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  • 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.

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.

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  • Circumcisionandhiv.com
    PO Box 40312
    San Francisco, CA 94140
    wilt31@gmail.com
    [Please put CIRCUMCISIONANDHIV in the subject line.]

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« Notebook: Rising food costs, the tanking dollar, sexual behavior in multiples, and PrEP, like condoms, may be a true pillar of AIDS prevention | Main | Notebook: Gossip is stronger than truth, "the mother" of all child-rearing wars takes Britain by storm, and studies show circumcision confers no protection viz STDs »

Wednesday, October 10, 2007

Notebook: Oh my! Is it Oct 10 already?

I hadn't intended to let this month get away from me like this. But here we are, on Oct 10, and this is this month's first post.

I would like to thank Gillian Longley for being the first contributor to our Tip Jar. Thanks, Gillian.

I have added a blog roll. Please suggest a blog you feel worthy. It doesn't have to be specific to circumcision and HIV, or even HIV, or circumcision. Intelligent writing on any issue or current trend or event that may impact the issue of HIV and promotion of questionable tactics to fight HIV is fair game.

Finally, welcome to NOCIRC of Colorado under our Websites That Have Linked to Us section in the left sidebar. Thank you for the link and the mention on your site.

Please take this moment to participate in an online open mic and leave a comment or two.

- David

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Comments

First a quick hello to Gillian your doing great work; I hope you'll come on and opine from time to time. :)

Since this is open mic night I thought I would post an interesting passage that I recently read in "The World Without Us" by Alan Weisman. To put this in context Weisman is interviewing several Massai including Santian, a member of the Massai tribe who "modernized" and works as an ecotourism guide in Kenya, and Konnyi, a tribal elder. In part, they are discussing the dilemma of modernization, or rather westernization, and its impact on their lives by destroying their traditionally nomadic ways. Toward the end of Chapter 6, the African Paradox, Weisman writes:

"...Only one thing, too terrible to contemplate, might slow all this proliferating before all the animals go extinct. The old man, Konnyi, had said it himself. "The end of the Earth," he called it. "In time, AIDS will wipe out humans. The animals will take it all back."

AIDS isn't yet the nightmare for the Maasai that it has become for sedentary tribes, but Santian saw how it could be soon. Once Maasai only traveled on foot through savannas with their cows, spear in hand. Now some go to towns, sleep with whores, and spread AIDS on their return. Even worse are the lorry drivers who now show up twice a week, bringing gasoline for the pickups, motor scooters, and tractors that the Maasai farmers purchase. Even young uncircumcised girls are getting infected.

In non-Maasai areas, such as up at Lake Victoria, where the Serengeti animals migrate each year, coffee growers too sick with AIDS to groom their plants have turned to growing easy staples like bananas, or cutting trees to make charcoal. Coffee bushes, now feral, are 15 feet high, beyond rehabilitation. Santian has heard people say they don't care anymore, there's no cure, so they won't stop having children. So orphans now live with a virus instead of with parents, in villages where the adults have all been but wiped out.

Houses with no one left alive are collapsing. Mud-stick huts with dung roofs have melted away, leaving only half-finished houses of brick and cement begun by traders with money made from driving their lorries. Then they got sick, and gave their money to herbalists to cure them and their girlfriends. Nobody got well, and construction never resumed. The herbalists got all the money, then got sick themselves. In the end, the traders died, the girlfriends died, the medicine men died, and the money vanished; all that remains are roofless houses with acacias growing in the middle, and infected children who sell themselves to survive until the day they die early.

"It's wiping out a generation of future leaders," Santian had replied to Koonyi that afternoon, but the old Maasai figured that future leaders wouldn't matter much with animals back in charge....."

It is kind of funny, I don't think there is anything that we don't already know but it's still interesting to read the first hand insight on what is driving the epidemic. The increasing usage of whores, truck drivers, the fact that even young uncircumcised girls are getting infected which implies that infected men, searching for a cure, are likely listening to the young virgin myths, and perhaps, to a degree, westernization. But is that really it or is it the despair, as Santian says, "...people don't care anymore...".

That is an interesting insight, "...people don't care anymore..." because if you don't care anymore then why bother? People simply start to live like they're dying and perhaps engage in riskier behavior then they might otherwise; get drunk, get laid, or whatever as often as you can afford. I think that mind set also implies that the individual may no longer take responsibilities that incurs even an insignificant amount of effort, like using a condom, why bother they think they will die anyway. Rather they will listen to, and try out, every gimmick and myth because the best thing about the myth is it only has to be done once. Screw a young virgin, visit the herbalists, or (coming soon) get a circumcision all of these will cure, or protect you, no repeat visits and no pesky responsibilities. But what will really happen is, as Satian said, "..In the end, the traders died, the girlfriends died, the medicine men died, and the money vanished..".

But what to do. How do you begin to address an essentially self fulfilling prophecy? How do you break the depression and get people thinking again, learning again, and caring again? A solution that is half baked, or even anything less than total, will drive the depression deeper, and the problem wider, as it becomes clear that any given half baked solutions ultimately lead to death just like the visit to the herbalist.

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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.

Medscape HIV/AIDS Headlines