Dr Rick

Overall the findings did not reach statistical significance with regards to the group as a whole and the risk of cervical cancer, but they were statistically significant for the risk of HPV infection and cervical cancer among partners of men with several partners.

<strong> Hmmm....what? Do you have a point to make?

<strong> The others posting here may not appreciate it, yet, but you and I both can both glean from the results that this specific finding was not statistically significant.

In other words, age of first sex had no significant impact on the results, no statistically valid conclusions regarding the impact one way or the other of age at first sex can be made from the study, and you are misrepresenting the data.

<strong> ...ditto; there's no statistical difference between the two groups.

<strong> ...and again; ditto

<strong> The study found no significantly negative impact by circumcision on low risk behavior.

<strong> It does so more than your misrepresentation of the data.

Rick

Dr Rick

Almost all of them do, and I just didn't post them; I cut them out when they were first posted to save bandwidth and keep them readable. Many of them, especially the ones from Africa, involved thousands of subjects.

If you want to look them all up and post that information, go ahead; it won't change anything about how wrong your assumptions and conclusions are.

Rick

Corwin

You didn't post them, and you expect us to 'just trust you' concerning their results and their validity. Wonderful.

I notice you dance around the more personal argument. What about the cigar cutter? You game? After all... it'll have a noticeable effect with regards to eliminating skin and bone cancer in the fingertips. It'll be easier to keep clean, and after all... you don't really NEED fingertips. You can live just fine without them... (oh... and chicks dig it. Besides... you want your hands to look like everybody elses, don't you?)

Mageth

You didn't post them, and you expect us to 'just trust you' concerning their results and their validity. Wonderful.

Perhaps I shouldn't be involved in this, but...

I fail to see where Rick asked any one to "just trust him." I would assume you or anyone else is welcomed to access the cited reports, analyze the study methodologies, parameters and results, and come to an informed conclusion on the relative validity or invalidity of the studies.

ybnormal

Where have I heard that before? Oh, yeah... "Go read the entire Bible yourself if you want to find the TRUTH"

Mageth

Where in the bible are scientific studies cited by title, author, and publication?

And if one wishes to discuss facts of the bible, one had best read the relevant sections before declaring them unfounded.

Dr Rick

Let's not dismiss the points of the others too hastily, Mageth; perhaps I am deliberately hiding something in failing to provide links to the medical literature, so here's <a href="http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=116864 62&dopt=Abstract" target="_blank">one</a> for their analysis...

Dr Rick

...and what most of you will find is that the "big secret" I've been hiding all along is that medical publications are propietary and do not allow access without a paid subscription.

Here by the way is the full abstract; notice both it's relative long-winded unreadability and the thousands of study subjects the authors used to reach their conclusions:

AIDS 2001 Aug;15 Suppl 4:S15-30 Related Articles, Links
 
Ecological and individual level analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection.
Auvert B, Buve A, Ferry B, Carael M, Morison L, Lagarde E, Robinson NJ, Kahindo M, Chege J, Rutenberg N, Musonda R, Laourou M, Akam E; Study Group on the Heterogeneity of HIV Epidemics in African Cities.
INSERM U88, AP-HP, A-Pare, Saint-Maurice, France. bertran.auvert@paris-ouest.univ-paris5.fr
OBJECTIVE: To identify factors that could explain differences in rate of spread of HIV between different regions in sub-Saharan Africa. DESIGN: Cross-sectional study. METHODS: The study took place in two cities with a relatively low HIV prevalence (Cotonou, Benin and Yaounde, Cameroon), and two cities with a high HIV prevalence (Kisumu, Kenya and Ndola, Zambia). In each of these cities, a representative sample was taken of about 1000 men and 1000 women aged 15-49 years. Consenting men and women were interviewed about their socio-demographic background and sexual behaviour; and were tested for HIV, herpes simplex virus type 2 (HSV-2), syphilis, Chlamydia trachomatis and Neisseria gonorrhoea infection, and (women only) Trichomonas vaginalis. Analysis of risk factors for HIV infection was carried out for each city and each sex separately. Adjusted odds ratios (aOR) were obtained by multivariate logistic regression. RESULTS: The prevalence of HIV infection in sexually active men was 3.9% in Cotonou, 4.4% in Yaounde, 21.1% in Kisumu, and 25.4% in Ndola. For women, the corresponding figures were 4.0, 8.4, 31.6 and 35.1%. High-risk sexual behaviour was not more common in the high HIV prevalence cities than in the low HIV prevalence cities, but HSV-2 infection and lack of circumcision were consistently more prevalent in the high HIV prevalence cities than in the low HIV prevalence cities. In multivariate analysis, the association between HIV infection and sexual behavioural factors was variable across the four cities. Syphilis was associated with HIV infection in Ndola in men [aOR = 2.7, 95% confidence interval (CI) = 1.5-4.91 and in women (aOR = 1.7, 95% CI = 1.1-2.6). HSV-2 infection was strongly associated with HIV infection in all four cities and in both sexes (aOR ranging between 4.4 and 8.0). Circumcision had a strong protective effect against the acquisition of HIV by men in Kisumu (aOR = 0.25, 95% CI = 0.12-0.52). In Ndola, no association was found between circumcision and HIV infection but sample sizes were too small to fully adjust for confounding. CONCLUSION: The strong association between HIV and HSV-2 and male circumcision, and the distribution of the risk factors, led us to conclude that differences in efficiency of HIV transmission as mediated by biological factors outweigh differences in sexual behaviour in explaining the variation in rate of spread of HIV between the four cities.

