A follw up on this post.
Being a molecular biologist lab rat, I do not have much experience with clinical work. I have been perfectly happy to miss out on the ickier parts of human pathology, and this weeks meeting on sexually transmitted infections (STI’s) seem to have strengthened my conviction. Some of the images I have seen has made me think I will never have voluntary sex again, – man have they been gross…
However, well into the second day, I have been immunized and finally find myself able to take in some of what the speakers say. And just to modify the somewhat comic impression from the last post, I will present a couple of talks that touch upon serious issues. At the same time it’s all about sex which makes them interesting (even though I’ll never have it again).
A talk that should have been on the list in the last post was
The Prepuce: Fact and Fiction
Which concluded that the prepuce (aka foreskin) is considered beneficial by some and without importance by others. The speaker Derek Freedman (Ireland) posed the entertaining question: “Do we have sex with our penises or with our brains” when commenting on the possible loss of sensitivity when circumcised. Now, the serious part was when he asked another and much more important question:
“Why has it taken so long to discuss circumcision to prevent HIV-transmission, and why is it not implemented in prevention programmes when circumcision confers 60% protection rates…?”.
A thought provoking question I think, considering that such a (relatively) simple procedure could potentially save millions of lives.
Another talk that I learned a lot from, and that touched upon some very different, but equally important issues, was
Down Low Women – by J.Risser University of Texas
Did you know that in poor areas of Houston US there’s a 2,5 % incidence rate of HIV. Did you know that women in these areas expose themselves to extremely high risk because having multiple boyfriends provides them, not with necessities like food and clothes, but with cell phones or money for a professional hair-do.
I ask them to help me with my wants; my needs I can take care of myself.
They are consequently not prostitutes as such, but still behave like them to posess (in my opinion) meaningless status-items. In doing so they are putting themselves at very high risk of HIV and other STI’s, – since they’re not using condoms in fear of exposing the boyfriends to each other, and since they apparently need several boyfriends to satisfy these needs. Appaling facts, – absolutely appaling. If I get the chance I am going to come back and blog more on Dr. Rissers research. Because, even though the facts are sad, the issues are fascinating.
No wonder sexually transmitted disease is hard to fight.
BIOpinionated 
“the prepuce (aka foreskin) is considered beneficial by some and without importance by others.”
Sure, it’s considered beneficial by those who have one and without importance by those who don’t remember theirs.
“Do we have sex with our penises or with our brains”
Silly question. Both of course. Try (if male) having sex without your penis. It may be possible (for paraplegics and the like) but it’s going to be a greater effort and it’s not the same. Same without a foreskin.
“Why has it taken so long to discuss circumcision to prevent HIV-transmission, and why is it not implemented in prevention programmes when circumcision confers 60% protection rates…?”.
Taken so long? The researchers raced to the media to promote circumcision as soon as their results (which were cut short) claimed to show protection, before any reviews had been published. The studies claiming to show “60% protection” amount to circumcising a total 5,400 men and leaving a similar number intact. After less than two years, 64 of the circumcised men had HIV and 137 of the control group. That’s the WHOLE basis of the claim. The studies were not (obviously) double blinded or placebo controlled, and several times the number infected dropped out, their HIV status unknown (so if circumcised men dropped out when they found they were HIV+ because they didn’t want to go back to the people who’d let them down so badly, while intact men just dropped out through loss of interest, that could easily skew the results). Non-sexual and same-sex transmission were ignored and discounted (some of the men who claimed not to have had sex at all got HIV).
“such a (relatively) simple procedure could potentially save millions of lives.”
It is the same people who held the studies who have made that calculation, and make the claim that circumcised men won’t be more likely to have unprotected sex as a result, or start having sex before their wounds have healed. If they’re wrong, on the contrary, it could cost more lives.
This discussion is always held as if circumcision were an emotionally and culturally neutral topic like, say, tonsillectomy. In fact, cutting off parts of men’s penises has always been riddled with cultural, emotional and psychosexual baggage – among supposedly neutral scientific researchers as much as anyone else.
Hi Hugh. Thank you for a great comment. Let’s see if I can answer equally great then: The foreskin results were results of scientific studies attempting to measure the importance of the prepuce, it was not a statement based on personal accounts. He asked the question about why it has taken so long to discuss circumcision because the first results of the benefit of this procedure dates back to the late 80s. I do believe you are mistaken when it comes to both the quality and the numbers of study-participants. A recent review by Mills et al. lists 11050 male study participants in a number of studies. Also I am not sure you have the same need for stringent double blind placebo controlled studies when the endpoint is as straightforward as HIV positive or not, although I agree that you may have a point there. Lastly I think you are right when you say that this procedure is not emotionally and culturally neutral. However, my point was made compared to the consequences of becoming HIV-positive.
[…] AIDS Day 2008: Down Low Women December 1, 2008 This post is an update from this previous posting and published as a part of Bloggers Unite World AIDS Day […]