4 ms·

Then why does the USA have the highest rate of circumcision and also the highest rate of HIV infection of developed countries? I don't think the claim holds up

by brendn 15y ago

Then why does the USA have the highest rate of circumcision and also the highest rate of HIV infection of developed countries? I don't think the claim holds up under scrutiny here. [EDIT: wording]

geebee 15y ago
Actually, this is a reasonable observation. But it actually does make sense. My understanding is that many (all?) of these studies have been conducted in sub-Saharan africa. The environment in which AIDS spreads may be very different in developed countries. The presence of secondary infections, unhygienic conditions, and other social norms may play a big role in the spread of aids and greatly amplify the protection that circumcision provides. The evidence does look compelling. Now, if the infection rate is already low, secondary STDs are rare, hygiene is at a very high standard, and transmission vectors are different, then the effects might be much less pronounced. I suspect it would be hard to create a controlled study of this in Europe, since you'd have to convince a large number of men who are probably in a very low risk group to be circumcised.
- brendn 15y ago
  Thank you for expanding on my admittedly rushed comment. I agree that comparing health data in the US to that of developing countries is problematic. But it raises interesting questions. One question, that I don't think has been answered sufficiently is that the controlled trials and published studies have been criticized for possibly overstating the effectiveness of treatment. (The trials were stopped early on ethical grounds which can overestimate the effects being tested.) Wikipedia has a fairly comprehensive roundup: http://en.wikipedia.org/wiki/Circumcision_and_HIV#Randomised_controlled_trials http://en.wikipedia.org/wiki/Circumcision_and_HIV#Randomised... I think my bigger point, though, is that it's easy to look at data and say, "Aha! This one thing is the solution" without stepping back and looking at all the different pieces that make up the big picture. It's going to take some combination of education, prevention, vaccination, and health policy to tackle this disease.
eli 15y ago
You don't think which claim holds up? That circumcision cuts infection rates? As I posted in a comment below, there's a fair bit of scientific evidence to support that.
philwelch 15y ago
The US has a wide range of ethnic, cultural, and socio-economic diversity that throws off a lot of statistics when compared to other, relatively homogenous developed countries.

by brendn 15y ago

Then why does the USA have the highest rate of circumcision and also the highest rate of HIV infection of developed countries? I don't think the claim holds up under scrutiny here. [EDIT: wording]

geebee 15y ago

Actually, this is a reasonable observation. But it actually does make sense. My understanding is that many (all?) of these studies have been conducted in sub-Saharan africa. The environment in which AIDS spreads may be very different in developed countries. The presence of secondary infections, unhygienic conditions, and other social norms may play a big role in the spread of aids and greatly amplify the protection that circumcision provides. The evidence does look compelling. Now, if the infection rate is already low, secondary STDs are rare, hygiene is at a very high standard, and transmission vectors are different, then the effects might be much less pronounced. I suspect it would be hard to create a controlled study of this in Europe, since you'd have to convince a large number of men who are probably in a very low risk group to be circumcised.

brendn 15y ago
Thank you for expanding on my admittedly rushed comment. I agree that comparing health data in the US to that of developing countries is problematic. But it raises interesting questions. One question, that I don't think has been answered sufficiently is that the controlled trials and published studies have been criticized for possibly overstating the effectiveness of treatment. (The trials were stopped early on ethical grounds which can overestimate the effects being tested.) Wikipedia has a fairly comprehensive roundup: http://en.wikipedia.org/wiki/Circumcision_and_HIV#Randomised_controlled_trials http://en.wikipedia.org/wiki/Circumcision_and_HIV#Randomised... I think my bigger point, though, is that it's easy to look at data and say, "Aha! This one thing is the solution" without stepping back and looking at all the different pieces that make up the big picture. It's going to take some combination of education, prevention, vaccination, and health policy to tackle this disease.

eli 15y ago

You don't think which claim holds up? That circumcision cuts infection rates? As I posted in a comment below, there's a fair bit of scientific evidence to support that.

philwelch 15y ago

The US has a wide range of ethnic, cultural, and socio-economic diversity that throws off a lot of statistics when compared to other, relatively homogenous developed countries.