Who knew?
December 13, 2006 11:29 AM   Subscribe

The WHO says being circumcised significantly reduces a male's risk of HIV infection and recommends male circumcision as part of a "comprehensive prevention package."
posted by thirteenkiller (153 comments total) 4 users marked this as a favorite
 
The results are so striking that the study is being cancelled so the controls can go get snipped. Meanwhile, people worry that circumcision give some men to a false sense of invulnerability.
posted by thirteenkiller at 11:32 AM on December 13, 2006


minus the "to", naturally.
posted by thirteenkiller at 11:34 AM on December 13, 2006


I'm floored.
posted by WinnipegDragon at 11:34 AM on December 13, 2006


...maybe the cut dudes just aren't getting as much play?
posted by Ambrosia Voyeur at 11:35 AM on December 13, 2006


Bystanders be advised that this might be a good time to get out the lawnchairs, a six-pack and some barbeque falvored potato chips. Circumcison and abortion threads are always fun.
posted by echolalia67 at 11:36 AM on December 13, 2006


This is good news for people interested in stopping the spread of HIV, and bad news for anti-circumcision advocates who are sure to want to talk about the undocumented harms of circumcision even in the face of this science.
posted by OmieWise at 11:36 AM on December 13, 2006


Dr Kevin De Cock, director of the HIV/Aids department of the World Health Organization

[the thing]
You gotta be fuckin' kid-ding...
[/the thing]
posted by ROU_Xenophobe at 11:38 AM on December 13, 2006 [1 favorite]


I am going to go and have this done toute suite! Pardon my French, motherfuckers.
posted by Mister_A at 11:38 AM on December 13, 2006


Now let's see a study which addresses the question of whether a circumcised male is less likely to transmit HIV.
posted by jamjam at 11:39 AM on December 13, 2006


Oh yay, let's have the circumcision debate again. Thanks for getting it off to a nice, non-argumentative start, OmnieWise.
posted by nanojath at 11:40 AM on December 13, 2006


This will wendell.
posted by clevershark at 11:40 AM on December 13, 2006


...won't be long now!
posted by Floydd at 11:42 AM on December 13, 2006


Condoms are far more effective than circumcision...cheaper too.
posted by thebatmanager at 11:42 AM on December 13, 2006


Jamjam, there is a study of that in progress just now with results expected in 2008, iirc.
posted by thirteenkiller at 11:42 AM on December 13, 2006


jamjam, you mean out of the population "males" or the population "males with HIV"? The second one, I assume... but it is unethical to perform such a study.

Anyway, I wonder about the mechanics of this apparent prevention. Is the foreskin more likely to become abraded during intercourse, or something like that? More skin= more chance for broken skin? OR is it that the foreskin provides the virus with a warm little spot, allowing it to stay viable longer, thus improving its chances of entering the bloodstream?
posted by Mister_A at 11:43 AM on December 13, 2006


It needn't be an either/or, batmanager.
posted by Mister_A at 11:46 AM on December 13, 2006


See also: Not screwing people with AIDs wihout a condom.
posted by Artw at 11:47 AM on December 13, 2006


The Who says, "He's a skinned ball whizzer, I've never seen him miss. A skinned ball whizzer, got such a subtle piss..."
posted by It's Raining Florence Henderson at 11:47 AM on December 13, 2006 [3 favorites]


You can have my foreskin when you pry it from my cold dead (and maybe a little sticky) hands!
posted by papakwanz at 11:48 AM on December 13, 2006 [1 favorite]


So which thin-skinned putz is going to make the MeTa callout?
posted by Mister_A at 11:49 AM on December 13, 2006


Cutting off the entire penis reduces HIV risk even more significantly. Any volunteers?
posted by rocket88 at 11:51 AM on December 13, 2006


nanojath writes "Thanks for getting it off to a nice, non-argumentative start, OmnieWise[sic]."

I wasn't arguing anything.
posted by OmieWise at 11:52 AM on December 13, 2006


nanojath: Oh yay, let's have the circumcision debate again.

So you're saying you want to cut this short...uh...I mean, nip it in the bud...err....that is to say, limit discussion involving this slice-of-life? Ok, I give up.
posted by Gamblor at 11:53 AM on December 13, 2006


Anyone who doesn't circumcise their pets is a cruel monster..
posted by docpops at 11:54 AM on December 13, 2006


The Who also says...

I'd gladly lose my foreskin to find you
I'd gladly give up all the extra skin that I had
To find you I'd suffer circumcision and be glad
...
I call that a bargain
The best I ever had
The best I ever had

posted by SteveInMaine at 11:54 AM on December 13, 2006 [2 favorites]


In related news, it's the latest rage. The ladies love it!
posted by Partial Law at 11:56 AM on December 13, 2006


This is good news for people interested in stopping the spread of HIV

So is slicing the tip of my dick off more effective or less effective than wearing a condom?

Oh, wait a moment...

"Male circumcision should never replace other known effective prevention methods and should always be considered as part of a comprehensive prevention package, which includes correct and consistent use of male or female condoms."

Glad that's been sorted out then.
posted by PeterMcDermott at 11:58 AM on December 13, 2006


Mister_A, if a condom used properly has a failure rate of about 3% then it would seem that if everyone used a condom (unrealistic, I know) regardless of their cut status, the benefit of being cut would be insignificant.

I simply suggest that promoting condom use may be a more effective solution than promoting that every man have this surgery performed.
posted by thebatmanager at 11:58 AM on December 13, 2006


Declawing is one thing - it was an aesthetic decision - but circumcision, no way.
posted by Alvy Ampersand at 12:00 PM on December 13, 2006 [1 favorite]


Like it or not, The WHO is kicking you out of your rut, you're heading off the beaten path, your penis is broken and your foreskin has been eaten by a declawed tiger. Take a good look around, pick somewhere to go, and go.
posted by ND¢ at 12:04 PM on December 13, 2006 [1 favorite]


I agree with you, thebatmanager, but the 97% effectiveness rate applies to men who use it properly (yes, you can dick up putting on a condom!), and more importantly, only applies to those sexual encounters wherein the man actually puts the condom on his huge, throbbing member.

