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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.

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  • 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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    wilt31@gmail.com
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« Notebook: Oh my! Is it Oct 10 already? | Main | Notebook: Aidsmap Plays Four Easy Pieces »

Tuesday, October 16, 2007

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

Science has finally proven that gossip, despite common sense and evidence to the contrary, is more powerful than truth. It's another way of saying that propaganda and "whispering campaigns" work. So what else is new, you might ask. We've known that forever in the United States as circumcision has maintained its clutch on new mothers for a century despite the evident harms and lack of anything more than the slight benefit it may confer in the rarest of circumstances. You can take it on faith that expectant mommies talk to each other and vie for the informal title of most caring and concerned. It's all done in the name of what's best. What's that old adage about the road to hell and good intentions?

Britain has its own battles to wage in the child-rearing field. It's well known in the legal realm that  an expert is anyone who can cobble together a resume from any old raw material. Schools you've never heard of? No problem. Unverifiable work history? How about a little rehabilitative voir-dire on that. And so in line with gossip as gospel truth, mommy experts are battling online and across Britain for the best child-rearing advice. I wonder however how vitriolic it could be. After all, Britain for the most part doesn't have to  contend with routine infant circumcision.

Finally, circumcision may be worthless in the fight against disease generally, yet a slight lower risk for the contraction of syphilis has triggered old beliefs, engendered by old gossip no doubt, among headline writers in Australia. The rightful headline, "Circumcision confers no benefit against STIs" became "Circumcision may lower syphilis risk" due to a rigorous adherence to old news from the grapevine by The Australian. As long as you know better, you and your child are safe. Headline skimmers, however, may find themselves at a slightly elevated level of danger. Luckily, it would seem most Australians have overcome the rumor mill on routine circumcision.

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Comments

Staph Infections Deadlier Than AIDS?

"Open wounds and exposure to medical equipment are major ways the bug spreads."

"These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread."

circum*COUGH*cision*COUGH*!!!

[Doctors Opposing Circumcision first warned against circumcision wounds as a point of entry for MRSA in October 2005]

*WARNING* NOT FOR THE SQUEAMISH!

DOC MRSA Warning


Courtesy of http://circumstitions.com

What can we say David but gossip is king. I mean didn't you know that everyone knows that their father's brother's nephew's cousin's former roommate had to get a circumcision because of some vague and mysterious foreskin problem? Don't let facts get in front of a first hand account like that. :)

Although to be fair I don't know that the blame can be fully applied to expectant parents and their bucket of gossip, half truths, and ignorance. Rather, I think that the bulk of the problem lies squarely with the medical profession in our country who for the most part, at best, take a seemingly politically correct middle of the road stance. This is despite the fact that the AAP hadn't been recommending circumcision since 1971. After which, rather than working to stamp it out, they just quietly allowed it to continue.

So from 71 clear through till oh lets say 98 or 99, give or take, it would have been very difficult to get good information on your own. A skeptical mind, strong tenacity, and a well connected library would have been required or perhaps a European acquaintance whose jaw might drop at the mention of circumcision. During much of that period, even to this day, in the rare chance that a parent discussed the matter with a doctor most doctors probably replied in such a way as implying that it was medically necessary thereby re-enforcing the gossip.

So a combination of gossip and bad advice is responsible for circumcisions through the late 90s, with most of the blame on the doctors, but with Internet and the wealth of information now available that needle is increasingly pointing to the parents. Even so the doctors will always continue to earn a significant fraction of the blame.

Given the abundance of information, it is actually quite amazing to me that most people don't know that this atrocity doesn't regularly occur outside of a few select countries and that it is clearly not medically indicated. I guess that is what they mean by gossip taking precedence over fact. Even more surprising is the notion that there are not only doctors who will accede to a parent's wishes and perform this on a healthy child but re-enforce the gossip. That is the most troubling thought, the doctor should know better but many don't and I don't think this can truly be brought under control until they take a realistic stance. That is what help do it in Canada, Australia, and New Zealand. That is what it will take in the US; except for reasons I can't fathom they don't have the courage to take that stance.


As to the Australian article it's hard to know what to say. Here we have a report on an study which, yet again, dispels the myth that circumcision provides any meaningful benefit against a wide range of diseases and rather than writing a positive headline they publish a negative version. It surprises me that in a country that has mostly solved their circumcision problem that an article would be spun so poorly. It has happened from time to time in New Zealand and the UK too possibly because there are still many circumcised men in higher age groups. Though a massively slanted headline like this is the kind of pandering I would expect only in the US.

The problem is it's already a custom here in the US. Furthermore, unlike female circumcision, male circumcision has gained religious sanctuary. So while "custom" and "religious rite" can't justify FGM, they are perfectly acceptable excuses to circumcise a male child.

Doctors need to be forced to take the same stance they take on FGM.

What would happen should a parent "demand" they have their baby daughter circumcised because "it's cleaner" and/or "it's a religious practice?" No sooner would the hospital be calling the police no doubt.

But with male circumcision? "Oh, the parents wanted it." Actually doctors continue to ask parents to have their son circumcised "because it prevents disease" or whatnot.

So doctors need to be forced to adhere to their own code of medical ethics.

It needs to be made so that they lose their licence and never practice medicine again should s/he be discovered to offer or have offered circumcisions and/or "comply with parents' wishes."

Doctors need to be firm and let parents piss and moan that they can no longer have their sons mutilated.

Indeed, parents wishing to circumcise their daughters can piss and moan all they want; doctors would NEVER comply with their "wishes" for WHATEVER reason.

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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