Male Circumcision and HIV

San Francisco circumcision ban ballot measure heating up

Amazing how indifferent people can be towards other people's suffering until someone tries to stop them from inflicting said suffering. The San Francisco circumcision ban ballot measure has spawned an astounding number of hostile and incredulous articles followed by similar comments on the interwebs. You can see the outpouring of attention on Google's news search page (search terms "circumcision" "ban").

There is so much going on in the world of intactivism at the moment. We have Intact America's ongoing "Put Down the Knife" campaign. We have a reboot of an important grass roots organization in my backyard, Bay Area Intactivists. There is the International AIDS Society conference happening in Rome in July in which yours truly will be in attendance on behalf of Intact America with your help. And then there are all the facebook groups that have been popping up over the last 12 months that support the right of every child to genital integrity and respect. Very heartening, indeed. It's a great time to be in the movement.

NEW BOOK: The Intactivists: San Francisco Pride 2009-2010

Hello Folks,

Well, it's been a while since this here blog has seen much action. That will hopefully change soon. I'm plotting my return at this very moment.

One thing I want to share with the few loyal readers that check this space on a regular basis is the publication of MC_HIV's first premium for regular supporters. Yes, friends, I have put together a little physical reminder that this isn't all pixels and blog posts. Many intactivists are out there on the front lines, engaging with the people.

Therefore, let me introduce this blog's first book, The Intactivists: San Francisco Pride 2009-2010. You can get it right here for $19.00 or you can get a numbered copy with a personal thank you if you subscribe here.

To avoid any failure to meet expectations, you can actually see all the images in the book here. And you can purchase copies of said images in beautiful glossy prints there as well. This book is a trade paperback rather than a glossy photo book. It is meant to be an object commemorating as well as documenting the efforts of all intactivists, but particularly of those who march in the parades and talk to people face to face.

All proceeds benefit this blog in one way or another, either by buying me more time to spend on it or by allowing me to donate to the work of others. I hope you will purchase a copy!

Best,

David Wilton

BAY AREA INTACTIVISTS EVENTS: Castro Street Fair and the AAP Annual Conference and Demontration

So, well, ok, the live broadcast on Ustream.tv didn't work so well at Folsom. Qik is apparently better, but their app costs $$. Anyway, on to the next events ...

I'll have something more complete to report for Folsom after this weekend's Castro Street Fair and the American Academy of Pedriatics annual conference and demonstration. Consult the official demo Facebook page for details if you want to be a part of the AAP demonstration.

image / flickr / yuichi sakuraba / JavaOne 2008, Moscone Center, San Francisco

You can check out SFMGMBill.org for details on signature gathering at the Castro Street Fair for the San Francisco version of the MGMBill.org effort. Consult the official Castro Street Fair website for details on that event. The intactivists booth will be at 18th Street and Collingwood [map].

A CALL TO ACTION: Lobby the CDC to release the numbers on neonatal circumcision

As the United States starts to fall in line with the rest of the world viz neonatal circumcision, many would like to see the trend reversed. The stats delivered at the AIDS 2010 conference in Vienna, purportedly from the CDC, would seem to be a sharp reversal for the likes of Halperin, Kilmarx, Bailey, Epstein, Bailis, Gray, Fenton and the others who harbor a fixation on genital cutting.

How should the challenge to our momentum be confronted? First, we need to lobby the CDC to release the numbers. With Halperin's self-described "cabal, mafia of nerds" in charge at the CDC, we shouldn't expect them to release these numbers voluntarily unless it serves their purpose of promoting infant male genital cutting. El Bcheraoui's slide may have been an oversight with an unintended consequence of rallying the intactivist troops. So let's capitalize on that, and get CDC to open their books and release the numbers.

Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333 USA
800-CDC-INFO (800-232-4636)
TTY: (888) 232-6348
24 Hours/Every Day - cdcinfo@cdc.gov
Tweet them at @CDCgov

MC_HIV to Document MGMBill.org Contingent at the 2010 San Francisco Pride Parade

MC_HIV will be at the San Francisco Pride Parade tomorrow. Our presence is essentially going to be one of documentarian for the MGMBill.org contigent. Have a look at last year's photos as a primer.

The images above are available free of charge for inclusion in intactivist activities and materials. If you purchase prints or digital copies, you help support this website and it's activities, which include outreach and educational efforts.

IRIN PlusNews: Detailed reporting of the Western World's attempt to target Africans for foreskin removal

African circumcision campaigns have from the beginning lacked respect for personal and cultural objections. These campaigns aim to convince or "brainwash" men into submitting. They apparently present circumcision as completely accepted and normalized in the West, never mentioning the controversy that has raged for decades (and last few years viz HIV) and the split largely between the United States and the rest of the developed world.

We know that circumcision is unlikely to provide much defense against HIV infection based on the flaws identified in the African RCTs and the faulty conclusions drawn by the biased researchers. We know that the men being pressured to be circumcised have come to believe in large numbers that they will be immune from HIV if they submit based on media reports. And we know that demographically circumcision has not shown itself to have much effect in HIV prevention. But what specifically do we know about the men targeted for foreskin removal?

