Circumcision

[fls]

I would put people who cirumcise healthy boys in the pro-circ camp. I would not classify people who circumcise boys for medical reasons** only as pro-circ.

Also I think its worth mentioning that I'm pretty sure that there are a lot of Jewish people who wouldn't circumcise their sons except that they feel obligated too. I realize that many people won't understand this, but my impression is that they really don't feel that they have a choice. And yes this falls under anecdotal ...

So what you are saying is that, with the exception of Z, we are all on the same side? Damn, we are a cantakerous bunch, then.

Linda

 

[Morrigan]

You're welcome.

By the same token, I needed to see some true colors.
Thanks.

The only "true colours" we see here is your bad faith. It's not Ivor's fault if the source you quote is more than unreliable.

 

[Kaylee]

As predicted by me in the penultimate circumcision thread to this one, NGO's are promoting circumcision for HIV prevention by only giving half the facts, combined with propaganda.

http://www.mg.co.za/articlePage.aspx?articleid=315825&area=/insight/insight__africa/

Simpungwe confirmed that research by the Health Department found that some Zambians believed they could have unprotected sex after being circumcised. "It worries us a lot, because then we think we'll be reversing our achievements," he said. "When we start doing mass circumcision we will bombard them with the correct health education."

...

He appears to be struggling to provide information that is relevant and appropriate to the young men in the room as well as the mothers with small children. Asked how long the wound will take to heal, he advises adults to be "very reserved" for at least a month after the surgery. Only towards the end of the session, in response to a question, does he bring up the necessity of continued condom use after circumcision.

Will the clinics tell most Zambians that they will need to continue to use condoms before or after they are circumcised?

I wonder how many Zambians would still want to be circumcised if they knew that they will still need to use condoms to prevent getting HIV.

Why are so many people not getting the few and simple facts about circumcision -- both in Zambia and in the USA?

 

[Kaylee]

... Damn, we are a cantakerous bunch, then.

Linda

We all seem to put up a good show.

 

[Gurdur]

Will the clinics tell most Zambians that they will need to continue to use condoms before or after they are circumcised?

Far be it from me to interfere with the long, slow auto-da-fé being performed on Beth and fls for their unforgivable crime of being dispassionately factual, but condom education campaigns in Zambia are quite prevalent and ongoing.

Unfortunately, Lusaka’s Post reports that, according to the 2005 Zambia Sexual Behaviour Survey (ZSBS), there is very little improvement in risky behavior related to HIV.

I wonder how many Zambians would still want to be circumcised if they knew that they will still need to use condoms to prevent getting HIV.

Judging from the news reports so far, it seems like quite a lot.

Why are so many people not getting the few and simple facts about circumcision -- both in Zambia and in the USA?

Pardon me? Who says they are not getting the facts?

 

[Ivor the Engineer]

Far be it from me to interfere with the long, slow auto-da-fé being performed on Beth and fls for their unforgivable crime of being dispassionately factual, but condom education campaigns in Zambia are quite prevalent and ongoing.

Unfortunately, Lusaka’s Post reports that, according to the 2005 Zambia Sexual Behaviour Survey (ZSBS), there is very little improvement in risky behavior related to HIV.

Judging from the news reports so far, it seems like quite a lot.


Pardon me? Who says they are not getting the facts?

Care to back your statements up with any evidence, Gurdur?

BTW, the report I linked to was from August 2007. Have you read it?

What do you think about Australia's new direction with regards to circumcision?

And if you don't mind me asking, are you circumcised?

 

[Kaylee]

Pardon me? Who says they are not getting the facts?

For Zambia, I am inferring it from this article, (link provided by Ivor in post #639):

http://www.mg.co.za/articlePage.aspx?articleid=315825&area=/insight/insight__africa/

Simpungwe confirmed that research by the Health Department found that some Zambians believed they could have unprotected sex after being circumcised.

"It worries us a lot, because then we think we'll be reversing our achievements," he said. "When we start doing mass circumcision we will bombard them with the correct health education."

...

He appears to be struggling to provide information that is relevant and appropriate to the young men in the room as well as the mothers with small children. Asked how long the wound will take to heal, he advises adults to be "very reserved" for at least a month after the surgery. Only towards the end of the session, in response to a question, does he bring up the necessity of continued condom use after circumcision.

In the absence of detailed guidelines from the WHO, Bowa admitted "we struggle with what is the minimum counselling message, because the period we have to deal with these clients is very short and if the message is too long people get discouraged".

For the USA, I am also inferring it from the fact that over half the American boys in the USA are circumcised, and that this has continued after 1999 through now, despite the fact that the AAP policy on circumcision since 1999 states that:

existing science evidence demonstrates potential medical benefits of newborn male circumcison; however, these data are not sufficient to recommend routine neonatal circumcision.

