Snapped this in HRE a week ago . . . it's Africa, so it's no real surprise.

They should ad "Stop F**king without Condoms!"

This statement is true Will ... but only if the first 3 inches are trimmed off.

While it's no magic bullet, numerous US health organizations, along with the UN World Health Organization, recognize male circumcision as a contributing factor to the reduced transmission of AIDS. To that end, the Bill & Melinda Gates Foundation is helping to subsidize the US$3-8 circumcision cost in countries like Zambia. Naturally, male circumcision should be viewed as part of a broader prevention strategy that should include increased testing, condom use, reduction in the number of sexual partners, and abstinence.

However, with almost 5 million sub-Saharan Africans infected with AIDS just last year, rather than deriding this as an "only in Africa" joke, I see this as a worthwhile campaign that can help to save African lives. Having lost several friends in Africa to AIDS, I believe that every life saved is a noteworthy accomplishment.

__________________________________________


Male Circumcision Offers a ‘Critical’ 60% Reduction in HIV Risk, UN Finds

Bloomberg News - June 3, 2011
Voluntary adult male circumcision has emerged in the past decade as a “critical” tool to prevent HIV infection, according to a United Nation's AIDS agency study. The 139-page report said male circumcision offers a 60 percent reduction in HIV risk and the benefits are life-long. The number of people with HIV, the virus that causes AIDS, rose 27 percent, to 33 million, between 1999 and 2009, according to the report.

__________________________________________

The joke is not that the risk reduction is not true but that people will read that sign and think they are good to go.

Looks like the goalie on the sign was working on his when the photo was taken.

quote:

Originally posted by KPete:
While it's no magic bullet, numerous US health organizations, along with the UN World Health Organization, recognize male circumcision as a contributing factor to the reduced transmission of AIDS. To that end, the Bill & Melinda Gates Foundation is helping to subsidize the US$3-8 circumcision cost in countries like Zambia. Naturally, male circumcision should be viewed as part of a broader prevention strategy that should include increased testing, condom use, reduction in the number of sexual partners, and abstinence.

However, with almost 5 million sub-Saharan Africans infected with AIDS just last year, rather than deriding this as an "only in Africa" joke, I see this as a worthwhile campaign that can help to save African lives. Having lost several friends in Africa to AIDS, I believe that every life saved is a noteworthy accomplishment.

__________________________________________


Male Circumcision Offers a ‘Critical’ 60% Reduction in HIV Risk, UN Finds

Bloomberg News - June 3, 2011
Voluntary adult male circumcision has emerged in the past decade as a “critical” tool to prevent HIV infection, according to a United Nation's AIDS agency study. The 139-page report said male circumcision offers a 60 percent reduction in HIV risk and the benefits are life-long. The number of people with HIV, the virus that causes AIDS, rose 27 percent, to 33 million, between 1999 and 2009, according to the report.

__________________________________________

I would argue that any study that showed that is probably flawed. I would look hard at the design...as it makes NO scientific sense to me.

Seems pretty obvious to me. Here's the explanation from the CDC:

http://www.cdc.gov/hiv/resourc...PDF/circumcision.pdf

Compared with the dry external skin surface, the
inner mucosa of the foreskin has less keratinization
(deposition of fibrous protein), a higher density of
target cells for HIV infection (Langerhans cells),
and is more susceptible to HIV infection than other
penile tissue in laboratory studies [2]. The foreskin
may also have greater susceptibility to traumatic
epithelial disruptions (tears) during intercourse,
providing a portal of entry for pathogens, including
HIV [3]. In addition, the microenvironment in the
preputial sac between the unretracted foreskin and
the glans penis may be conducive to viral survival
[1]. Finally, the higher rates of sexually transmitted
genital ulcerative disease, such as syphilis,
observed in uncircumcised men may also increase
susceptibility to HIV infection [4].

Frankly, it's unlikely Africans will use condoms for anything other than repairing bicycle flats, so it's worth looking seriously at transmission reduction alternatives like this. Of course, I don't think I'd want to be the guy trying to convince villagers to let somebody modify their privates.

quote:

Originally posted by ledvm:
I would argue that any study that showed that is probably flawed. I would look hard at the design...as it makes NO scientific sense to me.

Okay Lane, let's hear your argument.

What does your scientific acumen indicate that would refute the findings of the US National Institutes of Health and the UN World Health Organization? The NIH found in multiple clinical trials held in Kenya and Uganda that, "it was apparent that circumcision reduced a man’s risk of contracting AIDS from heterosexual sex by about half".

