Circumcision Spreads HIV?

May 23 2012 @ 11:14am

Brian Earp savages the studies purporting to show that male genital mutliation would prevent the spread of HIV/AIDS in African countries:

The "randomized controlled clinical trials" upon which these recommendations are based represent bad science at its most dangerous: we are talking about poorly conducted experiments with dubious results presented in an outrageously misleading fashion, toward public health recommendations on a massive scale whose implementation would have the opposite of the claimed effect, with fatal consequences. Read that sentence again if you want to get the point.

Here's how the mutilation-beats-HIV crowd conducted the tests (pdf):

While the "gold standard" for medical trials is the randomised, double-blind, placebo-controlled trial, the African trials suffered [a number of serious problems] including problematic randomisation and selection bias, inadequate blinding, lack of placebo-control (male circumcision could not be concealed), inadequate equipoise, experimenter bias, attrition (673 drop-outs in female-to-male trials), not investigating male circumcision as a vector for HIV transmission, not investigating non-sexual HIV transmission, as well as lead-time bias, supportive bias (circumcised men received additional counselling sessions), participant expectation bias, and time-out discrepancy (restraint from sexual activity only by circumcised men).

And here's how they came up with that stunning conclusion that mutilating the penis reduces HIV transmission by a relative 60 percent:

Across all three female-to-male trials, of the 5,411 men subjected to male circumcision, 64 (1.18%) became HIV-positive. Among the 5,497 controls, 137 (2.49%) became HIV-positive, so the absolute decrease in HIV infection was only 1.31%, which is not statistically significant.

Go deeper into the studies he cites and links to and it seems quite clear to me that this massive campaign to rid Africa of foreskins is likely to accelerate HIV transmission rather than slow it.