Jesse

Intensity:
This is just an assumption.

Likewise, without statistical studies it would be "just an assumption" that obesity would increase the risk of heart disease. But in both cases, it seems that experimental data backs up the theory. Remember, I was responding to your claim that we have a "clear explanation" for the empirically-observable link in the case of heart disease but not in the case of HIV infection.

Diring sex, a lot of lubrication is applied and with the rogour of sex, any dead foreskin at the tip of the glans is washed off.

I thought your outer layer of skin was all dead, except in the case of mucus membranes. I seriously doubt that the entire outer layer of skin on the glans is "washed off" every time a circumcised male has sex. Are you claiming that the glans of a circumcised male would look just like that of an uncircumcised male right after having sex? How long do you think you'd have to rub some other part of your body--your arm, say--before the entire outer layer of dead skin cells was removed?

Intensity:
That the glans is less sensitive (a function of the nerve-endings) does not necessarily mean the glans has a tougher skin. Dead cells dont constitute tough skin.

I think it's pretty uncontroversial that viruses that travel through skin are more easily transmitted through mucus membranes than ordinary skin.

ybnormal

What part of practice patterns stand in such stark contrast to research evidence." is not understood???

And exactly WHO refuses to understand?

Why must a (rare?) pointless infant death be required in each community,
before doctors START listening to other doctors, and STOP this deadly madness.

Repeating myself... "Something other than medicine is going on here."

One of the last sane

Maybe the docs have foreskin envy?

Some of us want our kids to have things better than we did.

Dr Rick

Consider this:

American Journal of Pathology 2002 Sep;161(3):867-73
Susceptibility to human immunodeficiency virus-1 infection of human foreskin and cervical tissue grown in explant culture.
Patterson BK, et. al.
Department of Pediatrics, Division of Infectious Diseases, Children's Memorial Hospital, Chicago.

"Numerous studies have indicated a protective effect of male circumcision against acquisition of human immunodeficiency virus (HIV)-1. We investigated mechanisms responsible for the possible increased HIV-1 susceptibility of human foreskin. Foreskins from eight pediatric and six adult patients with (n = 3) and without (n = 11) histories of sexually transmitted disease were evaluated. Six cervical biopsies from HIV-1-seronegative women were included as controls. CD4(+) T cells, macrophages, and Langerhans' cells (LCs) were quantified using image analysis. Cells expressing HIV-1 co-receptors CCR5 and CXCR4 were quantified using immunofluorescence and image analysis. Foreskin biopsies were infected ex vivo in organotypic culture with HIV-1. HIV-1 DNA copies in foreskin and cervical mucosal tissue were compared and the infected cell phenotype was determined. Foreskin mucosa contained higher mean proportions of CD4(+) T cells (22.4%), macrophages (2.4%), and LCs (11.5%) in adults than in children (4.9%, 0.3%, and 6.2%, respectively) or in cervical mucosa (6.2%, 1.4%, and 1.5%, respectively). The highest proportions of CD4(+) T cells and LCs occurred in patients with a history of infection. Foreskin immune cells expressed predominantly the CCR5 HIV-1 co-receptor. Adult foreskin mucosa had greater susceptibility to infection with HIV(bal) than cervical mucosa or the external surface of foreskin tissue. Circumcision likely reduces risk of HIV-1 acquisition in men by decreasing HIV-1 target cells."

Rick

alek0

I would like to know what does that have to do with circumcision of infants. Infants don't have sex. Circumcised men still can be infected with HIV, and if circumcision plays any protective role it is a lot smaller than simply using a condom. Only certain way to avoid HIV infection is not to have sex with an infected person. Which is easy to achieve without unnecessary surgeries on infants.

Dr Rick

Pretty much everything; it's clear from the medical literature that perinatal circumcision confers a protective effect against HIV aquisition and that the protective effect is diminished if not completely eliminated when the foreskin is left intact until adulthood.

<strong> ...but they have a strong tendency to grow into beings that do.

<strong> ...though less so than intact men.

<strong> You don't know what you're talking about.

Posted on this thread is both laboratory and epidemiologic evidence that circumcision confers relative protection against HIV aquisition; where's the evidence to back-up your unsubstantiated assertion?

The evidence that neonatal circumcision reduces HIV aquisition risk is greater than the evidence that condoms do.

<strong> More nonsense; one can aquire HIV through a variety of ways besides sex.