If circumcision reduces HIV transmission, that's great, because, inevitably, people will forget or neglect to use condoms during at least some sexual encounters. So why not both? You can't force people to get circumcised (if adults) or have their children circumcised, nor can you force them to wear condoms - that does not mean you can not encourage both as part of a comprehensive HIV-prevention strategy.
posted by Mister_A at 12:04 PM on December 13, 2006


Good on the WHO! While condoms may be cheap, every little helps in the epidemiological battle.

Mister_A - i think the scar tissue that forms after circumcision is less permeable to the virus.

An uncircumcised penis has little excretory glands in the frenum (where the foreskin meets the main bit). I gather it's these glands where the nasty virus makes an entrance. A circumcised penis presumably lacks these glands because of the operation & the scarring.

During copulation, male circumcision doesn't make HIV transmission any less likely from an infected male to an uninfected female. It DOES make transmission statistically less likely because there will be less infected males in the population.

As an aside - the idea has been around for a while. But it's good the WHO are shouting about it.
posted by algreer at 12:05 PM on December 13, 2006


SteveInMaine: "The Who also says...
...
I call that a bargain
The best I ever had
The best I ever had
"

P-p-p-people try to cut it down,
Just because I put it around,
I don't want to lose sensation,
Not gonna have no operation,
posted by PeterMcDermott at 12:08 PM on December 13, 2006 [4 favorites]


"So let me get this straight, Lord. The Arabs get all the land, all the water, and all the oil. And we get to cut off the ends of our WHATS??!!!"

-- Milton Berle
posted by Mike D at 12:08 PM on December 13, 2006


P-p-p-people try to cut it down,
Just because I put it around,
I don't want to lose sensation,
Not gonna have no operation,


Who's that trimming off the tip
Boris The Mohel
tie it off and then snip-snip
Boris The Mohel...
posted by jonmc at 12:12 PM on December 13, 2006 [1 favorite]


Pete Townshend and Roger Daltrey could not be immediately reached for comment.
posted by ZenMasterThis at 12:13 PM on December 13, 2006


We won't get moiled again?
posted by ZenMasterThis at 12:14 PM on December 13, 2006


Mister_A, if a condom used properly has a failure rate of about 3% then it would seem that if everyone used a condom (unrealistic, I know) regardless of their cut status, the benefit of being cut would be insignificant.

No, it would still (seem to) reduce your conditional risk by about half.

It's easy to forget how quickly even small risks cumulate. If the failure rate is 3% -- and it's exceedingly unrealistic to assume correct usage -- then your risk of exposure is over 50% with just 23 trials. And lots of men, in Africa and elsewhere, have sex more than 23 times / year.

That said, this seems like an interesting quirk or something to factor into epidemiological studies more than something useful. It's an enormous problem convincing men to wear a rubber, and you want to convince them to get circumsized as adults? Good luck.
posted by ROU_Xenophobe at 12:15 PM on December 13, 2006


If my child wants to get circumcised as a health measure when he's grown, that will be his choice. I'm not going to make that decision for him, anymore than I would preemptively remove my daughter's ovaries if ovarian cancer ran in my family.

And it's not "more gentle" to do it when they're babies, unless you believe that it's ok to cause babies pain since they don't remember it. A study just came out concluding that very young babies do indeed feel pain, even if they lack the ability to express it. At least an adult can be more safely anesthetized and know when he needs more painkillers during recovery.
posted by emjaybee at 12:16 PM on December 13, 2006


I am still going to have my baby declawed though, and file his teeth.
posted by Mister_A at 12:20 PM on December 13, 2006


Only if it's going to be an indoor baby. Declawing outdoor babies is cruel.
posted by Gamblor at 12:22 PM on December 13, 2006 [6 favorites]


I'm going to let my baby circumcise me.
posted by slimepuppy at 12:24 PM on December 13, 2006


talked about for years.
posted by gman at 12:25 PM on December 13, 2006


I've got a better idea. Let's encourage as many people as possible to fuck without condoms or circumcisions so that they all get AIDS and die and we can get back to worrying about more important things like when I'm going to be able to get my hands on a fucking Wii.
posted by hoverboards don't work on water at 12:25 PM on December 13, 2006 [2 favorites]


Gamblor and slimepuppy, youse made my day, thanks!

hoverboards, not so much.
posted by Mister_A at 12:27 PM on December 13, 2006


I haven't tested this thoroughly, but I think that cutting off the penis completely can reduce the reduce the risk of being infected by HIV by 100%.

I'd have more accurate results, but I thought it unethical to let the trials go on without cutting off the penii of everyone so that they could all benefit from our preliminary findings.

Down with HIV! Who's with me? *snip*
posted by splice at 12:29 PM on December 13, 2006


Just get the babies clay litter, the fancy clumping litter has lots of funky chemicals.
posted by weretable and the undead chairs at 12:29 PM on December 13, 2006


My baby gets lonely when I'm at work, and when I come back, he's usually left a mess on the floor - should I get him another baby to keep him company?
posted by Mister_A at 12:32 PM on December 13, 2006


Why do things by half measures? Let's make genital mutilation acceptable again for men and women — the less pleasurable sex is for everyone, the less likely people are to have sex, slowing down AIDS and other STDs.
posted by Blazecock Pileon at 12:32 PM on December 13, 2006


I haven't tested this thoroughly, but I think that cutting off the penis completely can reduce the reduce the risk of being infected by HIV by 100%.

Doubtful.
posted by peeedro at 12:34 PM on December 13, 2006


My baby gets lonely when I'm at work, and when I come back, he's usually left a mess on the floor - should I get him another baby to keep him company?

Have you tried crate-training your baby?
posted by docpops at 12:35 PM on December 13, 2006 [1 favorite]


WHO's on first...
posted by Bravocharlie at 12:35 PM on December 13, 2006


As a religious aside, does anyone know a credible source for the story that male babies' bodies produce a surge of vitamin K around their eight day of life? Vitamin K promotes blood clotting and in the Book of Genesis the order is to circumcise on the 8th day. That sounds interesting, but the only source I can find via google are anecdotal comments.

