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Foresight

Monday, February 02, 2009

Dr. David Serwadda, dean of the Makerere University School of Public Health and the director of the Rakai Health Sciences Program in Uganda, and Dr. Jordan Tappero, acting deputy director for the CDC Global AIDS program and former Global AIDS program director for the CDC in Uganda, talk about male circumcision and other efforts to prevent HIV/AIDS in Uganda.

Guests:

Dr. David Serwadda and Jordan Tappero

Comments [35]

Curly Bill

All of you miserable, insecure, inadequate, impotent d* ckheads whining about "mutilation" miss one important point. You would be miserable, insecure, inadequate, impotent d* ckheads even if you weren't circumcised. I'm circumcised. I'm glad I'm circumcised. My wife is glad I'm circumcised. It hasn't affected me negatively AT ALL. Grow up and get over your inadequacies. If losing a little piece of skin as an infant has affected you this much, you really do need therapy.

Dec. 02 2011 05:43 PM
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gary from queens

All of you who are citing studies supporting HIV transmission and detection, and AIDS diagnosis, are basing your opinions on discredited science. (It's amazing how some of you reject out of hand information coming from the government, but not information coming from government health agencies!)

Sources:

http://www.robertogiraldo.com/eng/papers/Farber_Reply_April_2006.html

http://www.robertogiraldo.com/

http://www.theperthgroup.com/

http://fumento.com/suaids.html

Feb. 03 2009 11:58 AM
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a. hammagaadji

We used to say that to foreigners we met in order to feel superior and pure and clean but with anti-gay activist priests and murders of gays getting international ink and air, the talking point has changed. Now it's owning up to the fact that we have them but we either have to kill them, socially marginalise them or not recognise them any human right whatever. One old talking point remains, this "disease" still came from white colonialists.

Feb. 03 2009 08:59 AM
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Mike from UES

10% sounds like just slightly below the average percentage of males that are gay and bisexual. Where did the myth come about that there is no homo and bisexuality in Africa?

Feb. 03 2009 12:24 AM
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ml66uk

"Most European men are uncircumcised. Europe has the highest rate of HIV in world."

WTF!? Most European men are uncircumcised, but the rate of HIV is lower than the rate in the USA, and way way lower than in Africa.

USA: 0.6%
UK: 0.2%
France: 0.4%
Germany 0.1%
Italy: 0.4%

In Africa, nine countries have HIV rates over 10%.

[figures taken from UNAIDS report - "estimated adult (15-49) HIV prevalence (%) for countries in 2007"]

There actually seems to be a correlation between high circumcision rates and high HIV rates.

Circumcision can only possibly help men who have unsafe sex with HIV+ partners, so why this bizarre obsession with genital surgery when we know that ABC works better than circumcision ever could? (ABC=Abstinence, Being Faithful, Condoms).

Rwanda has almost double the rate of HIV in circed men than in intact men, yet they've just started a nationwide circumcision campaign. Other African countries where circumcised men are *more* likely to be HIV+ than intact men are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives not save them.

It’s not like we've tried the things that really do work. In Malawi for instance, only 57% know that condoms protect against HIV/AIDS, and only 68% know that limiting sexual partners protects against HIV/AIDS. Some people haven't even heard of condoms. It just seems really misguided to be hailing male circumcision as the way forward. It would help if some of the aid donors didn't refuse to fund condom education, or work that involves talking to prostitutes. If anyone really cares about men, women, and children dying in Africa, surely they'd be focussing on education about safe sex rather than surgery that offers limited protection at best, and runs a high risk of risk compensatory behaviour.

Feb. 02 2009 09:16 PM
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Gary from Queens

Dear JP

I didn't pick today's subject, which happens to be about HIV. Not circumcision. I didn't personalize this issue. No one cares about YOU, because it isn't about you. Parents expecting a baby might want to know about the efficacy of circumcision, for example. Public policy and health insurance experts might want to learn about this issue. So Stop taking this as a personal afront to you. No one cares about YOUR penis. OK?

My initial argument was the unorthodox one that sex doesn't transmit HIV. I found studies to support my argument. I didn't read anything from you pro or con on THIS important subject. Perhaps you're too obsessed over the issue of your penis?