The following excerpt from an IRIN PlusNews article gives a few reasons some men have not heeded the call to sacrifice their foreskins despite intense pressure to do so. So much more could be known if reporters were on the ground asking questions. I'll talk about this and related issues in my upcoming presentation at the 11th International Symposium on Circumcision and Human Rights in Berkeley, California, July 29-31, 2010.

KENYA: "What would happen if my penis refused to heal?" Why men refuse circumcision

KISUMU, 15 June 2010 (PlusNews) -

...

Pain: Boniface Oyoo, 25, who drives a 'boda-boda', or motorcycle taxi, in Kisumu, said he had heard about voluntary medical male circumcision and its benefits, and even knew where he could go to get the services, but he was afraid of the discomfort and possible complications.

"I have talked to my friends who have gone for it. They tell me when you are being cut it is not painful, but after you go home there is some pain; that is what I fear," Oyoo said. "Then, at times I think, 'What would happen if my penis refused to heal?'"

Loss of income: Toby Onyango, 22, a spray painter at a vehicle repair workshop in Kisumu, said he was afraid of losing pay if he took time off to be circumcised and then to heal.

"I want to go for it ... [but] I am paid on a daily basis - I have to eat and feed my family," he said. "If I could get an alternative source of income during this time I would just go."

What will my wife think?: Jairus*, 41, a family man, knew the procedure would reduce his chances of contracting HIV, but said his wife would be suspicious.

"My wife believes I am faithful - if I go for the cut, she will just think I have been dogging [cheating] on her," he said. "I don't want to create that mistrust."

When you are cut you have to heal, and by the time you heal, your girlfriend is gone

Culture: Unlike most ethnic communities in Kenya, the Luo, largest ethnic group in Nyanza, do not traditionally circumcise men and many were unwilling to go against the cultural norm.

"We Luos do not circumcise ... it is like betraying my culture, and even my friends we grew up with will look at me badly," said John Ngesa, 37.

Loss of Sex: Romano, 21, found the six-week healing period, when men are advised to abstain from sex, too long to handle.

"That is the time your girlfriend can leave you for another man," he said. "When you are cut, you have to heal, and by the time you heal, your girlfriend is gone."

The HIV test: HIV counseling is part of the male circumcision process and an HIV test is recommended; for some men, fear of knowing their status was the main disincentive.

"I have never gone for an HIV test and I just fear it ... there are certain things that we do which makes us fear that test," said Jaoko*. "So, if I have to be tested for HIV to be circumcised, then I can't go for it," he said.

I am married, how could I get HIV?: Older married have been were particularly reluctant to be circumcised, partly because they see themselves at low risk of contracting HIV, even though it has been spreading fastest among married and cohabiting couples.

"I am married, so where do I get HIV, yet I am a faithful man? I trust my wife," Dan Musa, 43, told IRIN/PlusNews. "When you are faithful you are safe."

One last point bears mentioning. Why would a man accept circumcision all things being equal? The very question, why some men refuse circumcision, is loaded with cultural baggage and judgment. The natural default never needs questioning, and the human body as evolved is the default even when disease prevention is the objective.

Link: KENYA: "What would happen if my penis refused to heal?" Why men refuse circumcision

END OF 00s: The decade circumcision without consent gained a new lease on life

(I was going to do an end of year round up type thing. But I think we've covered the big stories except for the latest non-sense out of the circumcision camp claiming women just love a circumcised penis. The absurdity of the claim from the same old tired RCT data requires little more than an "um, no" response. All the researcher and self-selection bias that applies to all of their other junk science applies to the latest. And with that, here's the last post of the year.)

It has been 21 years since I first heard the idea that male circumcision somehow reduced the risk of HIV. For most of those 21 years, rational minds prevailed, and male circumcision never gained funding or much interest in this fight. That all changed in this first decade of the new century when a clever and determined group of circumcision epidemiologists decided to push the idea full force in the context of a demoralized and desperate HIV/AIDS research community.

To be fair, most scientists working hard to find a microbicide, to devise a vaccine, and to formulate prevention campaigns to reach the most affected kept to their areas of research and maintained their drive to improve prevention, treatment, and hopefully one day to find a cure. Perhaps to avoid conflicts that could potentially harm their own efforts, they either ignored the calls or accepted circumcision as proven, granting the agenda-driven scientists the benefit of any doubt since it lay outside of their own areas of research.

It appears that this deference has given the researcher-lobbyists for circumcision the opening to spin out wildly speculative impact, satisfaction, and cost-effectiveness studies that few have questioned. Serious students of their work can see the giant leaps, the stretched conclusions, and the wild-eyed unchallenged optimism, and understand that it's a disaster unfolding.

This is how we will end the first 10 years of the 21st century. So be it.

Let's accept it for what it is. Let's go forward and recruit and repeat. Let's recruit compassionate parents and educators. Let's find those who will help us. Let's make individual choices to speak out, to call bullshit, to keep our own children intact so that we can build a movement of millions.