That's interesting, because typically, I see the complication rates of circs go up as the child's age increases, and almost never see any bleeding issues in the first few days.
posted by docpops at 12:37 PM on December 13, 2006


Hey now I can't find my baby. There's this sort of wild dog sitting here though. Do you think it may have had something to do with his disappearance? Is there some more concise way to express my suspicion?
posted by Mister_A at 12:40 PM on December 13, 2006


Well, it may or may not be a triple post, but if we're going to head off teh crazy cirumcision war, we're going to need more powerful overtrolling than declawed babies.

Pft, you people. Bush is right to forcibly abort atheists and blacks and xbox owners. Plus, we are winning in Iraq, evolution is a myth, and MetaFilter's getting bought out by Wal-Mart this Friday, so go back to Russia ya whining leftoids.
posted by hoverboards don't work on water at 12:41 PM on December 13, 2006


login
posted by docpops at 12:43 PM on December 13, 2006


splice: "I haven't tested this thoroughly, but I think that cutting off the penis completely can reduce the reduce the risk of being infected by HIV by 100%.
"

But then you'd be more inclined to look to the prostate as your primary source of sexual pleasure, and that way lies even greater risk...
posted by PeterMcDermott at 12:44 PM on December 13, 2006


"Let's go back to my place & I'll show you my comprehensive prevention package."
posted by scalefree at 12:44 PM on December 13, 2006


*joins echolalia67 on the lawn chairs*

Basically, circumscised penises are a bit easier to keep clean, a little less likely to encourage urinary tract infections, and somewhat better at reducing transmission of HIV.

Uncircumscised penises are "natural, man" and "the way god intended".

The militant anti-circumscision crowd crack me up. It would be like a movement to stop mutilating children by putting tubes in their ears or removing tonsils.

Look, in areas RAVAGED by HIV, meaning not where most of anyone posting to this thread lives, they need any and all forms of assistance to get this under control.
posted by Ynoxas at 12:47 PM on December 13, 2006


Those who can, WHO; those who can't, HOOP.
posted by Astro Zombie at 12:47 PM on December 13, 2006


Awesome. Now all someone needs to do is post a thread on smoking, and then we've hit the MeFi TriFecta for the week.
posted by psmealey at 12:49 PM on December 13, 2006


that does not mean you can not encourage both as part of a comprehensive HIV-prevention strategy.

You could also encourage people not to have sex with people they don't know well enough to know if they have HIV.

Hard sometimes, but there's less mutilation involved, and that might be an acceptable tradeoff for some people.

Now all someone needs to do is post a thread on smoking, and then we've hit the MeFi TriFecta for the week.

This just in: circumcising your cigarettes (cutting 1/5 off the end) reduces risk of lung cancer by 20%.
posted by weston at 12:52 PM on December 13, 2006


My baby gets lonely when I'm at work, and when I come back, he's usually left a mess on the floor - should I get him another baby to keep him company?

What, and have to pay for more Baby Chow?

Seems easier just to give him a good slap-n-shake to reinforce your dominance. I've done that, and now the little spud just sort of sits there. Cute as a button, and real quiet; hell, half the time I forget to feed him 'cuz he doesn't bitch about being hungry any more.
posted by ROU_Xenophobe at 12:54 PM on December 13, 2006


Hey now I can't find my baby. There's this sort of wild dog sitting here though. Do you think it may have had something to do with his disappearance? Is there some more concise way to express my suspicion?


"dingo ate my baby!" for the win!
posted by stenseng at 12:54 PM on December 13, 2006


Yessss! stenseng - you move on to round 4 - the Speed Round!!!
posted by Mister_A at 12:57 PM on December 13, 2006


Are condoms harder or easier to use for the uncircumcised? Are failure rates higher or lower?
posted by jamjam at 1:02 PM on December 13, 2006


I think many people are reading this and thinking 'they will take away my foreskin'. Rest assured, folks, your foreskins are safe.
posted by sid at 1:03 PM on December 13, 2006


Oh, I know it's safe. In fact, I keep it in a safe, right next to mom's hymen.
posted by and hosted from Uranus at 1:07 PM on December 13, 2006


[Posts lyrics to "Pictures of Lily," "Mary Anne With the Shaky Hand"]
posted by joseph_elmhurst at 1:07 PM on December 13, 2006


How many declawed babies would it take to bring you down if you're only armed with an axe handle?
posted by dobbs at 1:08 PM on December 13, 2006 [2 favorites]


Why don't you axe Trotsky? Bwahaahaa! Oh wait that's an icepick. Or a pickaxe. Or an Ice-axe?
posted by Mister_A at 1:09 PM on December 13, 2006


I bet if circumcision works this well, castration will work even better.
posted by mek at 1:09 PM on December 13, 2006


A few years ago I might have relished presenting this study to the odd man outside the hospital here with the "circumcision is barbarism" sandwich-board, but after so many years I'm instead going to tell him the same thing I always do: Go home and spend more time with your kids (which he has). Thanks Ynoxas for addressing the issue. Thanks those wanting to tell workers on the aids highway to choose partners more selectively for the laugh.
posted by sarcasman at 1:11 PM on December 13, 2006


sid: "I think many people are reading this and thinking 'they will take away my foreskin'. Rest assured, folks, your foreskins are safe."

Just don't expect your kids to get into a state school if it's still intact is all.
posted by PeterMcDermott at 1:15 PM on December 13, 2006


unsurprisingly, it did not wendell
posted by matteo at 1:30 PM on December 13, 2006


My cut penis and I have really had a good laugh at some of the comments.

