The Circumcision Discussion

[jmspeach]

I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My husband says yes, it's better medically in the long run. My gpa who just turned 70 had to have a circ. due to endless complications lately.

As nurses in this area, is the medication that they use good? And what are some questions to ask my Dr. about it. I already know that my hospital i'll be at uses a med. when they perform it, I"m just wondering what you all think.

Thanks

Jen :)

[ZASHAGALKA, RN]

Timothy, I'm curious to know who funded this study. Do you have that info? I'm not saying that the WHO doesn't want to find a way to stop the spread of HIV, but I am wondering if people who may profit from the foreskins are involved in funding these studies.

You did.

These current two studies were funded by the U.S. Federal Gov't's National Institute of Health and the previous one by the UN World Health Organization.

Correction: the French Gov't's National Research Arm, Agence Nationale de Recherches sur la SIDA (ANRS), paid for the WHO trials.

And, there is a still current study being partially funded by the Bill and Melinda Gates Foundation, in conjunction with John Hopkins University.

~faith,

Timothy.

[RN mom of 2]

You did.

These current two studies were funded by the U.S. Federal Gov't's National Institute of Health and the previous one by the UN World Health Organization (of which, the U.S. gives the largest nation share of funding).

~faith,

Timothy.

Can you provide the link that states this? It doesn't mean there aren't other people involved in the funding, just because the above organizations are the ones reporting the findings of the studies that were done. You know what I'm saying? We have all been shown time and time again that things are not always as they seem, and there is a lot of underhanded stuff going on in order to benefit certain causes (you find the most corruption in money driven causes). I'm jaded (in a good way). I don't take anything at face value anymore. I'm not saying what you stated above isn't the truth, but I'd need to see detailed info about those really involved. And there are always cover ups....

[ZASHAGALKA, RN]

Can you provide the link that states this? It doesn't mean there aren't other people involved in the funding, just because the above organizations are the ones reporting the findings of the studies that were done. You know what I'm saying? We have all been shown time and time again that things are not always as they seem, and there is a lot of underhanded stuff going on in order to benefit certain causes (you find the most corruption in money driven causes). I'm jaded (in a good way). I don't take anything at face value anymore. I'm not saying what you stated above isn't the truth, but I'd need to see detailed info about those really involved. And there are always cover ups....

http://www3.niaid.nih.gov/news/QA/AMC12_QA.htm

"Who funded and who conducted the two adult male circumcision trials in Africa?

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), supported two clinical trials, one in Rakai, Uganda, and the other in Kisumu, Kenya, designed to determine whether adult male circumcision is safe and can prevent men from acquiring HIV infection in geographic areas where heterosexual transmission of the virus is most common.

The Ugandan study, led by Drs. Ronald Gray and Maria Wawer of Johns Hopkins Bloomberg School of Public Health and Drs. David Serwadda and Nelson Sewankambo of Makerere University in Kampala, Uganda, enrolled 4,996 men since the trial began in August 2003.

The Kenyan trial, also known as the UNIM trial (Universities of Nairobi, Illinois and Manitoba trial), opened in February 2002, in a collaborative effort between U.S., Canadian and Kenyan researchers. Drs. Robert Bailey, University of Illinois, Chicago, Stephen Moses, University of Manitoba, Jeckoniah Ndinya-Achola, University of Nairobi, and Kwango Agot, UNIM, are funded by NIAID and the Canadian Institute of Health Research. This trial enrolled 2,784 men.

What other trials have been conducted?

The first randomized controlled trial of adult male circumcision was funded by the French government’s research agency, Agence Nationale de Recherches sur la SIDA (ANRS). The trial, ANRS-1265, was conducted in South Africa to test the effect of adult male circumcision on HIV acquisition. Led by Dr. Bertran Auvert, the investigators found a 60 percent reduction in HIV acquisition for the men enrolled in the circumcised arm of the trial. (Auvert B, et al. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005 Nov;2(11):e298. Epub 2005 Oct 25.) There were a total of 69 HIV infections among participants: 20 were among the 1,546 circumcised men and 49 among the 1,582 uncircumcised men.

Despite these results, there was still debate among clinicians, policy makers and the international community over whether these results could be generalized to different populations. These NIAID-sponsored trials provide additional scientific evidence for the role of adult male circumcision in HIV prevention.

Are other studies of male circumcision being conducted?

In addition to the NIAID trials in Uganda and Kenya, a randomized trial led by researchers at Johns Hopkins University is studying whether male circumcision reduces male-to-female HIV transmission. (In contrast, the NIAID trials studied whether male circumcision reduces female-to-male transmission.) The Johns Hopkins-led trial, which is supported by a grant from the Bill & Melinda Gates Foundation, is scheduled for completion in 2007

How common is male circumcision in Africa?