The British medical journal The Lancet reported "that circumcision reduces a man’s risk by as much as 65 percent". Okay, maybe that's overly optimistic. The director of the US National Institute of Allergy and Infectious Diseases said that circumcision cuts a man’s risk by about half, not by 65 percent, because the validity of clinical trials depends on following randomized groups of patients, not selected ones. As I said above, circumcision is not a magic bullet, but it's undoubtedly significant.

What is the science behind these results? Well, look at Sandy's reply above. Also, circumcision may help to protect against HIV by removing cells in the foreskin to which the virus is specifically attracted. Called Langerhans cells, they display receptors that enable HIV entry. While there is disagreement as to the level of protection circumcision affords a given male, there is nevertheless a wide-spread consensus that some protection is provided.

The bottom line is that, as hunters, our interests are aligned with those who are working to save the lives of the very people that make our enjoyment of Africa possible. Rather than ridicule them, I would prefer to support them however possible.

quote:

Compared with the dry external skin surface, the
inner mucosa of the foreskin has less keratinization
(deposition of fibrous protein), a higher density of
target cells for HIV infection (Langerhans cells),
and is more susceptible to HIV infection than other
penile tissue in laboratory studies [2]. The foreskin
may also have greater susceptibility to traumatic
epithelial disruptions (tears) during intercourse,
providing a portal of entry for pathogens, including
HIV [3]. In addition, the microenvironment in the
preputial sac between the unretracted foreskin and
the glans penis may be conducive to viral survival
[1]. Finally, the higher rates of sexually transmitted
genital ulcerative disease, such as syphilis,
observed in uncircumcised men may also increase
susceptibility to HIV infection [4].

The key word above is "may".

Or...it "may"be that men who come from families that advocate circumcision are less promiscuous and have cleaner habits.

The WHO and NIH have published many citations of false information over the years.

But...by telling them to get circumcised to prevent aids...is like handing then a 6 shot revolver with only one bullet in it and telling them to play Russian Roullet. Even if it does reduce the rate a little...it definitely does not prevent it. And I will bet it is an associated enviromental factor (such as I described above) that is skewing the results.

The only way to prove such a thing would be a double-blinded controlled study (which would be easy to design) but can never be done due to immorality.

Incredible. Science and research is The Bomb when it comes to juvenile lions and God strike down the heathen that dares question any of the oracles on the subject, but when the topic is HIV, it is the citation of false information.

quote:

Originally posted by MJines:
Incredible. Science and research is The Bomb when it comes to juvenile lions and God strike down the heathen that dares question any of the oracles on the subject, but when the topic is HIV, it is the citation of false information.

There are well designed studies and poorly designed studies.

There are poor lion studies and good lion studies.

Funny as to outrage over the elephant calf. It is easy to see it is a calf.

But...just as Fujo said...it is the same as a 2 year old lion...problem is...many on this forum can't tell a 2 year old lion from a 6 year old lion...so...no outrage.

Lane, sometimes your efforts at being a contrarian cast doubt on both your reason, and in this case, your medical training. Being offended by some 'thing' doesn't obligate you to respond with a reflexive, poorly considered attack.

quote:

Originally posted by ledvm:
[QUOTE]Compared with the dry external skin surface, the
inner mucosa of the foreskin has less keratinization
(deposition of fibrous protein), a higher density of
target cells for HIV infection (Langerhans cells),
and is more susceptible to HIV infection than other
penile tissue in laboratory studies [2]. The foreskin
may also have greater susceptibility to traumatic
epithelial disruptions (tears) during intercourse,
providing a portal of entry for pathogens, including
HIV [3]. In addition, the microenvironment in the
preputial sac between the unretracted foreskin and
the glans penis may be conducive to viral survival
[1]. Finally, the higher rates of sexually transmitted
genital ulcerative disease, such as syphilis,
observed in uncircumcised men may also increase
susceptibility to HIV infection [4].

The key word above is "may".

The word "may" here refers to causality and not outcome with respect to the numerous clinical trials that have been completed. In my aforementioned quotes on the data by NIH and WHO, the results were neither in question nor prefaced with a modifier, which of course is why you chose not to quote them.

quote:

Originally posted by ledvm:
Or...it "may"be that men who come from families that advocate circumcision are less promiscuous and have cleaner habits.

Are you always in the practice of arguing issues in which you have engaged in no research whatsoever? If you had bothered you would know that these studies were clinically and scientifically sound, comparing circumcised and non-circumcised men engaged in identical patterns of at-risk sexual behavior.

quote:

Originally posted by ledvm:
The WHO and NIH have published many citations of false information over the years.