Let's not forget the other WHO classics:
The Dicks allright,
A penal matter,
Another Dicky day,
I can see (penis) for miles,
I'm Free (of the pesky foreskin),
Won't get Mohled agian, I could do this all day.
posted by winks007 at 1:31 PM on December 13, 2006


It would be great if you could do that all day, where "that" was something funny...
posted by Mister_A at 1:33 PM on December 13, 2006


Mister A, is that a requirement of this forum? If it's jokes you want...just ask.
posted by winks007 at 1:36 PM on December 13, 2006


Bring the funny, winks!
posted by Mister_A at 1:38 PM on December 13, 2006


No, I was busy elsewhere, cutting off the ends of my Who mp3s. (I hate long silences at the end of tracks, don't you?)
posted by wendell at 1:38 PM on December 13, 2006


Uncircumscised penises are "natural, man" and "the way god intended".

yeah, but he changed his mind ... or something ...

and now, through the wonders of the internets, i show you the official WHO circumcision video (sfw)
posted by pyramid termite at 1:39 PM on December 13, 2006


All I'll add is smegma.
posted by saysthis at 1:41 PM on December 13, 2006


We have graveyards full of circumcised AIDS victims in the U.S. Circumcision didn't protect them.

Europe doesn't circumcise, and the U.S. does. Shouldn't Europe have more HIV, then? Nope.

Besides, this study and others have never held up under scrutiny.

WHO is making a serious mistake endorsing this.
posted by goofyroo at 1:46 PM on December 13, 2006 [1 favorite]


Mr. A, What is the diff between a labrador and a gay? A Labrador sics ducks.
posted by winks007 at 1:46 PM on December 13, 2006


A woman phones up her husband at work, "I've got some good news and some bad news for you dear"

"I'm sorry honey," he says, "I'm up to my neck in work today and I'm totally stressed, so just give me the good news, OK?"

"Well," she says, "the air bags work...
posted by winks007 at 1:51 PM on December 13, 2006


Nice! And it's on topic, winks. I'm going to share this with my wife tonight - we have a lab and I have a dick, so she'll get a kick out of it.
posted by Mister_A at 1:52 PM on December 13, 2006


*in the name of all that is holy, grabs giant hook and pulls winks007 off the stage*
posted by jonmc at 1:53 PM on December 13, 2006


*applauds hookmaster j*
posted by and hosted from Uranus at 1:55 PM on December 13, 2006


One for you -

Bono hushes the crowd at the U2 concert. Then, after a long pause, he claps his hands over his head, once.

Several seconds later, he claps again. After another pause, another clap, and so on. Bono addresses the crowd:
"Every time I clap my hands, a child in Darfur dies,"
he intones mournfully.

A guy in the front row shouts,
"Well fucking stop it then!"
posted by Mister_A at 1:56 PM on December 13, 2006 [3 favorites]


jonmc, i saw the curtain coming down. IANAC
posted by winks007 at 1:57 PM on December 13, 2006


ROU_Xenophobe writes "If the failure rate is 3% -- and it's exceedingly unrealistic to assume correct usage"

Note that the 3% failure rate is for pregnancy (IE: of couples using condoms for BC 3% will get pregant over the course of a year) not the number of times the condom broke. Failure to use accounts for most of failure rate. For couples that dedicated I've seen success rates as high as 99+%.
posted by Mitheral at 2:04 PM on December 13, 2006


I want my tonsils back.
posted by chococat at 2:06 PM on December 13, 2006


This thread is the best example of whatever it is that I have ever seen.
posted by Mister_A at 2:11 PM on December 13, 2006


I've been wondering if I should maybe have my aftskin removed.
posted by Floydd at 2:14 PM on December 13, 2006


Looks like goofyroo joined today just to make that one stupid comment in this flamebait thread. A fiver well spent.
posted by bob sarabia at 2:18 PM on December 13, 2006


Snopes.com debunked that Bono clap-killer thing.

Seriously? People actually thought that really happened or is Snopes just running out of material to debunk?
posted by psmealey at 2:20 PM on December 13, 2006


I circumsized my forecastle, but I still got pirates.
posted by Astro Zombie at 2:36 PM on December 13, 2006


Yes, bob sarabia, and I read the guidelines, too. Have you?

"One of the things that makes MetaFilter valuable to its members is the contributions of the community. This means that a comment is appreciated for the value that it adds to the discussion."
posted by goofyroo at 2:37 PM on December 13, 2006


Results last year from a study in 3,280 heterosexual men in South Africa, which was also stopped early, showed a 60% drop in the incidence of new infections in men who had been circumcised.

Let's get a sample of 1000 uncircumcised people who result HIV negative after a number of tests.

Assume half of them get circumcision and return their life, having exactly the same frequency of intercourse they had in the past.

Unless you control also all of the person(s) they have intercourse with , the results will be flaved as it could also happen that a significant portion of the 500 circumcised people had sex with other infected or not infected people ; so that absolute number of infections isn't caused by circumcision, but by sexual habits.The same could be said for the non circumcised.

Also according to Wiki
The incidence of disease is defined as the number of new cases of disease occurring in a population during a defined time interval. In maths it would be #newcases/#peopleatriskofinfenction in two compable lenghts of time

To say that there is a decrease in incidence one need to comparare two incidences : an old one and a new one. The old one is probably incidence in hetereosexual uncutted , the new one is the one mentione in experiment.

So if the old incidence is, for instance, 200 new infected on a population of 1000, that would mean the incidence was 200/1000 = 2/10= 0,2

Now we need to reduce 0,2 of exactly 63% , so that the new incidence must be 0,074 . Therefore x/1000=0,074 --> 74/1000

So even if 126 person apparently may be spared by circumcision (at least for the duration of the experiment), in a frequentist approach to probability, the odds of getting HIV go from a 20% uncut to a 7,4% cut..which isn't a dramatic decrease. Results may vary with different approaches to probability, but still condom would remain the method that reduces the odds closer to 0%
posted by elpapacito at 2:38 PM on December 13, 2006


Elpapacito, that is some serious ciphering. Good job!
posted by winks007 at 2:45 PM on December 13, 2006


Am I the only one who happens to be a bearer of foreskin who wishes there weren't advocates or zealots on either side of this issue and just science? I understand why it's a contentious issue of course, but I would need some incredibly compelling evidence to consider chopping bits of myself off, especially important bits. The problem is that all the evidence is immediately called into question because of the advocates.

