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The Pro-Israel, Pro-Circumcision Lobby

Israeli-made bloodless circumcision device aims to eradicate AIDS

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Billboard in Swaziland promoting circumcision for AIDS prevention. (International Women's Health Coalition/Flickr)

Today at AIPAC, Israeli entrepreneur and CEO of Prepex Tzameret Fuerst talked up one of Israel’s lesser-known exports: circumcision. Holding aloft her company’s device for performing the procedure, she explained how Israelis are at the forefront of international efforts to arrest the spread of HIV in Africa through circumcision. But before this story hit AIPAC, it was on Tablet, which has highlighted the impressive medical benefits of circumcision uncovered by science in the last decade. Below, we repost Yair Rosenberg’s June 2012 piece on this remarkable story.

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“Male circumcision is a highly significant, lifetime intervention. It is the gift that keeps on giving. It makes sense to put extraordinary resources into it.”

Who would you guess recently offered this paean to foreskin fleecing? A rabbi? An imam? Nope. Try U.S. AIDS coordinator Eric Goosby at a health convention last month for top officials from 80 countries.

This exposes the shoddy logic of a German regional court that has banned religious circumcision, calling the practice a “serious and irreversible interference in the integrity of the human body.” As the AFP reported at the time, Goosby was reflecting a scientific consensus that has been cemented over the last seven years:

Studies show that circumcision can dramatically reduce HIV infections. One study in South Africa last year found new infections fell by 76 percent after a circumcision programme was launched in a township.

In 2006, trials in Kenya, Uganda and South Africa found foreskin removal more than halved men’s risk of HIV infection. Longer-term analysis has found the benefit to be even greater than thought, with a risk reduction of around 60 percent.

The medical success story here is even more remarkable than the AFP lets on. Those original trials, as the New York Times reported upon their publication, were so effective that they

were stopped early by the National Institutes of Health, which was paying for them, because it was apparent that circumcision reduced a man’s risk of contracting AIDS from heterosexual sex by about half. It would have been unethical to continue without offering circumcision to all 8,000 men in the trials, federal health officials said.

Unethical not to circumcise the men. Since then, study after study has confirmed these initial findings, establishing that while circumcision is far from a silver bullet when it comes to arresting HIV, it is undeniably a potent arrow in the quiver of prevention techniques. In light of this, global health organizations have begun a massive effort to circumcise 20 million African men by 2015. Everyone is getting in on the act: Israeli scientists have started training African physicians to perform the procedure. Supported by non-profits like the Bill and Melinda Gates Foundation, companies are competing to produce more efficient circumcision devices because, as the New York Times notes, “most African countries are desperately short of surgeons, and there is no Mohels Without Borders.” And just yesterday, the Times reported on how “a group of legislators in Zimbabwe had themselves circumcised last week to set a good example for the country, most in an impromptu surgical theater in a tent in Parliament House.”

And the benefits aren’t just for Africans. A peer-reviewed study conducted by Centers for Disease Control researchers found that “circumcision would reduce the lifetime risk of HIV diagnosis for all [American] males by 15.7% in the base case analysis, and the reduction ranged from 7.9% among white males to 20.9% for black males,” resulting in a discounted lifetime HIV health care savings of $427 per male. Other scientists have recently argued in the American Journal of Public Health and Health Affairs that the lack of Medicaid coverage for circumcision in 17 states perpetuates health inequalities among poor and minority populations who make use of the program and are at high risk for HIV. The American Academy of Pediatrics is soon expected to come out with a new policy pushing circumcision, reversing its prior stance.

Given this impressive scientific consensus as to the medical dividends of male circumcision, the German court’s judgment—which permits circumcision for “medical reasons”—is a confused and ignorant muddle. Some have rightly criticized it as an assault on millennia of Jewish tradition and practice (not to mention Islam), something one would have thought a German court would be sensitive enough to avoid. But the ruling itself, as the research above amply demonstrates, is logically incoherent and factually wrong for a simple reason: All circumcisions are medically beneficial. Whether or not the procedure stems from religious motivations, it will have measurable health benefits. So by the court’s own reasoning, all religious circumcisions ought to be permissible as long as the parents also want the medical dividends—which effectively means that circumcision has not been banned at all. Of course, it is very unlikely that this is what the court intended and much more likely that it was entirely unaware of the scientific consensus surrounding circumcision’s advantages.

But that scientific consensus reveals more than just the follies of this German court; it also exposes the deeply problematic aims of American advocacy groups which seek to outlaw circumcision for the entire United States. If, as global health organizations and years of research suggest, circumcision can have major positive health benefits—particularly for poor minorities who often don’t have access to safe sex instruction and are most at-risk for HIV infection—it is absurd to ban the practice. It’s one thing to abstain from a potentially medically beneficial procedure due to personal convictions; it’s quite another to enforce those convictions coercively on others.

Of course, none of the above research means we should start mandating circumcision. There are many reasons a person might legitimately choose to forgo circumcising their child, from wishing to wait for the child to be fully grown and make the decision for themselves, to being swayed by the (quite inconclusive) research on whether the procedure decreases sexual pleasure. Nor do such scientific findings mean we should avoid criticizing and attempting to reform unnecessary and potentially dangerous elements of religious circumcision rites. But they do tell us that safely administered circumcision can be a public good and is an important option that should be open to all parents who wish to grant their child its benefits.

Ultimately, those who seek to ban circumcision as the essential equivalent of child abuse—from this German court to activists who recently attempted to bar the practice in San Francisco—are doing so in the face of tremendous scientific evidence to the contrary. Their claims are at odds with countless studies, not to mention global health policy. The burden of proof, then, is upon these activists to defend their disregard for this science, not on the majority of Americans who choose to circumcise their children and take advantage of its documented benefits.