Wow, and here I was under the false impression that the National Institutes of Health is one of the foremost medical research facilities in the world. Given the volume of their errors, please educate us with a few examples from both NIH and WHO.

quote:

Originally posted by ledvm:
But...by telling them to get circumcised to prevent aids...is like handing then a 6 shot revolver with only one bullet in it and telling them to play Russian Roullet. Even if it does reduce the rate a little...it definitely does not prevent it. And I will bet it is an associated enviromental factor (such as I described above) that is skewing the results.

Once again, your willingness to mischaracterize the data casts further light on your economy of reason. The Lancet reported a 65% reduction and the NIH a 50% reduction. Given the option, I think most people engaged in Russian Roulette would elect to have three bullets in a gun chambered for six rather than the five bullets you suggest.

More to the point, it appears that regardless of the evidence that circumcision is a low-cost, high-yield measure to substantially reduce AIDS transmission in African men, folks like yourself would dismiss such breakthroughs and leave things to the status quo. That is unacceptable, Lane.

As Mike remarked, were you only as concerned for the native Africans as you are Africa's lions.

quote:

Originally posted by KPete:
Lane, sometimes your efforts at being a contrarian cast doubt on both your reason, and in this case, your medical training. Being offended by some 'thing' doesn't obligate you to respond with a reflexive, poorly considered attack.

quote:

Originally posted by ledvm:
[QUOTE]Compared with the dry external skin surface, the
inner mucosa of the foreskin has less keratinization
(deposition of fibrous protein), a higher density of
target cells for HIV infection (Langerhans cells),
and is more susceptible to HIV infection than other
penile tissue in laboratory studies [2]. The foreskin
may also have greater susceptibility to traumatic
epithelial disruptions (tears) during intercourse,
providing a portal of entry for pathogens, including
HIV [3]. In addition, the microenvironment in the
preputial sac between the unretracted foreskin and
the glans penis may be conducive to viral survival
[1]. Finally, the higher rates of sexually transmitted
genital ulcerative disease, such as syphilis,
observed in uncircumcised men may also increase
susceptibility to HIV infection [4].

The key word above is "may".

The word "may" here refers to causality and not outcome with respect to the numerous clinical trials that have been completed. In my aforementioned quotes on the data by NIH and WHO, the results were neither in question nor prefaced with a modifier, which of course is why you chose not to quote them.

quote:

Originally posted by ledvm:
Or...it "may"be that men who come from families that advocate circumcision are less promiscuous and have cleaner habits.

Are you always in the practice of arguing issues in which you have engaged in no research whatsoever? If you had bothered you would know that these studies were clinically and scientifically sound, comparing circumcised and non-circumcised men engaged in identical patterns of at-risk sexual behavior.

quote:

Originally posted by ledvm:
The WHO and NIH have published many citations of false information over the years.

Wow, and here I was under the false impression that the National Institutes of Health is one of the foremost medical research facilities in the world. Given the volume of their errors, please provide us with a few examples from NIH and WHO.

quote:

Originally posted by ledvm:
But...by telling them to get circumcised to prevent aids...is like handing then a 6 shot revolver with only one bullet in it and telling them to play Russian Roullet. Even if it does reduce the rate a little...it definitely does not prevent it. And I will bet it is an associated enviromental factor (such as I described above) that is skewing the results.

Once again, your willingness to mischaracterize the data casts further light on your economy of reason. The Lancet reported a 65% reduction and the NIH a 50% reduction. Given the option, I think most people would elect to have three bullets in a gun chamberer for six, were they engaged in Russian Roulette. More to the point, it appears that regardless of the evidence that circumcision is a low-cost, high-yield measure to substantially reduce AIDS transmission, folks like yourself would dismiss such breakthroughs and leave things to the status quo. That is unacceptable, Lane.

As Mike remarked, were you only as concerned for the native Africans as you are Africa's lions.

As a medically trained person...I do know the only true method of answering that question on on circumcision and aids...is by a double blinded controlled study.

There is NO way to verify sexual habits of any type of free roaming people. Sexual habits are the most lied about covered up thing in mankind.

I ask you this...do you think it is safe for a circumcised man to have sex with an aids infected partner???

The studies above are speculative.

quote:

Originally posted by MJines:
Incredible. Science and research is The Bomb when it comes to juvenile lions and God strike down the heathen that dares question any of the oracles on the subject, but when the topic is HIV, it is the citation of false information.