I wish there was some clarity on the issue just so I could feel completely comfortable with either avenue.
posted by haveanicesummer at 2:48 PM on December 13, 2006


Am I the only one who happens to be a bearer of foreskin who wishes there weren't advocates or zealots on either side of this issue and just science?

Nope you are not alone, but I guess it's an illusion. Some people will always attempt to twist results for their own immediate or short term advantage, even if this means causing unnecessary damage to others and even to self, damage that could be as easily rdueced or avoided.
posted by elpapacito at 3:09 PM on December 13, 2006


my boyfriend was circumcised and he still died as a result of AIDS.
posted by brandz at 3:12 PM on December 13, 2006 [1 favorite]


Snopes.com debunked that Bono clap-killer thing.

Snopes just won't let us have any fun.

As an aside, mad props to elpapacito for punctuating correctly more often. It makes it so much easier to read your comments. Thanks.
posted by grouse at 3:15 PM on December 13, 2006


Huh? Does this mean that Bono doesn't have the clap of merciful release after all, that saves innocent children from having to live in that hellhole they call Darfur?
posted by UbuRoivas at 3:17 PM on December 13, 2006


On the bright side, the women in the Horn of Africa & Sudan are usually circumcised, so at least they don't have to worry about AIDS.
posted by UbuRoivas at 3:20 PM on December 13, 2006


It's t'other way 'round: Every time a child in Darfur feels sweet release, Bono gets the clap.
posted by It's Raining Florence Henderson at 3:21 PM on December 13, 2006


Here is the main body of an email I sent the chief scientist of UNAIDS, a few months ago:

The points are still relevant.


"This latest development with respect to AIDS is certainly interesting. The data do indeed strongly suggest that male circumcision has a significant protective effect against the reception (and likely transmission) of the HIV virus. Indeed, in environments where this virus is rampant, it may even considered to be therapeutic to circumcise a male.

I understand that any decision about whether to encourage such a measure is extraordinarily complex, however it is disheartening to see (at least in the media) an almost complete omission with respect to the possible sexual functions of the male prepuce. While it may be true that there is little clinical data to support the idea that circumcision reduces sexual pleasure, it is acknowledged within the scholarly community that the male prepuce contains impressive sensory hardware in the form of highly organized arrays of meissner corpuscles, which are extremely sensitive to light touch. In fact, the very features of the prepuce which render it ideal for a platform of sensory reception may be the same features which render it vulnerable to infection. I believe it misguided to take this fact and conceive of the prepuce as being an intrinsically unhealthy and disease prone part of the body.

What is indisputable is that circumcision invariably removes a significant portion of specialized sensory hardware. Circumcised males are left with remnants of this tissue, which is why they are still able to enjoy sex (just as many females who have undergone female genital cutting are still able to).

It is my experience that the vast majority of medical professionals are completely unaware of the known physiology of the male prepuce, and I fear that this systemic ignorance may manifest itself in important decisions such as the one you are currently involved with.

I am not as concerned about which decision is reached as I am about the process by which it is reached. Routine neonatal mastectomies may indeed become a rational procedure in the future, however any such decision would surely take into account the value we assign to breast tissue vs. cancer prophylaxis.

I believe that scientists involved in decisions have a duty to educate themselves as much as is currently possible about the possible benefits and harms of the consequences of their decisions. In this context, this necessarily involves a thorough study into the known anatomy and function of the male prepuce.

I recommend viewing the following video, which, drawing upon peer reviewed literature, outlines what is known about the anatomy and function of the male prepuce, a very poorly understood part of human anatomy.

(alternatively you can download the file directly from here )


More info here

Another harm, as you point out, is the possibility of an illusion of immunity, which may cause a terrible backfire. While I think this is a very likely potential harm, it would be nice to see the other harms being addressed too.

A useful question to pose is the following:

If there existed a procedure whereby the female could be rendered similarly protected, which could be done just as safely as male circumcision, and involve similar amounts of excision with respect to quantity and quality of tissue, would it be wise to advocate for such a procedure?

I have tried engaging countless scientists over this issue, in a respectful and open minded way, however I have received very little response. I would greatly appreciate the opportunity to discuss this with people who are involved in this issue."
posted by spacediver at 3:23 PM on December 13, 2006


brandz, nobody's saying circumcised people won't get HIV.
posted by thirteenkiller at 3:23 PM on December 13, 2006


ed: " With the world seafood supply set to run out in 2048, the time has come for more exotic dining options."

I've always been happy to let people dine on my foreskin without ever feeling it necessary to have it removed first.
posted by PeterMcDermott at 3:27 PM on December 13, 2006


Mine is so big, it's like a doggone eight-skin.

Thanks, I'll be here all week!
posted by Mister_A at 3:29 PM on December 13, 2006


repeat after me:

correlation =/= causation
correlation =/= causation
correlation =/= causation

have you got it yet? I could say it a few more times if you like.

Foreskin does not give you AIDS. Having unprotected sex with people with AIDS gives you AIDS. What if they found that people who died their penis blue had a reduced risk of AIDS? Would you want to dye every baby's penis at birth?

Another thing that I'm curious about remaining unexplored is linking female circumcision with AIDS risk. I mean, if there was a notable decrease, you'd all want to remove girl babies' labia at birth, right?
posted by tehloki at 3:59 PM on December 13, 2006


brandz, nobody's saying circumcised people won't get HIV.

so, what's your point, thirteenkiller?
posted by brandz at 4:16 PM on December 13, 2006


Am I the only one who happens to be a bearer of foreskin who wishes there weren't advocates or zealots on either side of this issue and just science?

Both sides? I've never once seen a pro-circumcision zealot. Just pro-circumcision people who sort of laughed off the anti-folks.
posted by delmoi at 4:25 PM on December 13, 2006


repeat after me:

correlation =/= causation
correlation =/= causation
correlation =/= causation

have you got it yet? I could say it a few more times if you like.


