Male Circumcision and HIV

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

2009-11-09T16:59:43-08:00

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!

HEADLINE: Circumcision protects gay men with preference for insertive role, almost ENTIRE text concludes otherwise

2009-11-05T14:36:33-08:00

Gotta love the circumcision lobby's tenacity and hate the AIDS publishing industry's gullibility on this one ...

That's right. Under a headline that concludes circumcision protects "some" gay men, the text provides us with these conclusive quotes:

The study also showed that overall circumcision did not protect gay men from infection with HIV. Earlier data from the study presented to the conference of the International AIDS Society in Sydney in 2007 showed that circumcision had no protective effect.

...

Studies in Africa have shown that circumcision reduces the risk of HIV infection for heterosexual men. However, a recent meta-analysis found no conclusive evidence that circumcision was protective for gay men.
...
Statistical analysis that included the entire study population showed that circumcision did not provide any significant protection against infection with HIV.

Only 10% of the study’s person years of follow-up was contributed by men who reported insertive unprotected sex but not receptive sex without a condom. There were only four HIV infections in these men. Analysis showed that circumcised men who only reported insertive unprotected sex did not have a significantly reduced risk of HIV.

...

So how did these half-wit scientists conclude that circumcision was associated with lower incidence of HIV infection in these gay men?

Next the investigators restricted their analysis to men who stated a preference for the insertive position in all anal intercourse. These 435 men (279 of whom were circumcised) contributed 1710 person years of follow-up.

There were a total of seven HIV infections in these men, five of which were in the uncircumcised men.

Statistical analysis showed that circumcision was associated with a significant reduction in the risk of HIV infection for men with a preference for insertive anal sex (p = 0.049). This association was strengthened when the investigators adjusted for age and potentially serodiscordant unprotected anal intercourse.

They admit in the end that the evidence is weak and designing studies to provide strong evidence would be nearly impossible to design for many reasons, but characteristically omit any mention of ethical barriers.

Reference

Templeton DJ et al. Circumcision and risk of HIV infection in Australian homosexual men. AIDS 23: 2347-51, 2009.

Link: Circumcision protects gay men who have a 'preference' for insertive sex from HIV

INTACT AMERICA: Say No to Infant Circumcision - The Baby, Not The Parent, Is Your Patient

2009-10-19T09:28:24-07:00

Intact America Urges Pediatricians to Say No to Infant Circumcision - The Baby, Not The Parent, Is Your Patient

ISSUES OPEN LETTER CALLING ON ATTENDEES AT AMERICAN ACADEMY OF PEDIATRICS MEETING TO REJECT CALL TO RECOMMEND IN FAVOR OF CIRCUMCISION FOR FIRST TIME UNNECESSARY, RISKY SURGERY FAILS TESTS OF MEDICAL ETHICS AND HUMAN RIGHTS

WASHINGTON, Oct. 19 /PRNewswire-USNewswire/ -- Leaders of Intact America (www.intactamerica.org) today issued a call to conscience to doctors at the annual meeting of the American Academy of Pediatrics, urging them to say no to neonatal male circumcision.

Medical ethics requires informed consent of the patient before any surgical procedure or invasive treatment is carried out. Parental consent on behalf of a child is generally accepted only if the surgery is necessary to save the life or the health of the child. Because circumcision removes healthy, functional tissue and is not medically necessary, parental consent is inadequate. Intact America placed an ad in today's Washington Post urging pediatricians to say no to circumcision because "the baby, not the parent, is your patient."

Neonatal circumcision is performed on more than 1 million babies each year in the United States. The AAP is awaiting a report by a special task force on circumcision, considering whether for the first time to recommend in favor of the surgery. Evidence being considered by the task force comes from studies carried out in Sub-Saharan Africa, among adult men, which examined the role circumcision might play in mitigating HIV transmission. Researchers claim that circumcision reduced female-to-male transmission of HIV. However, no similar reduction was found for male-to-female or male-to-male transmission. In fact, recent studies were ended prematurely because women were contracting HIV at alarmingly higher rates than those in control groups from men who were failing to take the only universally-recognized anti-HIV measure, use of a condom.

The Centers for Disease Control, which is also citing the African studies in as it revisits its neutral stance on neonatal male circumcision, recently acknowledged there is no evidence of any benefit for male to male transmission, which -- along with shared needles among intravenous drug users -- is still the most common modality of transmission in the United States.

"Pediatricians must embrace their oath to do no harm and recognize that the baby -- not the parent -- is their patient," said Georganne Chapin, who heads Intact America, the clearinghouse for information on the anti-circumcision movement. "There is no justification to recommend unnecessary surgery to remove healthy, functioning tissue from a baby boy on the chance he might engage in unsafe sexual behavior decades into the future."