+1

And..... Lane, from a a practical viewpoint, the foreskin provides a perfect environment for certain STDs to spread. And it is obvious that lesions from other STDs make a person much more likely to become infected with HIV.

From everything I have read, I have come to understand that is somewhat difficult for HIV to be passed from female to male during VI due to the lack of a suitable pathway into the male's body. A break in the skin(such as a leasion) would provide the perfect pathway.

quote:

Originally posted by ledvm:
The studies above are speculative.

Forgive me, Lane. I was not under the impression that you were familiar with each and all of those studies, let alone having scrutinized their data and collection methods.

Of course, absent such scientific rigor and investigation, a remark like your's could only come from a fool. Agreed?

Why are you all even arguing over this?

quote:

Originally posted by Frostbit:
Why are you all even arguing over this?

Would you question why we would argue over a conservation issue in Africa?

How many of us have befriended trackers or camp staff that have later died from AIDS? Many, I suspect. So is it too much for us to show as much concern for the people of Africa as we do its animals?

The fact is, as African hunters we need to be on the vanguard in protecting Africa's flora, fauna, and people.

quote:

Originally posted by KPete:

quote:

Originally posted by Frostbit:
Why are you all even arguing over this?

Would you question why we would argue over a conservation issue in Africa?

How many of us have befriended trackers or camp staff that have later died from AIDS? Many, I suspect. So is it too much for us to show as much concern for the people of Africa as we are its animals?

The fact is, as African hunters we need to be on the vanguard in protecting Africa's flora, fauna, and people.

That's not my point. My point is perhaps it's at the "agree to disagree" stage.

I suspect if you did the same study and substituted regular tooth brushing in the place of circumcision...you would get similar results.

The only fools I know are the ones who believe: "Circumcision is one of the TOP defenders against HIV."

If you KPete are concerned with Africans...you would be advocating taking that sign down...as I can promise you it kills them through false security.

HIV+Africans= -habitat destruction-poaching=more animals.

Lane, if you read the studies cited on the CDC page, you might change your mind. Most of them adjust for confounding factors such as wealth disparities between subjects. Accordingly, it's not particularly fair (or correct) to assume that they're all blindly equating correlation with causation.

quote:

Originally posted by jorge:
HIV+Africans= -habitat destruction-poaching=more animals.

I hope you do not really mean that, and believe that you probably were just offering that in jest.

David,
I am all for genital hygene and proper medical care amongst Africans. But in your profession...you should see what that sign implies...a false sense of security.

It would be a lawyer's dream come true in the states to sue a Dr. that circumcised someone and told them it protected them against aids...when that patient got aids.

Those type of retrospective studies while useful are notorious for producing eroneous results. Therefore...they carry a low-order of power with practitioners...ie: take the results with a grain of salt.

I have read the summaries and designs of those studies and I stand by what I have said.

If it were cattle (etc.) we were talking about...It woulld be easy. Circumcise one group...breed them to infected cows...don't circumcise the another and breed them to infected cows and see what the respective infection rates were...with all else controlled. These types of controlled double-blinded prospective studies carry a high-order of correctness and often refute retrospective studies. Obviously for moral and ehtical reasons...these type of studies will probably not be done on this subject.

But...make no mistake about it...the above studies do NOT prove circumcision reduces HIV infection...they only suggest it as a possibility...to many other variables that could have influence...and...we know 100% for sure that circumcised men CAN get infected with HIV.

One of the issues with the sign is that if the man is HIV positive, circumcision offers no benefit for the sexual partner.

"There is very strong evidence showing that circumcised men are about half as likely as uncircumcised men to acquire HIV through heterosexual sex. However, circumcision does not make a man immune to HIV infection, it just means that it's less likely to happen. Male circumcision probably has little or no preventive benefit for women."


I saw that sign last year and thought it was BS. Appears to be some truth.

quote:

Being offended by some 'thing' doesn't obligate you to respond with a reflexive, poorly considered attack.

KPete, that is well written and can be applied right across the world today. If more people considered this statement there may be a lot less conflict on the globe.

I knew there was evidence of circumcision being protective against HPV spread, now evidence is mounting for circumcision being protective with regard to viral STD's (HPV, HIV, and herpes) in general.

There were 3 randomized trial in sub-Saharan Africa (RSA, Kenya, Uganda) that showed risk reduction with circumcision. The key phrase there is risk reduction, not complete protection.

This stuff is not really new. I think some people live with their heads in the sand.

