Formerly titled: Circumcision is Bad.
That's the message that some are desperately trying to get across. New York City disagrees.
This morning city officials announced a plan to use circumcision as part of the fight to combat the spread of HIV/AIDS:
Health department spokeswoman Sara Markt confirmed Thursday that the agency was in discussions "with the community about the possibility of increasing access to the service and educating the public about the risks and benefits of circumcision."
U.N. health agencies last week recommended circumcision for heterosexual men after three studies in Africa found that the procedure reduced men's chances of contracting HIV by up to 60%.
Calling New York City "the epicenter of the AIDS epidemic" in the United States, Health Commissioner Thomas Frieden suggested circumcision could hold preventative promise here, despite differences between the two at-risk populations.
Of course, there's no public, scientific polling to reflect opinion on circumcision as an ethics issue - most reasonable people agree that it is a decision that should be kept between informed parents and a Doctor. Rates of those circumcised in America have actually fallen from nearly the 85% high (update: link) since in 1970's, but I think it's safe to say that a majority of people in the world do not see it as an ethics issue.
You would not know that from a simple google search which reveals a suspiciously high number of sources militantly against the practice. You wouldn't know that from the biased nature some take while looking at the issue - where all science not consistent with their beliefs is immediately deemed meritless.
Nevertheless, new evidence against their message keeps materializing. Those studies referenced in the USA Today piece - the ones so easily discredited in the minds of the opponents? Those three were endorsed by the WHO and the U.N. back in February - PDF - where they stated:
Male circumcision trials to date (page 7)
In all three trials, the Data and Safety Monitoring Board conducted interim reviews and found a significant benefit in terms of risk reduction in the circumcised men versus the men in the control arm. In each trial, the Data and Safety Monitoring Board recommended that all of the volunteers be offered circumcision immediately. In other words, the evidence for a protective benefit of circumcision in the study population was strong enough that it was considered unethical to continue the study without offering circumcision to the control group.
The first trial to show efficacy was conducted in a South African trial. These data were presented at a conference in July 2005 and the data were published in November 2005.² The trials in Kenya and Uganda confirmed this finding.
The data are comparable across the three trials; in each case there was a protective benefit of roughly 50% among the men in the intervention arm.
A complete table with the details on all existing trials is on Page 8. Now, for those of us active in the fight to prevent the spread of HIV/AIDS in our communities, 50%-60% is no small number. From my perspective on long term progress, if at-risk African nations were to immediately begin circumcising infants as standard medical practice, it would be possible to reduce infections in future generations by a very high rate. Perhaps not 50%-60%, but anything approaching that number is a big step in fighting one of the most serious public health problems in the world today.
The ones who say "Circumcision is Bad" are attempting to wage an ethical / media war wherein their answers are the only correct ones and where good hard science that flies in the face of their mission must be discredited with claims from junk scientists. They want to do anything, ignoring the bounds of logic and reason and most importantly - any possibility of benefit to the world - to make their point seem larger than it actually is.
We can meet them with humor and facts.