Feb. 02 2009 03:05 PM
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JP from Hackensack

Ok guys,

You win. I’ll have my foreskin reattached tomorrow….. I guess my point is as badly pointed out as it is, for someone who is circumcised, I don’t feel mutilated, victimized or unhealthy. I don’t feel like I’m missing out on something big. I don’t feel wronged by my parents and yes Gary I do feel there are way, way, way, more important things to worry about then circumcised white babies. Does or should everyone feel like me? Hell no. Come on now, that’s just stupid. This is America, preach what you want, and this forum is proof of that. But ask your friends who are circumcised (I have asked and most of mine are) and ask them how they feel. Do they all feel mutilated? I’m sure some do. But I think you’ll find most don’t. If men felt mutilated everywhere, men would be marching in the streets...

Feb. 02 2009 01:46 PM
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Gary from Queens

Dear JP

Please don't put words in my mouth. I mentioned nothing about the "plumbing" of a circumcised penis. And I said nothing about mutilation, assuming you feel that it's OK to mutilate a baby without the baby's consent. What you want to do as an adult is your business.

And please don't try the pathetic "starving children" diversion on us. All issues have their priority. Did you see the studies I posted showing how impossible it is to sexually reansmit HIV? Did you see me go into a rant about the thousands of children getting toxic, life-shortening anti HIV drugs to counteract a harmless passenger virus? Just stick to the subject, or else bow out and get on a "starving children's" blog

Right now we're talking about a surgical procedure that has no efficacy and can cause hardship. Read before you comment. Circumsized penises, for example, do not have the protection of the foreskin, and as a result become more calloused and less sensitive. They're also constantly undergoing stimulation.

Nature provided foreskin for many reasons. Learn a few of them before spouting and ranting.

Feb. 02 2009 01:20 PM
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Jeff from Manhattan

1. Referring to circumcision as mutilation is cultural chauvinism. Piercings, tattoos, rhinoplasty, botox - there are a thousand body socially-acceptable body modifications that are not referred to as "mutilation." Everyone knows that Jews and Muslims engage in ritual circumcision.

2. This is an odd example of a religious ritual that seems to have practical value.

3. The scientists who completed this study are not "white."

4. Penises using condoms, like circumcised penises, are less sensitive during intercourse.

4. Let the fact speak: studies by AIDS researchers in Africa have found a significantly lower rates of HIV infection among men who have undergone circumcision.

Should international agencies administering healthcare, especially HIV-related programming suggest it as a practice to help control the rate of infection?

Feb. 02 2009 12:52 PM
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hjs from 11211

jp

there are different degrees of victimization, of course, but circumcision lessens sexual enjoyment, as studies show. there is usually no medical reason for it so it is abusive.
of course doctors have brainwashed generations of parents into doing this to the children. now I understand the insurance companies won't pay for it.
I don't think another person has any right to tell someone when or when not they have been abused . the victim has the only right to say when they have been harmed try to be more understanding.

Feb. 02 2009 12:46 PM
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snoop from brooklyn

JP, I never characterized myself as feeling victimized. What I said was that I was mutilated through something that someone did to my body without my consent.

Since you say that's not equal to getting beat up or starving, I guess that means that I could slash you across the penis and that would be OK because you would still have plenty to eat and you weren't beat up.

Honestly, that's a little weird. But good for you. I'm glad that you can put your life into such perspective. Perhaps we can all learn from you that we should just accept the world as it is, as long as nobody is beat up or starving.

But my point of view, as you have yet to convince me of the wisdom of yours, is that people should have a right to control what is done to their bodies, whether it's a fist in the face or a scalpel to their genitals. I sort of view both as points on a continuum of bad rather than as discrete types of events.

As for what I'm missing, I don't know. And that's the point.

Feb. 02 2009 12:44 PM
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JP from Hackensack

Gary from Queens,

My pluming works fine thank you. I think it is far more important to make sure a kid is well fed and a roof over their head then to start a society worried about American male penises being circumcised. Come on now. Circumcised or not, whole families are living on the streets in a country with tremendous wealth. I just don’t see people marching down the street against male circumcision. Which kills more in America today, poor health do to poor nutrition and poor or no medical care or does male circumcision kill more? There are far more important issues today to worry about. Now cutting off a woman’s clitoris at any age is a different story. This is done in this country and it is something worth worrying about.

