- from The Journal of Law and Medicine -
The Journal of Law and Medicine has published a new critique of the three randomised clinical trials from Africa that purported to find that male circumcision reduces female-to-male sexual transmission of HIV by 60 percent.
This critique provides a detailed documentation of numerous flaws in the execution of these studies and shows that the actual (absolute) reduction in HIV transmission was only 1.3 percent (without adjusting for the several sources of error bias), not the misleadingly and frequently touted 60 percent (relative figure only). The 1.3 percent is not considered to be clinically significant.
This is offset (in a parallel Ugandan RCT trial–Wawer et al., 2009) by a 61 percent relative INCREASE (6 percent absolute INCREASE) in male-to-female HIV transmission when the male partner was circumcised. It was reported that “Circumcision of HIV-infected men did NOT reduce HIV transmission to female partners over 24 months…Condom use after male circumcision is essential for HIV prevention” (p. 229). Quite unethically, some women were NOT informed that their male partners were HIV positive (p. 230) AND 17 women in the intervention group were infected with HIV during the trial (p. 229). This trial was stopped prematurely (before the results became statistically significant) because of its “futility”. The preliminary findings did not support the pro-circumcisionists’ genital mutilation agenda.
On the basis of the empirical evidence disclosed in the published African RCT reports, these contrived studies should NOT be used in the formulation of public health policy. Indeed, there is now a growing number of published critiques of the African RCTs showing these studies to be invalid.
Ref: Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns. J Law Med 2011;19:316-334. http://www.salem-news.com/articles/december112011/circumcision-hiv-rg.php
http://www.circumcision.org/hiv.htm
No. of Views:521
Thank you for finally stating what should be obvious: the male foreskin is not the cause of HIV infections. Nor will its removal lead to any decrease in the spread of HIV. Many HIV infections in Africa are being spread through non-sexual means. The foreskin is a normal part of male anatomy that serves many functions and will actually protect the individual from disease. The people and organizations promoting circumcision have a vested interest in perpetuating this mistaken belief that circumcision is protective from HIV. Follow the money trail.
It is reassuring to see people questioning the flawed randomized clinical trials that are causing so much pain and suffering in Africa now. To claim circumcision will reduce the spread of HIV/AIDS is ludicrous–and downright dangerous. Men, believing they are safe from acquiring HIV after circumcision, are no longer taking proper precautions for preventing the disease. If circumcision didn’t protect men from AIDS in the USA, which has the highest rates of both in the developed world, reason would tell us the misguided agenda won’t work in Africa either. The billions of dollars being spent to cut off foreskins in Africa would be better spent on aggressive educational campaigns about safe sex and condom use, safe healthcare practices, clean water, and adequate nutrition. Condoms are 98% effective and 95-times more cost-effective than circumcision without the risks and long-term harmful consequences.