Rick

Corwin

All well and good. (I was actually aware of the subscription issue... other disciplines have the same problem.) But again, correlation does not prove causation. Examine the data and one is extremely likely to find that circumcision has nothing at all to do with HIV rates at all. (The point that was brought up before about most circumcised men in that region being Muslims... with a correspondingly low incidence of high risk behaviors for HIV transmission...)

Even if the survey is completely accurate, (which I doubt. It's taking a rather simplistic view of an extremely complex issue.... its simple answer COULD be right... but for any given problem there is a solution that is intuitive, simple, and completely wrong...) the same results can be achieved with... A CONDOM. And guess what?

Condoms don't require elective amputations on an individual who can't give consent.

Dr Rick

...and here's another one that studied almost 7000 subjects and utilized sound statistical methods to decisively conclude that prepubertal but not adult circumcision is inversely associated with risk of HIV aquisition.

Just let me know if anyone wants the link.

AIDS 1999 Feb 25;13:399-405
 
Age of male circumcision and risk of prevalent HIV infection in rural Uganda.
Kelly R, Kiwanuka N, Wawer MJ, Serwadda D, Sewankambo NK, Wabwire-Mangen F, Li C, Konde-Lule JK, Lutalo T, Makumbi F, Gray RH.
Department of Population Dynamics, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
OBJECTIVE: To assess whether circumcision performed on postpubertal men affords the same level of protection from HIV-1 acquisition as circumcisions earlier in childhood. DESIGN: Cross-sectional study of a population-based cohort. SETTING: Rakai district, rural Uganda. METHODS: A total of 6821 men aged 15-59 years were surveyed and venous blood samples were tested for HIV-1 and syphilis. Age at circumcision was dichotomized into men who were circumcised before or at age 12 years and men circumcised after age 12 years. Postpubertal circumcised men were also subdivided into those reporting circumcision at ages 13-20 years and &gt; or = 21 years. RESULTS: HIV-1 prevalence was 14.1% in uncircumcised men, compared with 16.2% for men circumcised at age &gt; or = 21 years, 10.0% for men circumcised at age 13-20 years, and 6.9% in men circumcised at age &lt; or = 12 years. On bivariate analysis, lower prevalence of HIV-1 associated with prepubertal circumcision was observed in all age, education, ethnic and religious groups. Multivariate adjusted odds ratio of prevalent HIV-1 infection associated with prepubertal circumcision was 0.39 95% confidence interval CI, 0.29-0.53. In the postpubertal group, the adjusted odds ratio for men circumcised at ages 13-20 years was 0.46 95% CI, 0.28-0.77, and 0.78 95% CI, 0.43-1.43 for men circumcised after age 20 years. CONCLUSIONS: Prepubertal circumcision is associated with reduced HIV risk, whereas circumcision after age 20 years is not significantly protective against HIV-1 infection. Age at circumcision and reasons for circumcision need to be considered in future studies of circumcision and HIV risk.

Rick

[ September 09, 2002: Message edited by: rbochnermd ]</p>