Studies have shown that overall, 62 percent of adult males in Africa are circumcised. However, there are significant differences in these rates by region and tribal groups. In particular, male circumcision is strongly tied to religious beliefs. In Southern Africa, where the HIV epidemic is the most severe, rates of male circumcision are less than 20 percent.

How acceptable is adult male circumcision in Africa?

Surveys conducted in Africa in both men and women have found that adult male circumcision is acceptable (50 to 86 percent), provided that the procedure is safe, affordable and has minimal side effects or pain. Among the reasons cited include better hygiene, lower sexually transmitted disease rates, more modern/urban appearance, peer pressure and perceived attractiveness to women. However, because of varying religious and cultural norms, not all groups or communities practice adult male circumcision"

~faith,

Timothy.

[Anagray, BSN]

Ok, I wasn't going to post, but..taking a look at the whole health care and health conditions in 3d world countires (circed or not) is it a surprise to anyone that STDs and all other diseases are running rampid when compared to the West? why isn't anyone doing studies of France, Spain, England, etc. ?

Nat

[softstorms]

You are comparing apples and oranges. The forskin is not the transmitter or the barrier to STD's. I think the problem goes much deeper than that. Education is the only cure.

[ZASHAGALKA, RN]

You are comparing apples and oranges. The forskin is not the transmitter or the barrier to STD's. I think the problem goes much deeper than that. Education is the only cure.

Huh? Who is comparing apples to oranges?

And your assertion is under intense scrutiny right now. "Education" won't fix that.

~faith,

Timothy.

[caroladybelle, BSN, RN]

Ok, I wasn't going to post, but..taking a look at the whole health care and health conditions in 3d world countires (circed or not) is it a surprise to anyone that STDs and all other diseases are running rampid when compared to the West? why isn't anyone doing studies of France, Spain, England, etc. ?

Logically, to test something on a major scale, you go to the source.

If you are going to do a study on HIV or on circumcision, you need to be going to the areas where there is a significant HIV population and and both circumsized and circumsized men.

Some European countries have few circumsized males due to cultural issues. And the population of HIV infected men are relatively small.

If major difference in HIV infection rates is shown in Africa, where indeed there are major problems, this has greater significance than testing a few hundred patients in Europe.

And the results also are more pertinent TO Africans. Because their entire future is at stake here. The USA and EU lose many people to AIDs, but that number is miniscular compared to the utter devastation that AIDs is causing in Africa. They are losing much of an entire generation or two of people.

Imagine 30-50% of the Baby Boomer generation wiped off the face before age 40, and it occurring in a period of 10-15 years. Leaving their children with no parents, frequently few to no Aunts or Uncles to care for them. No medicaid, no welfare. Watching them die at home. As well as possibly losing a few siblings. In a land with civil war and land mines.

How chaotic would that be here.

This what AIDs means there.

Of course the study would be done there. The source, the data and the primary need is there.

[RN mom of 2]

Timothy, I spent some time researching those organizations to find out where their funding comes from. It appears to be from different sources, including drug companies. To be honest, I don't have a lot of time to search for ALL the info, as there isn't one page listing all of the contributors. I'm really curious to know what organizations are funding them, so when I can I'll keep researching them.

[ZASHAGALKA, RN]

Timothy, I spent some time researching those organizations to find out where their funding comes from. It appears to be from different sources, including drug companies. To be honest, I don't have a lot of time to search for ALL the info, as there isn't one page listing all of the contributors. I'm really curious to know what organizations are funding them, so when I can I'll keep researching them.

You'll have to show links to that. When the U.S. Gov't says, in its own links, that IT funded these research projects from the NIH, that the French Gov't funded the WHO trials, and that the Bill and Melinda Gates Foundation, in conjunction with John Hopkins, is funding the still current study, I find it very difficult to believe that 'the evil drug companies' are really funding it.

These aren't just 'organizations'; they are gov't agencies.

~faith,

Timothy.

[nurseofalltrades]

I give kudos to any male who has been circumcised. I witnessed my very first circumcision this morning. I never gave much thought to the whole procedure until I actually saw one with my own eyes! OUCH!:smackingf I am glad that they don't remember this when they are adults!!!!!!! Thank heavens Im a girl!:w00t:

[GardenDove]

This subject, for some reason is extremely volatile whenever I've seen it discussed on various internet forums. It seems to be laden with deep emotional and cultural undertones and strong opinions.

[Rock, LPN, RN]

It"s Barbaric And Should Be Discontinued !