Circumcision - Last Post, For Now

by Alanna Shaikh · 2009-06-08 01:01:00 UTC
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(photo credit: Svadlifari)

I'd like to correct some misconceptions that have come up in the comments about the three circumcision studies which were reviewed by the Cochrane collaboration when it found  that circumcision does reduce HIV transmission.

1) No one was "allowed" to get HIV because of this research. When you test a new medical intervention - a drug, a therapy, a surgery, you test it against current best practice. One group gets current best practice; in this case, HIV testing and counseling. The other gets current best practice (testing and counseling) PLUS the new intervention. Study descriptions here and here.

2) The reason that this review only found effects for 24 months was because the longest-running study was stopped after 24 months. The protective effect was so strong that they stopped the study in order to offer circumcision to the control group.

3) They did find the way that circumcision reduces HIV spread. I'll quote the part of the article that mentions it: "The protection is believed to come through removal of Langerhans cells in the foreskin, which are particularly susceptible to infection with HIV, and keratinisation of the glans, which provides greater barrier protection than mucosal tissue."

4) Because the research was on the risk of getting infected with HIV, all men were HIV-negative at the start of the study. They were chosen to have similiar demographic characterisitics and then randomized into two groups.

Alanna Shaikh
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