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Sexology and sexuality B‑class High‑importance

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Balance re harm/health benefit in early part of article

At present, in the introduction there is a paragraph about studies suggesting that circumcision reduces female-to-male HIV transmission (a possible health benefit of circumcision). Then there are many sections which do not discuss harm or benefit, and then later there are sections mentioning infection, death and other harm as well as other benefits. Therefore, the early part of the article is unbalanced: it mentions a possible benefit but does not mention any possible harm. I suggest either moving the paragraph mentioning HIV from the introduction into the later sections of the article, or else putting some information about possible harm of circumcision in the introduction to balance it. Note also this statement about the alleged HIV benefit: Apparently it may be possible to explain the reduced HIV infection in the circumcised men in those studies by the period of abstinence they had to have to allow their circumcision wound to heal; and also, circumcision may increase the rate of male-to-female HIV transmission in heterosexual intercourse. It may be premature to recommend circumcision as an anti-HIV public health measure. On another issue: Here's a recent article re touch sensitivity: --Coppertwig 15:06, 16 June 2007 (UTC)

A page at an activist website is not a reliable source, Coppertwig. Jakew 15:24, 16 June 2007 (UTC)

It's OK with me if the first reference I gave is not used as a reference on the article page: I wasn't suggesting that it be used as such. Everything I said still stands, and the second reference appears to me to be a published article appropriate for use as a reference on the article page. --Coppertwig 18:57, 16 June 2007 (UTC)

Are you serious? The second link is to a press release. The press release may be about a published article, but it is not itself a published article. (We discussed the article in #Sorrells Study.) Jakew 19:06, 16 June 2007 (UTC)

Of course I'm serious. The press release gives a link to an online copy of the published article which (the published article) I believe is appropriate to use as a reference to balance the existing discussion about sensitivity. --Coppertwig 19:56, 16 June 2007 (UTC)

The article is an appropriate source for Misplaced Pages. A press release is not. The article, along with other studies to investigate sensitivity, is cited in sexual effects of circumcision. Jakew 20:11, 16 June 2007 (UTC)

Right. Re harm/health benefit: I'm leaning towards moving the HIV paragraph from the introduction down into the section on HIV, and merging it into that section. --Coppertwig 12:20, 17 June 2007 (UTC)

HIV protection now shown as bunk - "It's the prostitutes, stupid!"

New analysis shows that what was previously thought to be a definite increase in protection against the spread of HIV caused by circumcision is in fact "statistically irrelevant once the study controls for the number of prostitutes in a country". The AAAS provides the layman summary, and links to the freely available journal article hosted by PLoS. Circumcision, HIV, and other Misplaced Pages articles definitely needs to be corrected/updated with this information. Their ultimate conclusion:

"This paper provides strong evidence that when conducted properly, cross country regression data does not support the theory that male circumcision is the key to slowing the AIDS epidemic. Rather, it is the number of infected prostitutes in a country that is highly significant and robust in explaining HIV prevalence levels across countries. An explanation is offered for why Africa has been hit the hardest by the AIDS pandemic and why there appears to be very little correlation between HIV/AIDS infection rates and country wealth."

— BRIAN0918 • 2007-06-20 13:39Z

Great find. Perhaps it is the economy (", stupid"). Prostitution is relied upon more heavily in places where gender/economic inequality severely limits (or entirely prohibits) other ways in which women could support themselves. A quote from the layperson summary:

It is not surprising that computer models rarely show the virus reaching epidemic proportions; it is very hard to transmit this illness heterosexually. Only when model building researchers introduce a highly sexually active infected subset of “prostitutes” to their mathematical models does the infection spread exponentially to the general population.

—Joie de Vivre 14:23, 20 June 2007 (UTC)

It's interesting that this article was submitted back in November 2006, before the study in December was stopped early because they thought the circumcision finding was so compelling (don't forget that they also recommended the uncircumcised study participants for circumcision). They had already received research to the contrary, so why did they go with the "compelling" research that hadn't even been completed? — BRIAN0918 • 2007-06-20 14:34Z

You appear to have misunderstood this paper, Brian0918. It does not 'debunk' the protection afforded by circumcision. It argues that, using the author's preferred mathematical model at the population level, prostitution has more impact than circumcision: "At a macro level, this suggests that circumcision rates should also be less significant across countries in predicting HIV/AIDS levels once varying levels of commercial sex work are included in the analysis as there is a very high correlation between circumcision and the Muslim faith percentage." Jakew 14:31, 20 June 2007 (UTC)

