How well does circumcision protect against HIV? Here is the sum total so far.
In the three trials, they circumcised a total of 5,400 men and left simlar groups alone. After less than two years, 64 of the first groups had HIV, and 137 of the second. That difference, 73 men, is the whole of the protection that has actually been demonstrated. All of the "modelling" (basically just multiplying those numbers by population and time) stands or falls on them. The overall Number Needed to Treat for the three trials was 39, so how did they beat it down to 5 or 15?
There are many other factors, such as the HIV status of partners, number of partners, frequency of sexual activity, use of condoms, and more, that the researchers assume were equalised by randomisatation and unaffected by circumcision, when they probably were not. The trials were not, of course, double blinded or placebo controlled, the true gold standard of medical trials. 673 men (327 circumcised) were lost from study, their HIV status unknown, and a difference of 73 could easily be hidden in those figures. (Finding you had HIV, after a painful and marking operation to prevent it, would be a powerful incentive to drop out, and they were not told their HIV status but encouraged to be tested nearby.)
Behind all this is the mystery of why circumcision has such a hold on the popular imagination; why it has been a "cure" in search of a disease for so long, why it has never been subjected to the same scrutiny as any other parental imposition or surgical procedure, and why cutting part OFF a man's (or baby's) penis is somehow seen as enhancing his manhood.
Comment Reply
How well does circumcision protect against HIV? Here is the sum total so far.
In the three trials, they circumcised a total of 5,400 men and left simlar groups alone. After less than two years, 64 of the first groups had HIV, and 137 of the second. That difference, 73 men, is the whole of the protection that has actually been demonstrated. All of the "modelling" (basically just multiplying those numbers by population and time) stands or falls on them. The overall Number Needed to Treat for the three trials was 39, so how did they beat it down to 5 or 15?
There are many other factors, such as the HIV status of partners, number of partners, frequency of sexual activity, use of condoms, and more, that the researchers assume were equalised by randomisatation and unaffected by circumcision, when they probably were not. The trials were not, of course, double blinded or placebo controlled, the true gold standard of medical trials. 673 men (327 circumcised) were lost from study, their HIV status unknown, and a difference of 73 could easily be hidden in those figures. (Finding you had HIV, after a painful and marking operation to prevent it, would be a powerful incentive to drop out, and they were not told their HIV status but encouraged to be tested nearby.)
Behind all this is the mystery of why circumcision has such a hold on the popular imagination; why it has been a "cure" in search of a disease for so long, why it has never been subjected to the same scrutiny as any other parental imposition or surgical procedure, and why cutting part OFF a man's (or baby's) penis is somehow seen as enhancing his manhood.
June 11, 2010 - 5:15pmThis Comment
Reply