Australian AIDS org says circumcision "has no role" in Australian context

The Australian Federation of AIDS Organisations has issued a briefing paper [html] with the telling headline, "Male circumcision has no role in the Australian AIDS epidemic."

Among the key points are:

• There is no demonstrated benefit of circumcision in men who have sex with men.
• Correct and consistent condom use, not circumcision, is the most effective means of reducing female-to-male transmission, and vice-versa.
• African data on circumcision is context-specific and cannot be extrapolated to the Australian epidemic in any way.

The first point is a reiteration of a recent study from Sydney that showed circumcision provided no protection for gay men. The second point is clear from the statements and caveats issued from the circumcision studies organizers themselves. The third point is clear from the key contextual attribute of all three studies, that the protective effect is in heterosexual couples in only one direction.

A high impact, succinctly written poster presentation given at this years's International AIDS Society Conference is available here [large pdf] and is worth printing in color for outreach activities.

Download Circumcision07.pdf

Comments

[J]

Dave I think that the third point can actually be interpreted slightly differently taking into account the entire context. With regard to Australia, but also the west in general, the context change includes (but are not limited to) prevalence, access to medical services, sexual practices, womens rights, mode of transmission, some other factors I am not thinking of, but most especially education. Its education which is, of course by far, the most important components. It just doesn't fit even for heterosexual couples.

What I like about this Australian (and that French) statement is that they essentially say "that is Africa it has nothing to do with us"; and they're right. Though that implies to me that perhaps the UN and others have capitulated to the fact that 'we can't educate these people' let's go to plan B which seems like a racist policy. It would probably prove more interesting, and productive, to determine the availability of condoms and educational opportunities and work out why they aren't available or aren't working (AFAO point 2). My guess is that neither are widely available and that the failures in Africa are mostly due to ineffective, inept, bureaucratic, and inconsistent policies of the UN, US, and other organizations.

At least there are some people out there who are still thinking. Hopefully this kind of information will smack some sense into our medical establishment. I am always stunned by how proponents (like our media) try and draw such direct parallels between Africa and the US. Hopefully more rational minds will prevail.

Also I liked the second PDF you posted, I hadn't seen that yet, it provided that something the French paper lacked. It seems there are some really nice parts of the UN charter too bad we've decided to ignore them. I especially liked: Article 3 clause 2:

“The interests and welfare of the individual should
have priority over the sole interest of science
or society”

If we are to follow this, as we should, that ought to torpedo any suggestion of using circumcision even in Africa.

And Article 6 clause 1:

“Any preventive, diagnostic and therapeutic medical
intervention is only to be carried out with the prior,
free and informed consent of the person concerned,
based on adequate information. The consent
should, where appropriate, be express and may be
withdrawn by the person concerned at any time and
for any reason without disadvantage or prejudice.”

This draws up the issue of how would this option be presented? It seems to me the options are:

A. You don't need a circumcision but you need to always wear a condom and you ought to be choosy about your sex partners.

B. You can get a circumcision but you need to always wear a condom and you ought to be choosy about your sex partners.

Now it seems to me that B would only be chosen if you thought that you could eventually discard the other two parts of that equation. Otherwise it doesn't make sense but perhaps thats because I am thoughtful :)