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links for 2010-06-20

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3 Responses

  1. “What if you meet in a dog park? How could you not talk about the dogs?”

    Speaking from experience… it’s a great crutch! Hell, having your dogs hold a conversation is excellent comedic relief. Also, you’ll most likely know the person’s dog’s name for 2-3 months before you learn the owners name. Just the nature of the dog park… which is a great place to meet people – it’s casual, its active, prone to interactions, low pressure, and immediate shared interests are present.

    Besides myself, my dog park was a relationship factory. Three marriages that I know of in 2 years.

  2. Quote:”Experimental evidence was needed to establish a causal relationship between lack of circumcision and HIV,[6]”

    Exactly. This is not how science is done. You need an open mind until you have done the experiment, otherwise you are at risk of imposing your presuppositions on the data.

    ” so three randomized controlled trials were commissioned as a means to reduce the effect of any confounding factors.[4]”

    But they were’t placebo-controlled or double blinded, two of the main ways of removing the possibility of experimenter bias.

    It was assumed that all HIV transmission was (hetero)sexual, when this is often not the case. A number of confounding factors were assumed to be corrected by the randomisation process, when this may not be the case. They include early termination bias, attrition bias (several times the number of men infected were lost from study – see http://www.circumstitions.com//HIV-SA.html#loss), number of sexual partners, frequency of intercourse, nature of intercourse (especially “dry sex” reportedly almost exclusively a practice where the man is not circumcised), use of condoms, and HIV status of partners. Some of these were measured, but only by self-report. Circumcision may change any of these (including even HIV status of partner/s, if it opens or closes access to a better or worse class of partner/s).

    “All three trials were stopped early by their monitoring boards on ethical grounds, because those in the circumcised group had a lower rate of HIV contraction than the control group.”

    Yet it wasn’t considered unethical to leave the men ignorant of the fact that they had become HIV+. That is what makes this experiment on poor Black men in Africa akin to the Tuskagee experiment on poor Black men in America.

    There are a number of countervailing studies, and contrary evidence continues to come in. In at least six African countries, more of the circumcised men have HIV than the non-circumcised men, according to the National Health and Demographic Surveys (http://www.measuredhs.com/countries/‘). Seventy-two per cent of new HIV infections in Malaysia are Muslim (http://www.bernama.com/bernama/v5/newsindex.php?id=504593), while only 60.4% of the population is Muslim. Virtually all Muslim men are circumcised, while men of the other religions of Malaysia are not.

    While circumcision may (or may not) partially protect men from infection by women, it does not protect women from infection by men, and may even increase the risk.

    “using circumcision as a means to reduce HIV infection would, on a national level, require consistently safe sexual practices [too]”

    A traveller came to a farmhouse and offered to make the occupants Nail Soup in return for a night’s shelter. He threw a large iron nail in a pot of boiling water and stated that “Using a Magic Nail as a means to make delicious soup would require herbs, spices, vegetables and meat consistently [too].” The farmer’s wife accepted this, and In the morning the traveller went on his way, refreshed after a night in a comfortable bed, minus the Nail, with some gold coins in his pocket and the thanks of the family ringing in his ears for the wonderful Magic Nail that made such delicious Nail Soup.

    • Survey data is just as prone to those confounds as randomized trials. And good luck finding a way to do a double-blind study on circumcisions.

      It’s a controversial topic. Both sides throw different studies at each other. But I go with the available data from the only randomized testing to take place, even if that data isn’t perfect.

      Whether infant circumcision is ethical or not, that’s a different matter entirely.

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