Go to
http://www.cirp.org/library/statistics/USA/
and look for the circumcision incidence rate table and graph in the middle of the web page. The table and graph were based on numbers collected by the National Hospital Discharge Survey.


This article
http://www.boston.com/news/nation/articles/2007/06/18/us_circumcision_rate_drops/
points out that rate of circumcisions that take place in the various communities in the USA varies widely depending upon each community’s ethnic background and immigration rates. I believe it is reasonable to assume that if doctors were actually informing parents what the pros and cons of the procedure were, and were also informing them of the AAP’s recommendation since 1999, that the overall rate of circumcision would be lower and that the regional rates would be more similar throughout the country.

 

[Kaylee]

-- dup post --

 

[Z]

The 50% reduction in HIV is sufficient to warrant circumcision for every boy, everywhere.

And, no, condoms don't make a significant enough difference to warrant not circumcising. Condoms are less effective on uncircumcised men, and they are not 100% effective in preventing HIV or other STDs. If circumcision cuts the chance by half, and condoms by 95% (for example), then condoms plus circumcision would cut the chances by 97.5%! That extra decrease in the chance of not getting HIV is worth far more than the 0.2%-0.6% chance of a little bleeding or possible infection (both of which are treatable), or the .003% chance of serious complications or malformations.

Plus, there's no guarantee that the kids' gonna use condoms when he grows up; circumcision at least guarantees the 50% chance of not catching HIV, without having to resort to drastic measures like total castration.

The only benefit I can possibly see from carrying around that vestigial bit of skin is that it has a few extra nerve endings, and keeps the head moist and sensitive. Big deal - if women want their men so sensitive that 30 minutes of sex seems like a long time, they can speak up. FWIW, I think a decrease in sensitivity is a good thing for women - they don't have to put up with early shooters and minutemen. So I don't see that as a benefit, really - meaning the one advantage is really a disadvantage.

 

[Ivor the Engineer]

<snip>

...The only benefit I can possibly see...

<snip>

That's all we need to know, Z

 

[Morrigan]

For someone who constantly whines about fallacies and emotional appeals from the opposite side, I must say his last post to be dripping with irony.

 

[Gurdur]

...... I am inferring it from this article..........

Point is, that condom education campaigns are still working, and that they are still being officially promoted in Zambia, alongside now medically-performed male circumcision. That answers your question.

I am also inferring it from the fact that over half the American boys.......

Any medical operation in the USA is performed with prior informed consent. The facts, IOW, are being made known.

I believe it is reasonable to assume that if doctors were actually informing parents what the pros and cons of the procedure were, and were also informing them of the AAP’s recommendation since 1999, that the overall rate of circumcision would be lower and that the regional rates would be more similar throughout the country.

Since the facts are indeed being made known, then your inference would not seem to be correct.

 

[Gurdur]

... Big deal....

And 17 pages of it. Makes one feel like saying, "Lose a prepuce and get a life!"

 

[Kaylee]

Point is, that condom education campaigns are still working, and that they are still being officially promoted in Zambia, alongside now medically-performed male circumcision. That answers your question.

Perhaps. I still haven't seen enough information that explains why some Zambians think they won't have to use condoms after circumcision. Is that lack of information the rule or the exception?

Any medical operation in the USA is performed with prior informed consent. The facts, IOW, are being made known.

Ever lived in the States and dealt with real life health care? My experience has been that while the pros and cons of any medical treatment are suppose to be explained -- they ususally aren't. Legal releases are usually very rushed affairs done to satisfy the lawyers but not actually done in a way that provides any real information in a useful way. [ETA: It reminds me of the way that most companies explain their privacy policy on the web.] At least in my neck of the woods. Perhaps this varies to a certain extent depending upon region and what type of insurance coverage one has.

I think it would be best to hear from any parents that may be reading this thread to find out what their experience was.

Since the facts are indeed being made known, then your inference would not seem to be correct.

This thread has made me think it might be fun to see how much the medical care experience differs among the forumites's countries. I know you read about informed consent forms in the USA, but I doubt you experienced how it actually works first hand.

Anyway, I may not be the best person to start this thread because luckily my medical needs have not been high -- but if no one else starts it I might.

 

[Ivor the Engineer]

Just in case anyone was even slightly convinced by Z's argument about being circumcised and using a condom providing significantly more benefit that just using a condom, you have to take into account both the incidence of HIV in the population and the chances of contracting HIV from a HIV+ partner. In the US, the incidence of HIV is about 3%, and the chance per-act for a heterosexual man engaging in vaginal intercourse is about 0.1%.

Thus the chance of your son contracting HIV if he uses only a condom is 0.03 * 0.001 * 0.05 = 0.0000015, or he has a 99.99985% chance of not contracting HIV per random sex-act.

