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The WHO agrees, circumcision reduces HIV infection March 28, 2007

Posted by Hegemony in Health, Science Rants.
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My apologies for the lack of updates as of late. This post will be part science and part crazy tirade so bear with me. Be aware, parts of this may be a little graphic.
The World Health Organization has just announced that they will begin plans to increase the availability of circumcision to Africans. This comes after three studies have shown that circumcision reduces the risk of contracting HIV for heterosexual men by at least half. That is downright significant. As it turns out, the foreskin is filled with a particular dendritic cell (a Langerhans cell) that HIV tends to infect upon being passed on.

So what is HIV? HIV is a virus, a retrovirus to be exact. It stores its genetic information as RNA and uses a viral protein called reverse transcriptase to make its RNA into DNA upon infecting a cell. The virus incorperates itself into the host cell’s genome. It multiplies when the host cell becomes activated and initiates its transcription factors. HIV can infect several types of immune cells but is particularly fond of helper T-cells which is where the majority of the damage is done. With no helper T-cells there is nothing to direct the immune response.

There have not yet been any studies on the effectiveness of circumcision on homosexual transmission but it can be assumed to a certain degree that it is beneficial. The WHO also recommends increased oversight of the procedures so that men know all the facts before undergoing the operation. Counseling would also be used to ensure these men do not become over-confident. This is solid science now people, no use arguing about it if you just don’t like the idea of circumcision. Which leads me to the crazy tirade… [clears e-throat]

Why in the holy crap do I hear so many people comparing circumcision to “female circumcision”? That’s really just a nice way of saying female genital mutilation (FGM). It’s just not the same thing; removing some external skin is not the same as FGM. It’s like they feel this gives some credence to their objections to compare it to a horrifying practice like female genital mutilation.

As far as I’m aware, a circumcised penis works pretty much the same. A victim of FGM on the other hand… has often had their clitoris removed, labia cut down, and the entire area slashed to promote the growth of scar tissue. This leaves a woman unable to become aroused and makes sex a painful, unpleasant experience. In what way does that sound like a simple male circumcision? Does that really sound like a reasonable comparison? I applaud this move by the WHO and can only hope that it helps us get ahead of the AIDS epidemic. I invite polite disagreement with me but abusive or obscene comments will be removed.

Comments»

1. seuden - April 4, 2007

I think this is great news, circumcision is overall healthier and to now hear that it can help prevent the spread of HIV, bring it on. Unfortunately like already stated in your post I also believe it could create over-confidence, which will need to be addressed. Still its a positive towards the combat against HIV, excellent news.

Nice post again Hegemony.

2. Anonymous - April 11, 2007

What other health benefits does circumcision provide? I’ve always heard that there were no real health benefits and it was more of an opinion thing. Is this so? Is there much of a debate about it?

3. Hegemony - April 11, 2007

This study is really the first to go into the benefits of circumcision. It’s difficult to study things like this. While it may have been an opinion at some point, we now have real scientific evidence.

4. Nas - May 28, 2007

“I think this is great news, circumcision is overall healthier”

Says who, seuden?

This doesn’t surprise me, I have to say. And, while it’s probably worthwhile in Africa where the whole contraception issue is a real problem, I do hope that this won’t cause other areas to take up circumcision on a large scale. OK, so the difference between a circumcised and uncircumcised penis is a matter of some debate – there have been studies showing a significant difference in levels of sensation, but equally there have been studies which show no difference whatsoever. However, the arguments other than HIV infection are completely ridiculous – increased personal hygiene? Only if you don’t wash! Cultural similarity? Not outside the US and Middle East.

5. seuden - June 7, 2007

“Says who, seuden?”

Sorry Nas, i forgot to put imho.

Being circumcised myself and knowing first hand that there are complications with the procedure for circumcision, these are quite rare especially with modern science and technology. That aside there is no health benefits for having foreskin afaik, are there?

Surely not having foreskin and a perfect breeding ground for bacteria (citation needed) is slightly, even if remotely, cleaner? Its easier to clean the penis without foreskin, more bacteria can be washed away and for a start there is probably less bacteria to start with. The fact is that circumcised penis’s have one less place for bacteria to hide and breed, so when sexually active, there is no bacteria hiding underneath the foreskin ready to be passed on to the other partner because there is no foreskin.

Even washing can irritate the foreskin and cause infectionm this also being rare, but i also know first hand (i do a lot with my first hand, lol). Seriously tho there are lots of different environments and situations that maybe one is better than the other but i think looking at it from an obvious point of view, less bacteria, less chance of infection, more clean, imo. I am also aware that there have been studies that show there is a high concentration of Langerhans cells which are a target for HIV on the foreskin but also that Langerlin which is a natural barrier to HIV is excreted by the very same cells.

Maybe my view and opinion is swayed by the fact that i am circumcised, i dont know but i still see circumcision being obviously cleaner generally. My view and opinion also only really covers everyday life in England (maybe the developed western countries) as i dont have any experience or knowledge of any other.

I hope i haven’t come across too biased, lol.

Btw, my missus prefer’s it circumcised😉

6. Alex H - June 8, 2007

I’ve always found the “cleaner” argument interesting because it assumes that guys don’t wash their dicks on a regular basis.

I can certainly understand that occouring (or not occouring as it were) in certain environments where there isn’t much/any water available for personal hygine…like Africa for instance…but I have trouble seeing the need in countries with indoor plumbing.

7. Raahem - December 20, 2007

The FGM part gave me some bad images but good article.

8. John - February 5, 2009

20 years from now, when the HIV epidemic is still raging across Africa and the globe, “researchers” will admit that genital cutting of men was, at best, wishful thinking, and at worst a hoax. There’s a powerful clue that these “researchers” and their media proxies are totally clueless in the realm of statistics: the claim that circumcision reduces HIV by a certain *percent*, without ever giving the interval of *time*. Turns out the ~50% reduction so often quoted is over a two year period, but to read the media you’d think this was an absolute lifetime measurement of risk. Do the math: in a four year period, half the men spared HIV in the first two year interval will be infected. That’s because people don’t have sex just once: they do it over and over for years and years. Suddenly the percentages don’t look so good.


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