The United States is the only western nation that still circumcises a majority of its baby boys for non-religious reasons. The circumcision rate in most European countries is less than five percent. Even here, the rate has dropped from around 90 percent thirty years ago to below 60 percent today, in part because of large immigration influxes from Latin America, the Caribbean and Asia, parts of the world where circumcision is rare. But the drop is also due to growing awareness among medical professionals and expectant parents that there is no medical reason to subject newborn boys to risky, unnecessary surgery that removes healthy, functional tissue.

"European countries have far lower rates of circumcision and far lower HIV rates, which underscore the lack of any link between the surgery and the disease," said Chapin. "In this country, there is similarly no link between circumcision and HIV based on geography, ethnic group or any other demographic subgroup."

"Preventing HIV requires use of a condom or other safe sexual practice," Chapin said. "Circumcision does not prevent HIV."

The AAP circumcision review task force is headed by Dr. Susan Blank, an Assistant New York City Health Commissioner in charge of the Bureau of Sexually Transmitted Diseases Prevention and Control. Chapin said Dr. Blank, who has made public comments in support of circumcision, must ensure the AAP considers all factors involved in an honest and open assessment, including underreported but very real risks to the baby including bleeding, surgical error, infection and, in several cases reported recently, even deaths.

Currently, no respected medical authority in the world recommends neonatal male circumcision -- not the AAP, CDC or the American Medical Association, which calls the surgery "non-therapeutic." The Royal Australian Academy of Pediatrics recently revisited its stance, and found that any benefits "do not warrant a recommendation of universal circumcision for newborn and infant males."

Circumcision also adds more than $1 billion in annual health care costs to taxpayers and families, and $1 billion in income to doctors.

For more information, please go to Intact America's website at www.intactamerica.org.

SOURCE Intact America

Bob Liff of M+R Strategic Services, Inc., (O) +1-917-438-4628 or (c ) +1-917-287-7089 bliff@mrss.com, for Intact America ©

Link: Intact America Urges Pediatricians to Say No to Infant Circumcision - The Baby, Not The Parent, Is Your Patient

ICGI PRESS RELEASE: Pediatricians at AAP National Conference Picketed by Intactivists

2009-10-15T09:26:48-07:00

Intactivists will be protesting what they believe to be an unethical and sexist practice—infant circumcision—at the American Academy of Pediatrics National Conference and Exhibition (AAP NCE, 2009), Washington Convention Center, Washington, DC, October 17-20.

Washington, DC (PRWEB) October 14, 2009 -- Intactivists will be protesting what they believe to be an unethical and sexist practice—infant circumcision—at the American Academy of Pediatrics National Conference and Exhibition (AAP NCE, 2009), Washington Convention Center, Washington, DC, October 17-20.

This year’s AAP convention theme is “Pediatric Heroes: Champions for Children.’ Intactivist Dan Strandjord, Chicago, says, “Cutting off the end of a boy’s penis is not what a medical “hero” should do. It is a "villainous" practice, there is no medical reason for it. A real super hero would have the courage to “put down their scalpel” and force other doctors to do the same.”

Demonstrators will be carrying placards satirizing the conference’s cartoon characters of pediatricians as flying super-heroes. It depicts a super-hero protecting a baby boy with the comment: “Real heroes don’t cut babies.”

Girls are protected from genital cutting, even a pinprick, by federal law, but boys have no protection.

Circumcision is a multi-million dollar income stream for doctors, a source of revenue that is almost doubled in order to repair poorly performed circumcisions.

No medical association in the world, including the AAP, recommends infant circumcision yet the barbaric practice continues.

Originally ‘invented’ by doctors in the late 19th century to control masturbation, the practice has become medicalized without ever passing scientific review.

###

NOTE: I've been informed that this post's original title mistakenly identified Intact America as the source of this press release. That is not the case. My apologies. Again, Intact America is NOT behind this press release and had nothing to do with its dissemination. ICGI issued it.

PRWEB Link: Pediatricians at AAP National Conference Picketed by Intactivists

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

2009-09-30T07:00:00-07:00

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

2009-09-27T09:00:00-07:00

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!

AIDSMAP: Controversial vaccine trial produces results

2009-09-24T07:36:11-07:00

Aidsmap has two stories this morning on a vaccine trial using two types of vaccine that has produced a one-third reduction in HIV infection in a truly massive sample (over 16,000 participants). The study was conducted in Thailand and went forward against the advice of numerous scientists because one of the components of the trial produced a jump in infections in an earlier trial. Aidsmap outlines the controversy in An unpopular vaccine study produces surprising result.

Aidsmap also has a short write-up on the details of this first modestly effective vaccine trial in Vaccine reduces risk of HIV infection by one-third in large trial. The authors of the trial rightly call this an historic event in the course of HIV/AIDS.

UPDATE: Aidsmap has more reactions: Vaccine trial “is the beginning” of a new path of research, says US health chief.

PENN SAYS: Matching Penises

2009-09-18T17:14:02-07:00

From Crackle: Matching Penises