Feb. 02 2009 12:39 PM
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Mike from UES

I wonder why no one discusses the fact that semen has extremely powerful immune system suppression factors. Over the millions of years mammalian evolution through sexual intercourse, female's immune systems have adapted to the necessity of dealing with the genetic material of multiple males as well as multiple children each presenting a different challenge to the reproductively active female immune system. Males on the other hand will have an immune reaction to their OWN sperm. For this reason, the male reproductive gonads are an immunologically privileged site. If males will have an immune reaction to their OWN sperm what are the immunological ramifications of males that are continually exposed to the sperm of other men?

Feb. 02 2009 12:26 PM
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JP from Hackensack

Snoop, as childish as I am, you still did not answer my question. How do you feel victimized? Do you feel abused like a child who gets the crap kicked out of him everyday? Do you feel victimized like a child who was malnourished because he was not allowed to eat? Do you feel victimized like a child who had no roof over their head and was forced to grow up exposed to the elements? Come on now, how do you really feel victimized? Help put things in perspective here. What are you really crying about you being personally victimized?

Feb. 02 2009 12:22 PM
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Gary from Queens

a couple of additional studies refuting the sexual transmission of HIV:

no correlation exists between the prevalence of HIV and any of the STDs.:
Chitwarakorn A. Sexually Transmitted Diseases in Asia and the Pacific. Chiang Mai, Thailand: Ministry of Public Health, AIDS Division, HIV/AIDS Situation in Thailand, 1998

The same lack of transmission rate in Africa as anywhere else:
Gray RH, Wawer MJ, Brookmeyer R, et al. Probability of HIV-1 transmission per coital act in monogamous heterosexual, HIV-1 discordant couples in Rakai, Uganda. Lancet 2001;357:1149-1153.

This topic (justification for circumcision) is dubious from the start.

Feb. 02 2009 11:59 AM
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snoop from brooklyn

JP, good for you. I'm glad you don't feel victimized.

But so what? Really, must you presume that your worldview is the one that is correct? How arrogant and really, how childish.

Regardless of whether a presumed adult such as you, JP, feels victimized, performing elective surgery on someone who can't consent is just plain wrong. Basic medical ethics.

Feb. 02 2009 11:59 AM
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Gary from Queens

Dear JP

Here's a "wise rout to education" for you:

www.nocirc.org/

If you really want to know what circumcision has done to you, do a little reading.

Feb. 02 2009 11:35 AM
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JP from Hackensack

Snoop, do you really feel victimized? How? I just don’t see it. I don’t feel the least bit victimized. What are your symptoms? Do you have bad dreams? Maybe there are some other issues you have not confronted that are making you feel victimized…

Removing a woman’s clitoris is genital mutilation. That’s like chopping off a guy’s penis and replacing with a plastic rod. He can still have sex but he’s not going to feel anything.

Feb. 02 2009 11:33 AM
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Mike from UES

The un circumcised male CAN experience the circumcised experience, it just involves retraction of the foreskin, and keeping it retracted, it's easy for any un circumsised male to do and it is done when necessary. Unfortunately, the circumcised male can never duplicate that flexibility. The fact is that this option has been PERMANENTLY removed.

Feb. 02 2009 11:30 AM
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Taher from Croton on Hudson

Most European men are uncircumcised. Europe has the highest rate of HIV in world.

Feb. 02 2009 11:24 AM
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JP from Hackensack

Mutilation? Oh come on now and give it up…. Does everyone have to be a victim? I’m 40 years old and I was circumcised as a baby. Is my life shattered because I’m circumcised? Am I really missing out on a huge sexual experience that my un circumcised brothers have? Are those of you claiming its mutilation even circumcised? And if your not, then how do you really know if it is? Should I be suing my elderly parents for circumcising me? Really, what’s next, they abused me because I had to stay at the dinner table until I ate my Lima beans? Grow up and stop being a bunch of Pansies, really.

And come on now, medical industry in Africa making money off of circumcisions in Africa? What are you smoking? Oh yea, it’s a booming lucrative industry and thousands of African doctors are retiring young because they are so rich. So are the thousands of Western World doctors that are donating their free time to work in Africa saving Africans.

