Tuesday, August 12, 2008

A little followup...

...to this post on circumcision.

A new study has shown that male circumcision has a even higher rate of protection against STDs and HIV than expected, at 59%. It was previously thought to be about 50%. Of course, the argument about this meaning that circumcised men will not use condoms, thinking they are safe, has been trotted out again. Obviously condoms are much more effective than circumcision at preventing the spread of HIV and other STDs. They have about a 10% failure rate for HIV transmission in normal use-- meaning there's a 10% chance that a man who uses a condom every time and has sex with an HIV-positive woman will get HIV anyway. But a circumcised man who doesn't use condoms has a 41% chance of getting HIV from an HIV-positive woman. In addition, condoms protect women from HIV-positive men and circumcision does nothing for them.

This clearly means that circumcision shouldn't be touted as an answer to HIV, right?

Well, no. But those who are against circumcision aren't really looking at the real information here. Of course you can't tell a person who is circumcised that they are fully protected, they aren't. BUT. An uncircumcised man using a condom has a 10% chance of getting HIV from a positive woman. A circumcised man using a condom has a 4.1% chance. So an uncircumcised man is more than twice as likely to get HIV from a woman who is positive. That's pretty significant, and it could be used to argue that much the same way as people should use condoms AND hormonal birth control if they want to protect against pregnancy, because the risk is so decreased (condoms have a 14% failure rate, the pill has a 5% failure rate, so when you use them together there's only a 0.7% failure rate), men should both be circumcised and use condoms to prevent HIV.

However, even that's not the full story. Let's say you live in the United States, where 0.6% of adults (which we are assuming is your dating pool) are HIV positive. That means there's probably about a 0.6% chance that any given partner of yours would be HIV positive, if you don't know their status and you don't know if they have any risk factors, obviously the numbers would change if they were a drug user or something and obviously they would change in the other direction if they were a virgin.

Now, the risk of infection for an uncircumcised man from one exposure to an HIV positive woman without using a condom is 3%. So the risk for an uncircumcised man of getting HIV from a woman of unknown HIV status, without using a condom, would be 0.018%. The risk when using a condom would be 0.0018%. The risk for a circumcised man, using a condom, with a woman of unknown status, would be 0.000738%. Both are pretty low rates and the difference is actually only 0.001062%.

I'm kind of the opinion that the benefits in preventing HIV and other STDs is sufficient to outweigh the risks of any complications from the procedure itself, but probably not enough to warrant doctors encouraging patients to do so, so ultimately, it should neither be considered necessary nor harmful and should be up to the parents and their cultural and religious needs, until more evidence is in. Still, I find it interesting how the studies are being manipulated to support one side or another.

Also, if you are going to post comments, please be aware that I don't really care to hear middle-aged men blame their lack of sexual prowess on their circumcision. If your significant other hates your sex life, then however convenient it might be to blame something you had no control over, your time and energy would probably be better spent giving her a massage and engaging in some roleplay.

12 comments:

estherar said...

LOL! That last paragraph of yours is perfect!

Basiorana said...

Heh, thanks. That just gets so old!

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