Sunday, November 28, 2010

The circumcision and HIV model

Information re HIV can be found at
28 November 2010. reports that "Approximately a quarter of men undergoing circumcision resume sexual activity before their wounds have fully healed" and that "if the proportion of men engaging in sex during wound healing increased to 30%, then circumcision would lead to more new HIV infections in women than it would avert." Individuals could use my computer program ConfTwoProp to get an idea of whether more than 30% of circumcised males have sex soon after being circumcised. ConfTwoProp can be downloaded free at
Note: People are invited to comment on this blog and make their own suggestions. Do you think people are sufficiently informed about circumcision? Should people sue in court regarding not being informed? Did you personally experience a problem? You can also email me at or go to the Facebook page CLASS ACTION SOUTH AFRICA.

People wanting to publish their own articles can get published (and make a few cents) at
You can also download a free statistics program ConfTwoProp (written by me - I have a BSc from UNISA) at  or at to do surveys on HIV etc
The model used for infection rates for HIV in South Africa seems flawed in that one usually hears of the effects of circumcision on the rate that males become infected at.

Another site:
A group against circumcision: 
It has been reported at
journal/116-1181/595/ that there could be a greater chance of vaginal dryness in the female when having sex with a circumcised male (as opposed to an uncircumcised male). Vaginal dryness can cause abrasions in the woman and therefore result in greater chance of the woman becoming infected with HIV. It also reports that: O’Hara and O’Hara reported that women who had experienced coitus with both intact and circumcised men preferred intact partners by a ratio of 8.6 to one.4 Most women (85.5%) in that survey reported that they were more likely to experience orgasm with a genitally intact partner: ‘They [surveyed women] were also more likely to report that vaginal secretions lessened as coitus progressed with their circumcised partners (16.75, 6.88–40.77).’4
Now if women are more satisfied with an uncircumcised male partner, could it be they would be less inclined to stray and spread HIV? Study published in The Lancet, Volume 374, Issue 9685, Pages 229 - 237, 18 July 2009. doi:10.1016/S0140-6736(09) 60998-3.  The study assessed whether circumcision in HIV-infected men would reduce transmission of the virus to female sexual partners. Circumcision of HIV-infected men did not reduce HIV transmission to female partners over 24 months; longer-term effects could not be assessed. Condom use after male circumcision is essential for HIV prevention.  The results indicate that there is a probability of 21.7% HIV infection rate for female partners of circumcised HIV infected men, compared to 13.4% HIV infection rate for female partners of HIV infected men. Women with circumcised partners had more than a 50% increase in the infection rate of women compared to women with un-circumcised partners.
It seems that we need to use a new model. I suggest one below:
Study the infection rates of women who have only uncircumcised partners and compare it to the infection rates of women with circumcised partners, then compare that and other findings to the general population.
I think one would find a high infection rate in the women with the circumcised group, partly because of abrasions. If this is so, this group of women might cause a higher rate of infection in other males in the general population if they strayed sexually.

I have sent the following representation to the South African Government and South African Human Rights Commission (shortened version):
Dear SAHRC and Government,
In brief, I request that doctors be made to inform patients, who undergo circumcision, of the possibility that a change in sexual function will result and that it may result in more vaginal dryness and so the possibility of abrasions and greater transmission of the HIV virus may result.
I am approaching you (The SAHRC) on the grounds that:
1) I am acting in the public interest
2)Everyone has the right to bodily and psychological integrity...
3)Everyone has the right to information regarding the effects of medical operations such as circumcision.
Eddie Miller (T E Miller)

The site below says that: Uncircumcised men who wait for 10 minutes after coitus and then wipe the genitals with a dry cloth have less of a chance of getting HIV than circumcised men.
 Why did intact men who cleaned later without water have lower risk for HIV?
The above site says:
 Frederick Makumbi and other members of the Rakai study team, as well as other AIDS experts, speculated that washing could remove enzymes in vaginal fluid that neutralize HIV, that “the acidity of vaginal secretions may impair the ability of the AIDS virus to survive,” and that water with its neutral pH may facilitate viral survival.[5,6]

 The study team did not consider that men’s prepuce and its secretions as well as semen – like women’s sexual organs and secretions – might also have viral defenses that are damaged by washing immediately after coitus. Years before the Rakai circumcision trial, Fleiss and colleagues’ 1998 review of the “hygienic and immunological properties of the prepuce and intact penis” noted commensal bacteria and secretions with anti-bacterial and anti-viral activity associated with the foreskin.
The above website recommends that:
  First, all interested parties should mobilize all available channels (newspapers, NGOs, churches, etc) to get two public messages to intact African men:
(a) Don’t go for circumcision. If a partner is HIV infected, you are safe with condoms. If for some reason you are exposed, according to available evidence you are safer if you are intact and wait at least 10 minutes to clean your penis than if you have been circumcised.
(b) Wait at least 10 minutes after coitus to clean your penis, and then do so by wiping with a cloth, without water or other fluid.
Second, programs to circumcise men and babies in Africa should be suspended pending further evidence on the impact of post-coital penile cleaning on HIV incidence.
SEE ALSO which explains why much of the HIV/circumcision research is flawed.
See also