Re: I apologise, for the overprotection.
- From: Mitchell Coffey <m.coffey@xxxxxxxxxxxxx>
- Date: Thu, 26 Mar 2009 15:20:56 -0700 (PDT)
On Mar 26, 4:19 pm, spintronic <spintro...@xxxxxxxxxxx> wrote:
Right.
http://www.nytimes.com/2009/03/27/health/27std.html?hpw
(Circumcision protects against HIV as well.)
Male circumcision, already shown to reduce the incidence of H.I.V.
infection in men, also reduces transmission of both herpes simplex
virus Type 2 and human papilloma virus, a new study has found.
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Health Guide: Herpes SimplexAccording to the Centers for Disease
Control and Prevention, at least 45 million people in the United
States ages 12 and older have had herpes, or H.S.V.-2, the incurable
infection that can cause recurrent painful genital warts. About 20
million are currently infected with human papilloma virus, or H.P.V.,
which causes various genital cancers, including most cervical cancers.
There is no treatment or cure for H.P.V., but there is a vaccine now
licensed only for girls and women.
The study, a randomized clinical trial published on Thursday in The
New England Journal of Medicine, assigned more than 3,000
uncircumcised Ugandan men who were not infected with H.S.V.-2 to
undergo immediate circumcision or to be circumcised 24 months from the
start of the investigation. A subgroup was similarly evaluated for
H.P.V. infection.
At 24 months, 114 men of the men initially circumcised and 153 of the
non-circumcised were positive for H.S.V.-2. After controlling for
various health and behavioral factors, the researchers estimated that
circumcised men had a 25 percent reduced risk for infection.
For the types of H.P.V. that cause genital cancer, the results were
even more dramatic. About 18 percent of circumcised men were infected
at the end of two years, compared to almost 28 percent in the control
group. Even after adjustment for types of sexual practices, symptoms
of sexually transmitted infections and other variables, the
circumcised men had a 35 percent reduced risk of infection.
The mechanism for the effect is unclear, but the authors suggest that
the retraction of the foreskin during intercourse exposes the penis to
infection, and that the moist area under the foreskin may then provide
a protected environment in which the viruses may flourish.
Asked about the applicability of the African results to men in the
United States, the study senior author, Dr. Ronald H. Gray, a
professor of reproductive epidemiology at Johns Hopkins, said, “There
is no reason to believe that this is in any way unique to Africa.”
The study confirms the results of two previous trials in South Africa,
and Dr. Gray believes that taken together the studies have significant
implications for public health.
“The findings suggest that there are important lifetime health
benefits to the procedure,” he said. “I think it’s important that
pediatricians consider the lifelong benefits that might accrue from
circumcision when they are advising parents on whether the procedure
should be performed in baby boys.”
Other experts agreed. Robert C. Bailey, a professor of epidemiology at
the University of Illinois at Chicago who has published widely on the
subject, said that the American Academy of Pediatrics and other
professional associations “are not taking the lead in providing
clinicians, nurses and midwives — the people who assist parents in
making decisions” with the information they need. “And so parents are
not being fully informed.”
An editorial published with the study said that rates of circumcision
in the United States are declining, and that they are lowest among
black and Hispanic patients, groups with disproportionately high rates
of H.I.V. and herpes infection and cervical cancer. There are 16
states in which Medicaid does not pay for routine circumcision, and
this may exacerbate the problem among the poor, the editorial said.
The authors acknowledge that both intervention and control subjects
were self-selected, and that compliant subjects might be at lower risk
for infection to begin with. That could result in an underestimation
of the effect. Since the men were evaluated only at 24 months, it also
is difficult to determine whether the lower rate of infection was due
to a reduced rate of acquisition or an increased rate of infection
clearance.
Still, considering the results of their own and previous studies, the
researchers conclude that circumcision should now be accepted as an
effective intervention for H.S.V.-2 and H.P.V. prevention, even though
they emphasize that the procedure is only partially effective, and
that the promotion of safe sex is still essential.
Since when were Christian men required to be circumcised?
Mitchell Coffey
.
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