I didn't misunderstand it. The whole point of this research is to stop the spread of AIDS in Africa. By touting circumcision as a potential cure to the spread, when in fact it is "statistically irrelevant", was irresponsible, and likely led to numerous more infections during circumcision with unsterilized equipment. But, anyways, this article should at least be updated to show that with respect to HIV/AIDS in Africa, circumcision is not going to help in the long run, and may even be detrimental if people are circumcised with unsterilized equipment (which of course is more common in the worse areas), and/or believe that they can have more sexual activity if they are circumcised (thus voiding any possible single-exposure benefit from circumcision). — BRIAN0918 • 2007-06-20 14:34Z

No, this article should not be updated as you describe, because doing so would a) violate WP:NPOV, and b) wildly extrapolate beyond the sources. Jakew 15:06, 20 June 2007 (UTC)

Obviously it should be updated, and obviously I did provide my own commentary, but I figured you would be able to know the difference between the two. It's also obvious that we can no longer just say "a man's risk of acquiring HIV through heterosexual intercourse is halved if he is circumcised". At most we can say that there is a correlation between previously-circumcised men and a reduced risk of getting HIV during individual sexual encounters, but that this may be due to cultural differences, such as the size of the prostitute population. This at least is more neutral and takes into account the actual evidence. — BRIAN0918 • 2007-06-20 15:56Z

This is an article on Circumcision, not on HIV prevention. If Circumcision reduces the chance of infection by HIV (all other things being equal), it is potentially worth mentioning. Other ways to prevent HIV infection are not suitable subjects for THIS article. It MIGHT be acceptable to include claims that the protection afforded by circumcision may lead more people to get infected if they stop using condoms, but this requires some sort of impirical evidence. You and I might think that this will happen, but until we have proof, we could be wrong.SimonHolzman 16:10, 20 June 2007 (UTC)

I don't think you understand. This article was misrepresenting the role of circumcision in preventing infection. While it may be correlated with a reduced chance of infection during individual sexual encounters, we cannot say (as we were in this article) that it definitely is somehow reducing the individual risk, let alone the overall risk. — BRIAN0918 • 2007-06-20 16:14Z

(Edit conflict.) No, we can't say that either. Again, it is unsupported by sources. Talbott's argument is that "cross country regression data does not support the theory that male circumcision is the key to slowing the AIDS epidemic", not that "no data supports the theory that..."

Talbott's paper is arguing with the methodology used in one class of observational study: ecological studies. He specifically identifies Drain et al (his ref 9) and Halperin and Bailey (his ref 11). He argues that, if data are analysed differently, the effect of circumcision in the analysis is "less significant".

Cultural differences, such as the size of the prostitute population, can act as a confounding factor in observational studies (such as comparison of different countries). That is why the three randomised controlled trials were conducted, in which men from the same culture were randomly divided into two groups, and one group which was then circumcised. To quote from the 2003 Cochrane review: "However, observational studies are inherently limited by confounding which is unlikely to be fully adjusted for. In the light of forthcoming results from , the value of IPD analysis of the included studies is doubtful." Jakew 16:19, 20 June 2007 (UTC)

Again, as I said, circumcision may reduce risk during individual sexual encounters, but as Talbott has shown, it won't work to slow the AIDS epidemic. — BRIAN0918 • 2007-06-20 16:23Z

Correction: as Talbott has argued. There are papers by Drain et al, Halperin and Bailey, Gray et al, and others that argue that it will work. Jakew 16:25, 20 June 2007 (UTC)

Please see the honest version

Corrects misrepresentation in procedures, sexual effects, history, Assoc statements, and jewish origin.

Please revert back to this honest version.

Also found here:TipPt 00:55, 3 July 2007 (UTC)

Tip, these are huge changes for which you know you don't have consensus (your comment above makes it perfectly clear that you expect to be reverted). Jakew 11:39, 3 July 2007 (UTC)

Jakew, the honest version was once fully consensus ... even by you. Then I left for a couple weeks and the religious cabal, with your consent, made radical changes. Your version is now very silly.

You omit the most common complication (meatal stenosis), primary known cited sexual effects, misrepresent Assoc statements, mislead on pain, mislead on procedures, misrepresent the jewish tradition, and promote circumcision medically ... when it's never recommended medically (for neonates).

Your comment on reversion is silly, because you revert everything that's not pro-circ.TipPt 14:39, 3 July 2007 (UTC)

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