It is well know that there is a ton of stigma regarding the use of condoms in Africa. Circumcision will not protect 100% of the time, but it is better than nothing(which is what you seem to have in a lot of village shebeens)

The number one factor of prevention with all infectious disease is effective hygiene. It has been known since times BC, that circumcision made hygiene of that area less owner/operator dependent. I have NO doubt that clean lesionless foreskin is less susceptible to viral invasion. Circumcision may make this goal easier to achieve...but it is not mandatory. Soap and water and the ability and willingness to use them can be just as effective...and cheaper.

A sign advocating that once one is circumcised that he is defended against aids...is misleading and dangerous in my opinion.

I do think that it is a good medical practice and as a parent...had my son done.

But...going after aids with circumcision IS sticking ones head in the sand.

Actually, Lane, not all of the studies were retrospective. At least one tested uncircumcised people to confirm they weren't HIV positive, then circumcised some and not others, and then looked at the infection rates years down the road. Sounds a lot like your cow proposal, albeit without the deliberate exposure.

I do agree that someone could read the sign the wrong way. Its message could certainly use some fine tuning. But getting away from the sign, I don't think anyone here is saying that circumcision will always prevent transmission; what we're talking about is reducing transmission rates. And when one considers that condoms really haven't caught on with many African populations, despite truckloads of money being spent on education/promotion, there might be some value to trying to make circumcision more widespread. Once a baby is circumcised, his chance of catching HIV is reduced, regardless of whether he is good about condom use when he grows up. Even if that transmission rate is reduced only 5%, there may be some value. If he doesn't get HIV when he has sex with another villager, then maybe he won't have HIV to pass on when he has sex with the next one (or two, or fifty). When looking at a huge population (and not just one person), anything that can meaningfully reduce transmission is a good thing, so long as costs aren't too high. There is evidence in front of us that supports circumcision as a transmission reducer, so why not promote it? It's likely a better place to dump money than most of the other HIV work being done over there. You don't think we should just preach abstinence and monogamy and hope for the best, do you?

Clinical trials such as you have described still have a low order of positive predictive value as compared to controlled studies (like cow study mentioned where all variables are eliminated except study concept).

I concede the fact that circumcision is a good idea from a general health perspective.

I think it is a pipe dream to think it is a meaningful solution to aids. And...I think it is irresponsible to post it on a sign as a protective measure which may give recipients of the procedure a false sense of security.

Nuff said really...

Hell, I'm still stuck on having to trim the first 3 inches off........ Don't they know that a condom will unroll? I finally figured that out.

The funniest part is that there is hunters coming to africa and then paying these okes wifes/girlfriend and hookers for a good night and then sleep with their own wifes when they get back.

its like hunting buff whth a .22 at 100 to 1 odds

quote:

Originally posted by 375 fanatic:
its like hunting buff whth a .22 at 100 to 1 odds

It's more like paying Russian roulette. Anyone who is stupid enough to visit a whore in Africa(they are +-100% HIV+) deserves their sentence. Any woman stupid enough to be married to such a fool also deserves what she gets.....

Maybe circumcised dudes wank off more leading to less incidence of disease

quote:

Originally posted by MJines:

quote:

Originally posted by jorge:
HIV+Africans= -habitat destruction-poaching=more animals.

I hope you do not really mean that, and believe that you probably were just offering that in jest.

Not a question of what I believe or not believe, just stating a fact devoid of opinion.

quote:

Originally posted by MJines:

quote:

Originally posted by jorge:
HIV+Africans= -habitat destruction-poaching=more animals.

I hope you do not really mean that, and believe that you probably were just offering that in jest.

I would guess that you know that he did "really mean that" and what you meant to say was that you hope that he is not rooting for AIDS to kill off Africans.

I have no idea if Jorge is "rooting for AIDS", but I know a lot of white Africans are(I personally have some WA friends who say that AIDS came too late). And that is one of the reasons black Africans have so little regard for the rights of their white counterparts(If whites don't value them as humans, why should they value whites as humans?).

It kinda reminds me of what someone once said about the chickens coming home to roost.

That about covers it. Thanks

quote:

Originally posted by JBrown:


I have no idea if George is "rooting for AIDS", but I know a lot of white Africans are

Easy with the generalization pal

quote:

Originally posted by David Hulme:
Easy with the generalization pal

David
You are quite correct, but please note that I said " a lot ", not "all", or "most", or the "majority".

I stand behind my comment that "a lot of....", but as I pointed out, they are very short sighted.

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