Truly the mantra of the innumerate wishing to dismiss some scientific study. If A happens before B, and you already know C causes A and C does not cause B, then A causes B. In this situation, that construction is met.
posted by delmoi at 4:29 PM on December 13, 2006


There was an old rabbi from Keith
posted by rdone at 4:46 PM on December 13, 2006


"If A happens before B, and you already know C causes A and C does not cause B, then A causes B."

Okay, let's play:

If A=Dinosaurs Go Extinct, B=Mars Rover Lands on Mars, and C=Asteroid Up The Arse [or Insert Favorite Mass Extinction Theory Here]...

Then because the Mass Extinction of Dinosaurs occured prior to the Mars Landing, whatever caused the Dinosaur Extinction but not the Mars Landing is somehow proof that the Dinosaur Extinction caused the Mars Landing?

I think you might have got your logic gate painted shut, there.
posted by It's Raining Florence Henderson at 4:47 PM on December 13, 2006


I am also sick of mutilating my eyes by covering them with glasses.
posted by Astro Zombie at 5:56 PM on December 13, 2006


delmoi- it seems to me like some people in this thread are taking this as a victory over the anti-circumcision crowd. I guess that unsettles me a little bit? Zealots was a bit strong I admit.
posted by haveanicesummer at 5:56 PM on December 13, 2006


Glasses are additive, Astro Zombie. And temporary. I'm pretty sure you 're trolling, though. You don't actually equate circumsision to corrective lenses, do you?
posted by Evstar at 6:07 PM on December 13, 2006


Circumcision alone is insufficient to prevent the spread of HIV; condoms are vastly more effective. The study seems to suggest that circumcision does not prevent transmission, but merely delays it: if you routinely have unprotected sex, circumcised or no, eventually you will probably contract HIV.

I suppose one thing that circumcision has going for it is that once it's done, you can't forget about it or elect not to do it, as you can forget or elect not to use a condom.
posted by owhydididoit at 6:14 PM on December 13, 2006


I suppose one thing that circumcision has going for it is that once it's done, you can't forget about it or elect not to do it, as you can forget or elect not to use a condom.

Until my removable foreskin patent goes through anyways.
posted by haveanicesummer at 6:18 PM on December 13, 2006


And then Astro Zombie's idiotic comment would make a bit of sense! It all comes full circle man...
posted by Stauf at 7:01 PM on December 13, 2006


Snopes.com debunked that Bono clap-killer thing.

Appropriately enough however, the clap can increase your chances of HIV infection.

So don't applaud circumcised people.
posted by Alvy Ampersand at 8:13 PM on December 13, 2006


haveanicesummer: your removable foreskin constitutes and infringement upon my patented detachable penis. Kindly cyst and decease!
posted by Mister_A at 8:14 PM on December 13, 2006


"an", sorry...
posted by Mister_A at 8:15 PM on December 13, 2006


Glasses are additive, Astro Zombie. And temporary. I'm pretty sure you 're trolling, though. You don't actually equate circumsision to corrective lenses, do you?

Let's see -- I have worn them every day of my life, for every waking hour of my life, since I was 13, and can't see without them. I'd say their about as permanent a feature of my body as my circumcision. I suppose I could actually physically change my body with laser surgery, but I rather like my glasses.

Just because you don't like my point doesn't mean I'm trolling. I am, instead, making fun of you, because the other option is to tell you to concern yourself with your own fucking body and not spend a lot of time insulting mine. Which is what anti-circumcision zealots do when they throw around loaded, moralizing phrases like "mutilation."
posted by Astro Zombie at 9:40 PM on December 13, 2006


Cliff notes: guys overly protective of own cocks, will spend hours arguing finer points of "what makes better cock" in order to remain confident in own cock.

Check.
posted by The God Complex at 10:02 PM on December 13, 2006


You know, I'd be interested to know what the women in this thread think. I don't trust my own judgement here, on the grounds of conflict of interest.
posted by Richard Daly at 11:07 PM on December 13, 2006


Cliff notes: guys overly protective of own cocks, will spend hours arguing finer points of "what makes better cock" in order to remain confident in own cock.

Well...uh...yeah. I mean, if someone came up to you and told you that your sex will never be as good as the sex they're having, because of something irreversible that happened when you were 8 days old, you'd probably go on the defensive. Especially if that person clearly has no idea, and absolutely no way of knowing, how sex feels to you.
Although most people keep it quiet after middle school, a fair amount of men are concerned about their penis size. Busting out "ALSO YOU'RE MISSING TISSUE AND YOUR SEX WILL NEVER BE AS GOOD AS IT SHOULD" just adds another thing to worry about.
posted by 235w103 at 11:22 PM on December 13, 2006


How about this, Astro Zombie? What say we start cutting off the eyelids of all male infants, around about the age of eight days old? After all, it's just a tiny flap of skin that serves no real purpose -- and it will help all those little kids keep their eyeballs real clean so that eyeball infections are minimized, thereby saving lots of people from poor eyesight as they get older?

Also, in my sun-worshipping religion, sacrifice of the eyelids to the sun is a pact with the deity that stops us from blocking out it's fiery glory.

Or would that just be nonsensical voodoo?
posted by PeterMcDermott at 11:35 PM on December 13, 2006 [1 favorite]


Which is what anti-circumcision zealots do when they throw around loaded, moralizing phrases like "mutilation."

You should see those noisy zealots!

Every Saturday they hang outside the synagogue down the street with their signposts, yelling "Hands off our willies!" and "We like wearing contact lenses" and such.

Very loaded, moralizing rhetoric from those zealot strawmen, yessir. Folks 'round these parts just can't sleep at night, evidently.
posted by Blazecock Pileon at 11:37 PM on December 13, 2006


I circumcized myself using mom's pinking shears.

Now I have a frilly dilly.
posted by five fresh fish at 12:02 AM on December 14, 2006


And I believe this is my first one ever, but I can't resist:

Metafilter: Your sex will never be as good as the sex we're having.
posted by PeterMcDermott at 12:06 AM on December 14, 2006


Failure to use accounts for most of failure rate. For couples that dedicated I've seen success rates as high as 99+%.

