Gay men's HIV prevention 'falter[s]', JAMA misleads and ignores evidence viz male circumcision

A JAMA article highlighting the newly rising rates of HIV seroconversion in gay men ignored studies that rule out circumcision as an effective intervention, claiming the effectiveness is unknown. Aidsmap has caught it and pointed out Jaffe et al.'s ignorance. Inevitable conclusion: American researchers and commentators simply can't be trusted anymore require heightened vigilance to determine biases on issues of prevention, particularly the weight given to the relative value of new prevention technologies.

Link: Aidsmap | Gay men's HIV prevention in the US and Europe is 'faltering'.

Edit: And this just in, a cross sectional survey of black and Latino men in three US cities presented "no evidence that being circumcised was protective against HIV infection among black MSM* or Latino MSM. ... Further, circumcision was not associated with a reduced likelihood of HIV infection among men who had engaged in unprotected insertive and not unprotected receptive anal sex." Link is to the abstract. If anyone has a pdf copy for the pdf library, please forward it to me. Thanks.

Hat tip to Hugh on the Intactivist Pages for the heads up.

*Men who have sex with men.

Comments

[IntactwhitemaleUSA]

Check out this disgusting story. At least the guy decided to do it of his own free (perhaps misguided?) free will.

http://news.bbc.co.uk/2/hi/africa/7119096.stm

[IntactwhitemaleUSA]

Also, I just noted the comment from the UNICEF director saying that parents should be encouraged to have their children circumcised at birth. Good Grief! I'm hoping some of this will be ameliorated when G.W. leaves office, but I'm doubtful.

[Joe in CA]

African men are going to wake up to a cruel reality when they realize they contracted HIV despite their circumcision status.

It's really sad to read all this ignorance from Africa.

"I must admit when I learnt men are not circumcised in some parts of the world I was totally suprised and wandered how they will be enjoying sex with the skin there."

Do tell, buddy...

[Joe in CA]

"Yes. This initiative will certainly help. UNICEF is committed to supporting good advocacy and accurate communications around male circumcision for HIV prevention. We are very pleased with the interest that BBC is taking in this story, and of the initiative of Kennedy in Zambia! This procedure is available today, now, costs less than $50 a time, and it will reduce infection risks in men (and ultimately in women) by at least 60%. We continue to hope for a vaginal microbicide, and a vaccine, but the recent news on both of these is not good, and we may not have much good news on these even in ten years time. All men in countries where HIV prevalence is high, and where male circumcision is rare, should be encouraged to consider the procedure. Parents should be encouraged to consider having their infants boys circumcised shortly after birth (a procedure much simpler than Kennedy's).
David Alnwick, senior Unicef adviser, HIV and AIDS, Nairobi, Kenya"

Yes, INDEED.

Step right up!

[J]

Hmm I sent a slightly modified comment that I posted to the Halperin Post article. Let see if they put it up on their page. I doubt it.

There is another discussion going on about a woman who went back to Africa to do her FGM ritual. Article and discussion here. Some of you may want to chime in.

Sent to BBC:

There is nothing to research the whole issue really boils down to this:

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.

The primary advice simply doesn't change, you still need to always where a condom and you must limit and be choosy about your sex partners. Along side condoms and selectivity, circumcision is irrelevant. To consider circumcision is to consider a situation where you might try and forgo the condom for whatever reason and presume that since your circumcised it's fine.

All that shows is that the neither the man nor the woman are thinking too hard. In a low HIV prevalence population this is a bad idea, in a pandemic zone this is suicidal. You're being sold a lemon but for those who think their circumcisions will protect them, spin the barrel, pull the trigger you only have to be wrong once.

If an adult wishes to get circumcised fine that's his problem but to suggest this for children is wholly unethical. Dr. Margaret Somerville the founding director of the Centre for Medicine, Ethics and Law at McGill University, had some good things to say about this: http://www.intact.ca/canary.htm It is as applicable in Africa as it is in Canada.