Rick

[ September 08, 2002: Message edited by: rbochnermd ]</p>

Mark_Chid

Absolutely NONE of which have anything whatsoever to do with circumcision! Stop muddying the waters.

alek0

"More nonsense; one can aquire HIV through a variety of ways besides sex."

And how does circumcision protect against other ways of aquisition? Other ways of aquisition are irrelevant for this discussion, unless you are going to claim that circumcision prevents HIV infection by drug use since circumcised men would be less likely to use drugs since they are happier with appearance of their penis. Considering your attitude towards it, I wouldn't be surprised if you did...

As for condoms and HIV prevention:
TITLE: Barrier methods of contraception, spermicides, and sexually transmitted diseases: a review.
AUTHOR: d'Oro,-L-C; Parazzini,-F; Naldi,-L; La-Vecchia,-C
SOURCE: Genitourin-Med. 1994 Dec; 70(6): 410-7.
"Epidemiological studies show a consistent reduction in the risk for use of condoms against gonococcal (most studies giving relative risk, RR, estimates around 0.4 to 0.6) and HIV infection (RRs between 0.3 and 0.6 in most studies). "

TITLE: A meta-analysis of condom effectiveness in reducing sexually transmitted HIV.
AUTHOR: Weller,-S-C
SOURCE: Soc-Sci-Med. 1993 Jun; 36(12): 1635-44.
"Although contraceptive research indicates that condoms are 87% effective in preventing pregnancy, results of HIV transmission studies indicate that condoms may reduce risk of HIV infection by approximately 69%."

TITLE: Effectiveness of latex condoms as a barrier to human immunodeficiency virus-sized particles under conditions of simulated use.
AUTHOR: Carey,-R-F; Herman,-W-A; Retta,-S-M; Rinaldi,-J-E; Herman,-B-A; Athey,-T-W
SOURCE: Sex-Transm-Dis. 1992 Jul-Aug; 19(4): 230-4.
"Worst-case condom barrier effectiveness (fluid transfer prevention), however, is shown to be at least 10(4) times better than not using a condom at all, suggesting that condom use substantially reduces but does not eliminate the risk of HIV transmission."
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All the studies on condoms have consistently found reduction of risk. There are studies on circumcision which have found no difference or even increased risk:

TITLE: Circumcision and HIV infection: review of the literature and meta-analysis.
AUTHOR: Van-Howe,-R-S
SOURCE: Int-J-STD-AIDS. 1999 Jan; 10(1): 8-16.
JOURNAL NAME: International-journal-of-STD-and-AIDS;
INTERNATIONAL STANDARD SERIAL NUMBER: 0956-4624
LANGUAGE: English
MAIN ABSTRACT: Thirty-five articles and a number of abstracts have been published in the medical literature looking at the relationship between male circumcision and HIV infection. Study designs have included geographical analysis, studies of high-risk patients, partner studies and random population surveys. Most of the studies have been conducted in Africa. A meta-analysis was performed on the 29 published articles where data were available. When the raw data are combined, a man with a circumcised penis is at greater risk of acquiring and transmitting HIV than a man with a non-circumcised penis (odds ratio (OR)=1.06, 95% confidence interval (CI)=1.01-1.12). Based on the studies published to date, recommending routine circumcision as a prophylactic measure to prevent HIV infection in Africa, or elsewhere, is scientifically unfounded.

Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States, prevalence, prophylactic effects, and sexual practice. JAMA 1997; 277:10527.
"First, circumcision status does not appear to lower the likelihood of contracting an STD. Rather, the opposite pattern holds. Circumcised men were slightly more likely to have had both a bacterial and a viral STD in their lifetime. "

----------------------------------------------
So, where is your proof that circumcision is more effecttive than condom use? And your proof for justification of surgery with all its inherent risks on unconsenting minors?

Finally, to quote: J-Infect-Dis. 2000 May; 181(5): 1865-6.

"The mere idea of cutting off healthy erogenous organs of nonconsenting minors to reduce their risk of getting a disease that is easily preventable by less drastic means is abominable. "

Mark_Chid

Fact is that since condoms are only 97% effective you are at far greater risk of AIDS if you are promiscuous and use condoms than if your are monogamous and do not. Behaviour is the major risk factor in sexually transmitted disease - and fucking around is still a bad idea, even if its 97% safe!

Dr Rick

So, does this mean you're not going to accept my generous offer?
Rick