I've always wondered about the supposed 3%. I'd like to know where that number comes from, as I can't imagine any other group as likely to lie about something as unintended (especially young) parents. "Of course we used a condom! It must have been that 3%!"
posted by dreamsign at 4:44 AM on December 14, 2006


How about this, Astro Zombie? What say we start cutting off the eyelids of all male infants, around about the age of eight days old? After all, it's just a tiny flap of skin that serves no real purpose -- and it will help all those little kids keep their eyeballs real clean so that eyeball infections are minimized, thereby saving lots of people from poor eyesight as they get older?

Also, in my sun-worshipping religion, sacrifice of the eyelids to the sun is a pact with the deity that stops us from blocking out it's fiery glory.

Or would that just be nonsensical voodoo?


I see your point.

Wait. No I don't.
posted by Astro Zombie at 7:01 AM on December 14, 2006 [1 favorite]


Peter McD: You're way off, and you know it.

It would be much closer to the following:

There is a disease that comes into existence in the next 20 years that causes a significant number of people to go blind. There is no cure, and little treatment.

It is found that surgically removing someone's eyelashes can, for whatever reason, decrease the person's chances of contracting the blinding disease. They will of course be without their eyelashes forever, and therefore their eyes will look different than natural eyelash keepers. There also appears to be a slight difference in the tactile sensation of blinking at first.

So, if you were faced with the prospect of contracting the incurable sure-blindedness disease, how fiercely would you defend your eyelashes?

Also remember you live in a place where entire segments of the population are going blind, not in your gentrified neighborhood where it is still a novelty, not an epidemic.

As far as the sex and foreskin thing goes... increased sensitivity and therefore accelerated ejaculation are not things most men seem to be seeking. My penis is scarred and mutilated circumscised, and it feels things just fine. I for one would not desire greater sensitivity on the glans.

If there really is a strong link between heightened sexual pleasure and foreskins, then wouldn't circumscision be a great treatment for premature ejaculators who were uncut? In fact, of men I know that have commented to me that they feel they are "quick on the trigger", they all are cut. So, it could very well be the case that being cut actually enhances the sexual sensation. There's no way to know, with pleasure being such a personal thing, so it is ridiculous to even talk about.

Basically, some men have sensitive glans, some don't. Some men are circumscised, some aren't. The permutations are not hard to figure out.

I think the fear that someone somewhere is having better sex than you is perhaps the most universal human fear of all. Every single aspect of the sexual equipment and method and technique is scrutinized and analyzed and has someone trying to distill the essence out so it can be captured and bottled.

(And I love the quote about "premature for who?")
posted by Ynoxas at 7:45 AM on December 14, 2006


Delmoi: If A happens before B, and you already know C causes A and C does not cause B, then A causes B. In this situation, that construction is met.

It's Raining Florence Henderson: Okay, let's play:

Whee!!

If A=Dinosaurs Go Extinct, B=Mars Rover Lands on Mars, and C=Asteroid Up The Arse [or Insert Favorite Mass Extinction Theory Here]...

Gotcha. So, by construction, we are testing to see if Dinosaurs go extinct happens before Mars Rover Landing, and we KNOW mass extinction causes Dinosaurs to go extinct, and likewise we KNOW that mass extinction did NOT cause Mars Rover landing, then we can say that Dinosaur extinction causes Mars Rover Landing.

Except..... we do NOT konw that the mass extinction event caused Dino extinction, nor that it is not a contributing cause to the Mars Rover landing (by virtue of those little shrews).... Ah, the perils of analogy!

I think you might have got your logic gate painted shut, there.

No, the gates are working just fine... they're just being attached to the problem in a bad way, I think. I'm at a loss as to how a transitive cause is not a cause - if C causes A and A is determined to cause B, C must be a cause of B, right?
posted by dwivian at 9:18 AM on December 14, 2006


I think you missed a couple of points, dwivian. Let's take the extreme examples out of it so we don't further obscure the logical miscue.

The proposed construct said that if A precedes B, and C causes A but not B, then A must cause B. There is, however, nothing about this statement that actually constitutes a proof, because there are an almost infinite number of events that precede any given event B that have causes not also directly causing B. This construct provides no direct link between A and B at all, other than their relative positions on a temporal line, and C has no relation to B at all, other than to constrain it from one (and only one) possible value. So A could be anything, anywhere - however remote - that happens prior to B. The fact that the direct cause of A isn't also the direct cause of B eliminates one possible cause of B, but provides no evidence at all that A, specifically, played any role (let alone a major one), in B.

Keep in mind, also, that this deconstruction is not a refutation of A as a cause for B, either. A might very well have caused B. But the proposed logic gate can't be used to prove it.

Your equation - if C causes A and A is determined to cause B, C must be a cause of B - is quite different from delmoi's, because you explicitly state that A is determined to cause B, which is actually the determination in question at this point. You can't prove this point by making it a given.
posted by It's Raining Florence Henderson at 9:44 AM on December 14, 2006


So, it could very well be the case that being cut actually enhances the sexual sensation. There's no way to know, with pleasure being such a personal thing, so it is ridiculous to even talk about.

Eh, no. It's not like doctors have just been blue-skying about this. Scar tissue, the stuff hypothesized above to possibly be responsible for AIDS-transmission resistance, is less sensitive than normal tissue. And the removed tissue is the most sensitive of the entire penis, a not insignificantly nerve-bundled area. Your personal anecdotes of boyfriends who were "quick on the draw", and your conclusion that it is related to circumcision (and not, say, that they'd be even less in control if they were intact) is the ridiculous bit. No offence.

But now it sounds like I'm taking up the cause. I'm not. Just responding to a bit of dismissive rationalization.

I've never once seen a pro-circumcision zealot.

