Thursday, December 14, 2006

Amazing, Circumcision Halves H.I.V. Risk, U.S. Agency Finds (NYT). Cicumcision cuts the risk of infection during heterosexual sex by half.

The science behind it is this:

"Uncircumcised men are thought to be more susceptible because the underside of the foreskin is rich in Langerhans cells, sentinel cells of the immune system, which attach easily to the human immunodeficiency virus, which causes AIDS. The foreskin also often suffers small tears during intercourse."

While exciting news, it might also give circumcised men false confidence about their immunity to infection. Acknowledging the psychological impact of such information is a key part of creating strategies to fight the disease.

Furthermore, circumcision is a danger unto itself in unsanitary conditions:

"Every year, some South African teenagers die from infections, and the use of one blade on many young men may help spread AIDS. "

This connection was hard to make in the past because cultural norms confounded making real comparisons between circumcised and uncircumcised groups in Africa:

"Researchers have long noted that parts of Africa where circumcision is common — particularly the Muslim countries of West Africa — have much lower AIDS rates, while those in southern Africa, where circumcision is rare, have the highest.

But drawing conclusions was always confounded by other regional factors, like strict Shariah law in some Muslim areas, rape and genocide in East Africa, polygamy, rites that require widows to have sex with a relative, patronage of prostitutes by miners, and men’s insistence on dangerous “dry sex” — with the woman’s vaginal walls robbed of secretions with desiccating herbs.

Outside Muslim regions, circumcision is spotty. In South Africa, for example, the Xhosa people circumcise teenage boys, while Zulus do not. AIDS is common in both tribes."

This information will mean that adult circumcisions may be offered to large groups in Africa in the coming years. I am reminded of the main character in Absurdistan, Misha, who is forced by his father to have an adult circumcision and is traumatized by the procedure (in a funny way though). Hopefully, African men will be able to deal with it a little better than a melancholic soul searcher in the grand Russian tradition like Misha.

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