The chance of Z's son contracting HIV, being circumcised as well as using a condom is 0.03 * 0.001 * 0.5 * 0.05 = 0.00000075, or he has a 99.999925% chance of not contracting HIV per random sex-act.

As you can see, this difference in risk between the two men when they each use a condom is practically insignificant (even after 100 random sexual encounters the difference is only 0.0075% in favour of Z's son), especially when you consider the other real-world factors that can heighten the risk of sexually contracting HIV, such as cuts or sores on the genitals, which circumcision will not help protect against infection, but using a condom will.

I would therefore suggest rather than having your son circumcised, put the money you would of spent on it away in a bank account. When he is older and getting interested in sex, use that money to buy him a wagon load of condoms and get him to use them.

 

[Gurdur]

Perhaps. I still haven't seen enough information that explains why some Zambians think they won't have to use condoms after circumcision. Is that lack of information the rule or the exception?

If I may say, you confuse prejudices with lack of information. The information is provided but the prejudices often remain. Just like this thread. Ironical, isn't it?

Ever lived in the States

Fortunately I've never had to live for long periods in the States.

and dealt with real life health care?

I live somewhere else, a civilized place. Great health care where I live. Yes, it's just so not the USA.

My experience has been that while the pros and cons of any medical treatment are suppose to be explained

I take your point. I see what you mean. Nonetheless, the info is provided; what you're complaining about is that the info isn't driven into the thick heads of people mercilessly along with a great deal of education. Well, true. But the info is provided.

This thread has made me think it might be fun to see how much the medical care experience differs among the forumites's countries. I know you read about informed consent forms in the USA, but I doubt you experienced how it actually works first hand.

I have often dealt with informed consent, from both sides.

 

[Ivor the Engineer]

If I may say, you confuse prejudices with lack of information. The information is provided but the prejudices often remain. Just like this thread. Ironical, isn't it?

Fortunately I've never had to live for long periods in the States.

I live somewhere else, a civilized place. Great health care where I live. Yes, it's just so not the USA.

I take your point. I see what you mean. Nonetheless, the info is provided; what you're complaining about is that the info isn't driven into the thick heads of people mercilessly along with a great deal of education. Well, true. But the info is provided.

I have often dealt with informed consent, from both sides.

Or perhaps, Gurdur, it is lack of condoms too. Last time I checked only 1 in 5 couples in Africa had access to condoms.

 

[Kaylee]

If I may say, you confuse prejudices with lack of information. The information is provided but the prejudices often remain. Just like this thread. Ironical, isn't it?

Fortunately I've never had to live for long periods in the States.

I live somewhere else, a civilized place. Great health care where I live. Yes, it's just so not the USA.

I take your point. I see what you mean. Nonetheless, the info is provided; what you're complaining about is that the info isn't driven into the thick heads of people mercilessly along with a great deal of education. Well, true. But the info is provided.

I have often dealt with informed consent, from both sides.

I like to give people the benefit of doubt, but I can see that you aren't actually interested in discussing the topic.

No problem. Have a nice life.

 

[Beth]

I would put people who cirumcise healthy boys in the pro-circ camp. I would not classify people who circumcise boys for medical reasons** only as pro-circ.

Sorry, I'm not clear on this. Are you talking about parents who make that choice? Or those who actually perform the circumcision? Or are both of those groups 'pro-circ'?

Also I think its worth mentioning that I'm pretty sure that there are a lot of Jewish people who wouldn't circumcise their sons except that they feel obligated too. I realize that many people won't understand this, but my impression is that they really don't feel that they have a choice. And yes this falls under anecdotal ...

I can understand that they feel obligated. Does that make them pro-circ?

People can be pro-circ for different reasons.

Of course! But I tend to reserve the 'pro' description for those who actively encourage others to circumcise their sons. I also reserve 'anti' for those who actively discourage others from it. That's why I wanted to find out who you include in the definition of those two camps.

Not sure agreement is allowed to happen in this thread ....

Sorry. I'm try not to let it happen again

I think it would be best to hear from any parents that may be reading this thread to find out what their experience was.

Our experience (our kids are 19 and 8) was that the hospital gave us consent forms for a bunch of things - vaccinations, circumcision, etc. when we checked in. My husband didn't sign the form authorizing circumcision, so it wasn't done. No pressure at all to sign it other than being handed the form in amongst other consent forms and a follow-up when he didn't hand the signed form back to make sure that was his decision and not simply an oversight.

 

[Gurdur]

I like to give people the benefit of doubt, but I can see that you aren't actually interested in discussing the topic.

That would be a fully incorrect inference of yours. It simply isn't true. Never mind, though.

No problem. Have a nice life.

You too. Nevertheless, I shall often pop up here in my irrepressible way. I do realise that my having a sense of humour may contribute here to a kind of lack of communication, as a cultural difference between us, but I remain unrepentant on that score.