The wise route is education, condoms and anything the medical community can through at the problem. Saying education and condoms is enough is just like saying preaching abstinence is just enough. This is a medical crisis where millions of people are dying. You have to do everything you can.

Feb. 02 2009 11:21 AM
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Gary from Queens

The other study disputing the popular notion of HIV transmission was very comprehensive. the conclusion:

"It would take an American woman over 270,000 random sexual contacts with men to become antibody positive to HIV. It would take an American man 7-8 times that number of random sexual contacts with women to become antibody positive to HIV."

Padian NS, Shiboski SC, Glass SO, Vittinghoff E. Heterosexual transmission of HIV. Am J Epidemiol. 1997 Aug 15;146(4):350-7

This study addressed the sexual acquisition of antibodies to HIV.

And I'm NOT gay!

Feb. 02 2009 11:13 AM
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Mike from UES

Actually, by causing the glans of the penis to become less sensitive and the skin more tough and able to withstand abrasion, circumcision facilitates the ability of males to engage in sexual activity with females that are not lubricated and presumably non cooperative. Even rape becomes an easier possibility because of the insensitivity and toughness of the circumcised glans that facilitates rough sex that would never be contemplated by a non circumcised male, who's glans is as sensitive as the inner labia of a female. Given that African's prefer "dry sex" (google it to see exactly what it is and how it's done and why) I can see why this evil circle of male circumcision and the inducement of dry sex creates the physiological conditions that lead to all sorts of sexually transmitted diseases.

Feb. 02 2009 11:07 AM
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Gary from Queens

WRONG! Before you can discuss circumcision, you first must show that HIV is sexually transmissible. But every major study indicates that it's not. I'll just cite these two:

The first one was a review article published in N Engl J Med 1997;336:1072-8, that surveyed several studies by Rosenberg & Weiner, 1988; Lawrence et al., 1990; Blattner, 1991; Hearst & Hulley, 1988; Peterman et al., 1988; Royce RA, Sena A, plus Cates W Jr, Cohen MS.

Conclusion: "On average, it requires 1000 heterosexual acts, and 100-500 homosexual acts to successfully transmit HIV." [...] "The simple fact is that this is merely a very popular assumption. All the scientific studies that have tried to measure the sexual transmission of HIV have repeatedly shown that it is virtually impossible to transmitt HIV sexually or by any other means."

Feb. 02 2009 11:06 AM
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Buzzie

Whats the name of that reggae song they just played?

Feb. 02 2009 11:02 AM
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Glen Ganaway from Manhattan

Amazing how much money another group of white men has spent on studying minority men's penises.

Feb. 02 2009 11:01 AM
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Paul Johnson from Stamford, CT

Is it not possible that men or parents who go to the trouble of circumcision are also more responsible in there behavior?

Feb. 02 2009 10:58 AM
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snoop from brooklyn

I was circumcised as an infant and I feel mutilated. Something was taken from me that nobody can give back.

Mutilating babies is not a solution.

Consenting adults? That's their choice. But slicing off a piece of a child's genitals without consent is just unconscionable.

Feb. 02 2009 10:58 AM
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Zach

I fear that the notion that circumcision prevents the contraction of HIV will lead to more people having unsafe sex, simply because they are circumcised and thus, "protected" by this negligible procedure.

Feb. 02 2009 10:57 AM
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anonyme from ny

I ownder if there is a way to get this result without genital mutilation

Feb. 02 2009 10:54 AM
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hjs from 11211

I've never bought into this. circumcision is used to lessen a man's sex drive. won't condom use be safer than circumcision to stop hiv?

Feb. 02 2009 10:52 AM
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Jeff Putterman from Queens

This sounds like part of an economic stimulus program for Mohels!

Feb. 02 2009 10:50 AM
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Nathan Tableman from Hoboken, NJ

Looks like G-d knew what he was talking about...kind of interesting from a theological standpoint.

Feb. 02 2009 10:49 AM
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joan harrison from brooklyn

Education, condoms --not genital mutilation of minors.

Feb. 02 2009 09:42 AM
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a. hammagaadji

Just imagine how much money the medical industry would shovel in if every male in Uganda and the world over gets circumcised by doctors. Uh huh.

Feb. 02 2009 09:21 AM
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