Stay out of dark alleys, man. Stay out.
posted by dreamsign at 10:02 AM on December 14, 2006


Oh and

If there really is a strong link between heightened sexual pleasure and foreskins, then wouldn't circumscision be a great treatment for premature ejaculators who were uncut?

that's better reasoning, but no, thanks, I think I'd go for the various available forms of behaviour mod before surgery. If you were an overeater with an unstapled stomach, wouldn't stapling your stomach be a great treatment for you? Maybe as a last resort.
posted by dreamsign at 10:05 AM on December 14, 2006


dreamsign: I'm not saying circumcision "makes" someone a premature ejaculator, give me a little bit of credit. But millions of men can attest to the fact that your penis does not become a sensitory wasteland and numb as a post just because you're cut. I was just listing "cut guys go off early too" as a simple example of that fact, nothing more.

My point is that, DESPITE the scar tissue, practically all cut men find sex to still be pleasurable, and the penis, especially the glans, to be highly sensitive.

To me it's absurd because it's like arguing over which color of feather is softer.
posted by Ynoxas at 10:21 AM on December 14, 2006




ynoxas it's not about glans sensitivity - it's about the fact that a shit load of your fine touch receptors are chopped off. the prepuce houses the primary sexual hardware, not the glans.

Watch the video i linked to earlier.

sorry I don't have time for a comprehensive reply as am off to airport
posted by spacediver at 10:57 AM on December 14, 2006


Metafilter: I for one would not desire greater sensitivity on the glans.

***
I think the fear that someone somewhere is having better sex than you is perhaps the most universal human fear of all.

Speak for yourself. =)

***
Scar tissue, the stuff hypothesized above to possibly be responsible for AIDS-transmission resistance, is less sensitive than normal tissue. And the removed tissue is the most sensitive of the entire penis, a not insignificantly nerve-bundled area.

You're assuming that increased sensitivity = increased pleasure. It could be that increased sensitivity = increased discomfort.

I mean, it *could*, ya know!
posted by Doohickie at 12:19 PM on December 14, 2006


"Well...uh...yeah. I mean, if someone came up to you and told you that your sex will never be as good as the sex they're having, because of something irreversible that happened when you were 8 days old, you'd probably go on the defensive. Especially if that person clearly has no idea, and absolutely no way of knowing, how sex feels to you.
Although most people keep it quiet after middle school, a fair amount of men are concerned about their penis size. Busting out "ALSO YOU'RE MISSING TISSUE AND YOUR SEX WILL NEVER BE AS GOOD AS IT SHOULD" just adds another thing to worry about."


Just go get a Prince Albert...then if anybody tries to pull this BS on you you can say, "Right, well, I hit the G spot every time I thrust, you can keep your foreskin, thanks!"

Fight fire with fire!
posted by baphomet at 12:43 PM on December 14, 2006


What could possibly be more important than men focusing more on their own pleasure?
posted by It's Raining Florence Henderson at 12:51 PM on December 14, 2006


Me focusing me on my own ?
posted by elpapacito at 4:30 PM on December 14, 2006


So is it really true that no one's willing to address spacediver's point that it makes just as much sense to prophylacticly remove at least one of a girl's breasts?
posted by NortonDC at 10:03 PM on December 14, 2006


re: NortonDC re: spacediver's point

It is indeed a very relevant point: If removal of a single breast (which could be considered a low-level elective surgical procedure under the same rationalization as circumcision) reduced the chances of breast cancer by 50%, would we start lopping off female babies' breasts left and right?

I'm just trying to put this into perspective here. If a signifcantly body-altering surgical procedure reduces your chances of acquiring a certain detrimental condition, but only to the point where there is still a large, tangible risk of acquiring that condition, is it worth it?

Why bother with circumcision to reduce the transmission risk of HIV by 50% when wearing a condom will reduce it by ~99%? It's not like everybody didn't know this already, but if you have sex with a carrier twice, you have exactly the same risk as you did before.
posted by tehloki at 11:39 PM on December 14, 2006


Noone will address it because it is not the same thing. For one thing, noone is advocating penile removal. Also, cancer is not communicable. But anyway...

It would be more analagous to compare it to performing breast reduction on women to reduce cancer rates.

So, if it came to be that women who had their breasts reduced 1 cup size had a significantly smaller chance of getting cancer, would this be such a big deal, or raise so many objections?

Is having a C cup instead of a B cup enough to ignore a possibly life-saving procedure? Would people be talking about mutilating women by simply reducing the size of their breasts? Again remember we're talking about where someone is at much greater risk than you likely are.

(And please try not to miss the forest for the trees. I realize breast augmentation can be a complex thing. I personally know women who refused to get mastectomies because they said it made them "not a woman anymore". They died.)
posted by Ynoxas at 8:07 AM on December 15, 2006


I wonder if you could prove there were dead men out there that would be alive today, were it not for foreskin. Hmm..
posted by tehloki at 9:32 AM on December 15, 2006


tehloki - Noone will address it because it is not the same thing. For one thing, noone is advocating penile removal.

People are advocating partial removal of the subject's penis, just as spacediver's thinking encompasses partial removal of breasts from a subject.

Also, cancer is not communicable.

HIV is spread through nursing. Should we tell mothers to remove their breasts to eliminate that vector? Maybe Ynoxas would settle for merely removing their nipples.

Gee, this all sounds a bit gruesome to me.
posted by NortonDC at 1:14 PM on December 15, 2006


Ynoxas writes "So, it could very well be the case that being cut actually enhances the sexual sensation."

No, it really could not. Removal of a whole lot of tissue and nerve endings cannot increase sensitivity.


Ynoxas writes "But millions of men can attest to the fact that your penis does not become a sensitory wasteland and numb as a post just because you're cut."

Nice strawman, but nobody said that. What people actually say is that there is less sensation, not no sensation.

Point is, what people need--especially in Africa--is not another piece of bullshit. What they need is education and free condoms by the truckload. Women need empowerment to stand up to men who don't want to use condoms. Gay men, too, need that empowerment.

Even more to the point, what people need to do to stop spreading HIV is stop fucking people with HIV without barriers.
posted by dirtynumbangelboy at 7:23 AM on December 16, 2006


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