After all, individuals are free to discount scientific evidence on the basis of value considerations, even dubious ones, and base their life decisions upon that calculus. But such subjective notions should never form the basis for coercive state policy any more than, well, religion.

Your move, Foreskin Man.

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SEE ALSO: “Leading Pediatric Group Endorses Circumcision” (August 2012)

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yidishkind says:

I’m speechless by the utter stupidity displayed in this article. Preventing AIDS (real or imagined) is a completely separate issue from the concerns about mild sexual dysfunction caused by circumcision and the right to bodily integrity established by the German court (which is something religious Jews obviously have objections to but is an important issue to be addressed soberly). Female circumcision has been shown repeatedly to reduce AIDS rates as well, it’s no reason to recommend it. There IS a way to prevent AIDS that’s much cheaper than circumcision, has no complications and will not LEAD TO ANTISEMITISM once some of these men inevitably decide they’ve been damaged by this procedure: Jewish groups could help distribute condoms in Africa. It’s especially needed as the Catholic Church does not and it will actually reduce AIDS cases. This campaign however will lead to more AIDS cases. Why? Although destroying a mucous membrane may cut down on the spread of disease if done in infancy, having an OPEN WOUND for weeks will lead to a higher chance of AIDS being spread through sex. That combined with the fact that many men are being erroneously told that this procedure prevents AIDS and acts as an “invisible condom” will lead to more AIDS cases and more deaths. Teaching people to use condoms will reduce AIDS cases. This will lead to an increase. It’s bad public health policy. Think circumcision will prevent AIDS? Why is the AIDS rate so much higher in the US where nearly all adult men are cut while it’s much lower in Western Europe where only Jews and Muslims are cut? Clearly circumcision is no cure.

That’s one thing. But attacking opponents of circumcision in America by bringing up this misguided African AIDS campaign is absolutely ridiculous. And intellectually dishonest. Criticize them based on what they actually say, based on their antisemitic cartoons but not based on events in Africa. As before, Mr. Rosenberg makes shocking logical fallacies and displays a disturbing need to justify circumcision to anyone, everyone, every time it’s questioned. As a Jew I’m saddened and ashamed. As a religious thing circumcision is one thing, something worthy of debate but not the end of the world and certainly not something that should be outlawed. But as a matter of public health this policy is disastrous and Jews should be staying far far away from it.

TLCTugger says:

Israel’s HIV incidence is higher than non-circumcising Japan’s. Most of the US men who have died of AIDS were circumcised at birth.

Circumcision is neither necessary nor suficient to prevent AIDS.

Foreskin feels REALLY good. Seriously, it’s the best part.

Jackno says:

The HIV prevalence rate among circumcised males between the ages of 15 and 49 in Zimbabwe is higher than that of the uncircumcised male” after a Bill Gates funded circumcision drive. Loss of pleasure and just a wound with no health advantage. In fact real world data shows a natural penis is not at higher risk for HIV, HPV and all other STDS.

Real population data shows no protection against HIV infection by cutting off parts of a babies penis. However, the harm caused by baby boy penis parts removal is well known. The parts of the penis that are cut off are some of the most highly innervated parts of the human. The lips, nipples and fingertips have similar touch sense. To take this away from another person without their consent is heinous. To do this to a newborn baby is creepy, child abuse and a human rights VIOLATION.

There are no real world studies that show cutting off penis parts helps prevent HIV, HPV and other sexually transmitted infections in men! In the US no lowering of HIV risk has been noted, and the US has a high circumcised adult population with a high HIV rate and Europe and Japan have a very low number of adults that are circumcised and have a very low HIV rate. In the US only the number of sexual partners and NOT circumcision status is linked to HPV. There is clear evidence that baby boy penis parts removal does not shield the man the baby becomes from STDs in developed nations.

Evidence of this comes from the Laumann study (USA, 1997), based on over 30,000 American men, which showed no advantage to the circumcised group. The most recent comparative study from Dunedin, New Zealand (cohort of about 500 men) backs this up, concluding: “Circumcision does not appear to shield men from most types of STDs in developed nations”. SOURCE: Journal of Pediatrics, MARCH 2008.

In the US cut and natural men have HIV and HPV in the same % and example of this comes from the US Navy: Although known HIV risk factors were found to be associated with HIV in this military population, there was no significant association with male circumcision.

Some studies show that circumcised men pass HIV to partners at a higher rate and acquire STDs at a higher rate. In other words natural will save STD costs:

from Puerto Rico
“Circumcised men have accumulated larger numbers of STI in their lifetime, have higher rates of previous diagnosis of warts, and were more likely to have HIV infection.”

Also consider some interesting Africa data:

The US sponsored DHS Comparative Reports No. 22 showed that in Africa there appears no clear pattern of association between male circumcision and HIV prevalence. In 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries HIV prevalence is higher among circumcised men.

In 2010 the same Kisumu team (Bailey) that did one of the flawed Africa studies reported the cut Kenyan men were no less likely to have HIV after all.

The recent CDC Zambia study did find that men with herpes were more likely to be HIV-positive, but also found that lack of circumcision did not increase the risk of HIV infection.

In 2009 the same Rakai team (Wawer/Gra-y) reported that the Ugandan men they cut were 50% MORE likely to infect their female partners.

Let’s see, how did the circumcision trails compare with the Harvard trials? Circ’s 60%, Harvard HPTN 052 anti-viral 98% reduction in STD transmission. Well… don’t let science get in the way of your propaganda campaign. Carry on.

The Canadian Pediatric Society also announced this week that it will be releasing a new circumcision policy statement that comes closer to recommending circumcision for boys than in the past.

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The Pro-Israel, Pro-Circumcision Lobby

Israeli-made bloodless circumcision device aims to eradicate AIDS

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