Along the way, let's encourage those who are with us. Let's give money to our new and old institutions who are now becoming more visible. Let's write, speak, tweet, facebook, and do old school tabling at events everywhere that HIV/AIDS is being addressed. Maybe one day most of us will live intact lives although many still will not.

While the very existence of our public activism is no small victory, it isn't total victory. However, it is progress from where we have stood in the United States with more than half of our boys being mutilated every year for decades now while our adults suffer the highest rate of HIV in the developed world. While we have done a lot, we can and must do more.

FOLSOM (and Castro!) STREET FAIR 2009: An Assessment of Outreach Efforts

Ok, let's just throw this up. I haven't been posting much, and the reasons are many. Never mind that, let's just get something up, even though this is a very superficial look at what we encountered at Folsom and Castro Street Fairs.

On consecutive Sundays (Sept 27 & Oct 4), several intactivists under the banner of Male Circumcision and HIV and sponsored by Attorneys for the Rights of the Child staffed a booth at Folsom Street Fair and Castro Street Fair, respectively, in San Francisco.

I took on the task of organizing our appearance at the Folsom Street Fair because I had encountered incorrect information viz circumcision and HIV at another street fair targeted at gay men. Folsom and Castro are essentially gay-oriented events.

Lloyd, one of our booth volunteers, felt after our positive experiences at Folsom, that we really needed to be at the Castro Street event as well. So he scrambled to get us a place with less than a week to go. He amazingly pulled it off and viola, we were in.

Folsom Street Fair

Folsom is "the world's largest and best loved Leather fair" according to their website. Hence, we expected an open and welcoming reception. This we got. To measure our success, we used a tally system for each person or group of people that stopped by long enough to talk to us. We received 97 positive or very positive responses to our presence vs. only five negative or very negative responses.

Very Positive               57

Positive                      49

Neutral                        8

Negative                       3

Very Negative               2

Among the people who stopped by was a European who had been circumcised 30 years prior who expressed his profound regret at the decision. Quite a few Brits stopped by to mention their dismay at the practice in the United States. We had several straight couples where the man expressed his disappointment at being circumcised and the woman seemed indifferent. We encountered one unpleasant individual in the form of a rather good-looking late 30s gentleman who simply couldn't wrap his mind around why we would have any opinion on circumcision much less a negative one. His anger was a barrier to any productive exchange of ideas and he stormed off after Lloyd and I made it clear we were not going off message.

Castro Street Fair

Castro is more of a gay pride style event, having been founded by the Mayor of Castro Street himself, Harvey Milk, in the late '70s. It is family friendly and hence attracts families. Our breakdown of visitors went as following.

Very Positive               39

Positive                      9

Neutral                        5

Negative                       0

Very Negative               1

At Castro, we only encountered one stone wall. She came in the package of one of these self-described public health workers whose attachment to public health work was vague and not readily forth-coming. She said we were surely going to be responsible for untold death and destruction for opposing what she considered an obvious and established reality that circumcision "saves lives." She said we should be ashamed of ourselves for "lying to the public." She seemed self-satisfied as she looked down her nose at us and sauntered off, presumably to enjoy the fair, when it became clear we thought she was being closed-minded on an issue she knew, as we used to say in Texas, jack-squat about viz foreskins, or HIV, for that matter. Everyone else we talked to was great.

Honestly, there were others whom we engaged and who spoke of their experiences, opposition, and struggles with the issue. However, the days were long, I didn't speak to them all myself and how else to put this: I don't remember. Unfortunately, I couldn't resist the pull of the spectacle and snuck out for libations from time to time at both Folsom and Castro. Hence, foggy memory here.

Photos below (taken early or late each day and hence not representative of the crowd level). Please leave comments!

EDIT: And don't forget we had LIVE video from the booths on the day of the events!

From Folsom Street Fair:

 

 

From Castro Street Fair:

Thanks to Lloyd, Frank, and Will for planning and helping out on the day of the fairs, and to Steven for planning assistance!

TED: The Bruce Bueno de Mesquita Method of Predicting the Future (of Circumcision Policy?)

Is it possible to reliably predict whose point of view will win out in the infant circumcision debate? If we could identify interested individuals and extract the right metrics, could we then say where the debate over infant circumcision will lead? More to the point, is there some way to determine what percentage of baby boys in the United States will continue to have circumcision imposed on them by looking at who is involved in the debate, how committed these people are, and what's in it for them?

Prof. Bruce Bueno de Mesquita of New York University has been doing this in a lot of other areas, mostly in the realm of politics, and coming up with a 90% accuracy rating as noted by the CIA. In April, Mr. Bueno de Mesquita gave a TED talk to explain his methodology, using Iran's nuclear ambitions as an example. It is fascinating.

LIVE (at times): Folsom Street Fair Outreach, San Francisco

We are live at the Folsom Street Fair in San Francisco. This is our first outreach event and our (obviously) first year at Folsom Street Fair. This is all very experimental at the moment. So wish us luck in pulling this off and in sending in live reports.

If you feel moved by these efforts, DONATE! Yes, please give if you can. The costs of this effort have come to about $700.00 so far. Not a lot, but still a lot for a grassroots (mostly) one man operation. Hit the Subscribe! link above right.

Thanks!