. Intact America is working to promote awareness about the normal, intact body and the value of the male foreskin as a normal, sensitive and functional part of the body. The foreskin serves to protect the penis from injury and contamination, and also has a role in sexual pleasure, due to its specialized nerve endings and its natural lubricating function.

Doctors began routinely circumcising infant boys in the last decades of the 19th century, when it was viewed as a means to discourage masturbation, and the evils that were believed to be associated with masturbation. Claims over the years that circumcision prevents various diseases – including, in recent decades, sexually transmitted diseases – have been found to be mistaken or exaggerated.

The most common method of circumcision involves the infant being strapped to a board. In some cases, an analgesic is applied to the baby's pubic area to somewhat lessen the pain, but many circumcisions are performed with no pain control at all. A metal instrument is used to forcibly separate the foreskin from the head of the penis, and the foreskin is then cut off. The surgery takes up to 15 minutes. The open wound it creates is exposed to urine and feces for several days as it heals. In addition to pain, the baby is subjected to the potential complications that accompany any surgery including, as occurs more than 100 times annually, complications leading to death.

Lesser but more common complications include abnormal bleeding, infection of the penis, scarring resulting from the removal of too much skin or, in rare cases, removal or subsequent loss of the entire penis. A case in point occurred recently in Georgia, where a family won a $2.3 million judgment after a botched circumcision accidentally removed a third of their son's healthy penis.

No professional medical authority recommends routine circumcision as a medical procedure, including the American Association of Pediatrics, which has said there are no benefits associated with male circumcision to justify recommending it.

Sixteen states refuse to cover non-medically-necessary circumcisions under Medicaid. Nationally, costs related to circumcision exceed $1 billion annually.

Link: INTACT AMERICA LAUNCHES CAMPAIGN TO CHANGE THE WAY THE NATION THINKS ABOUT MALE CIRCUMCISION

Tuesday, June 16, 2009

The Bill and Melinda Gates Foundation funds African circumcision to the tune of US$50m

The Bill and Melinda Gates Foundation has come forward with a US$50 million grant to fund mass circumcisions in several East African countries. While this sounds like a huge investment, it is but a drop in the bucket to reach the levels of circumcision prevalence required as asserted by the pro-circumcision lobby to achieve any population level effect - an effect which has been shown by Garenne and others to be illusory.

In any event, US$50 million will fund only about 600,000 circumcisions. A lot to be sure, but not enough. And therefore akin to throwing money on the bonfire.

Link: Bill Gates helps fund mass circumcision programme

Sunday, May 31, 2009

Dr. DEAN EDELL: The Circumcision Debate

EDIT: This is a recent radio broadcast. Sorry I don't have a date. Fans of Edell will instantly recognize his voice. He speaks about HIV and circumcision among other issues. The graphics (G-rated) come from the YouTuber who posted the audio.

Saturday, May 30, 2009

AFRICA: Prevention efforts and infection patterns mismatched

In at least five African countries, scarce resources are being spent on national HIV prevention campaigns that do not reach the people most at risk of infection, new research has found.

Between 2007 and 2008, UNAIDS and the World Bank partnered with the national AIDS authorities of Kenya, Lesotho, Swaziland, Uganda and Mozambique to find out how and where most HIV infections were occurring in each country, and whether existing prevention efforts and expenditure matched these findings.

The recently released reports reveal that few prevention programmes are based on existing evidence of what drives HIV/AIDS epidemics in the five countries surveyed.

LINK: Aidsmap | Africa: Prevention efforts and infection patterns mismatched.

Meanwhile, Botswana continues to gain publicity because that country has adopted a sensationalized effort to circumcise a half million men and boys. The effort is unlikely to make any difference because it hasn't addressed the multiple concurrent partnerships endemic to the region and responsible for the wildfire-like spread of HIV. A full 43% of pregnant Botswana women are said to be infected with HIV.

Friday, May 29, 2009

Tradition vs. Rights: What can the gay marriage debate teach us about forced infant circumcision?

The fight for gay marriage is interesting in many respects. One of the more interesting issues is the positioning of tradition against fairness, equality, and privacy rights. The following video seeks to do this by giving a taste of the marriage experience if many Biblical traditions were still observed. How thought-provoking in light of the continued practice of infant circumcision. I haven't quite got my brain wrapped around this yet, but it's something that I can't stop thinking about.

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    New administration, new leadership at the United States CDC. Help us update the contacts. Comments are open. Leave the new info, and we'll revise the page as new comments indicate.
  • The AAP/CDC Project
    The CDC has come out with a misleading and counterproductive white paper on circumcision and HIV. Please check out the The AAP/CDC Project page for names and addresses of people you should contact to press the issue. Follow this [link] to go directly to that page.

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Navigation

  • For specific topics, please browse recent posts or the subject categories.

Elsewhere on the Web

  • Circumcision and AIDS at MGMbill.org
    A decidedly anti-circumcision site with a calm approach to addressing the human rights issues likely to become problematic in the rush to roll out circumcision as an HIV prophylactic.
  • Circumcision and HIV at circumstitions.com
    One of the most thorough reviews anywhere of circumcision and the history behind the HIV prevention community's study of it. The science behind this prophylactic tool is much more equivocal than the most recent researchers would have you believe. New Zealand based.
  • Circumcision and HIV: Harm Outweighs Benefits from circumcision.org
    From the Circumcision Resource Center, Boston, Massachusetts. This human rights organization has published such books as Questioning Circumcision: A Jewish Perspective and Circumcision: The Hidden Trauma. Sitting on its board are a number of individuals affiliated with Harvard and other Ivy League institutions.
  • Circumcision and HIV infection from CIRP.org
    From the Circumcision Information Resource Pages. Not as up-to-date, but an excellent primer on the issue.
  • Doctors Opposing Circumcision statement on HIV
    Doctor's Opposing Circumcision is a Seattle based physicians group that provides education, information and advice on medical circumcision and its effects.
  • Statement on AIDS and Circumcision from the International Coalition for Genital Integrity
    Another thorough treatment of male circumcision's likely impact on the spread of HIV from an "alliance of organizations dedicated to protecting the normal anatomy of males, females and the intersexed ... [that] was formed to coalesce the many activist organizations, each with a specific focus, into one, common voice."
  • Does circumcision prevent HIV infection? - NORM-UK
    John Dalton puts together a critique of the African studies and their weaknesses. He examines the evidence, appropriateness, and possible outcomes from promoting circumcision and calling it a "prevention."

Sources

  • HIV/AIDS Medscape [free registration required]
    This site is owned by WebMD.com. It is a great source for breaking news. I wouldn't necessarily trust it completely on the issue of circumcision as it is US-based. But the HIV/AIDS coverage is pretty good.
  • UCSF HIV InSite Gateway to HIV Information
    The University of California - San Francisco is a leading medical teaching and research university in the HIV/AIDS field. Generally very reliable, it occasionally oversells or misstates the prevention message, most obviously and unfortunately regarding circumcision.
  • IRIN PlusNews
    I don't like this source because it tends to be a bit sensationalist, in my opinion. But it is pretty good for divining which way the wind is blowing.
  • Aidsmap: Circumcision News
    An otherwise great source, they have recently begun to climb on the bandwagon. The tone of the reports seem reticent as evidenced by their providing some great quotes. Coincidence? Inadvertent? Maybe, but hope not.

Aidsmap Headlines