Post by Ron LowPost by windinghighwayIn the early days of research into
the HIV-foreskin link, almost every survey from different countries
showed that foreskins were implicated.
You are utterly ridiculous as usual.
Let's wait till I have finished with you, then we can decide who is
ridiculous.
Meanwhile, my statement above is entirely correct, so what's
ridiculous about it?
Post by Ron LowStats from about half the nations in Africa show that the circumcised
have markedly higher HIV incidence.
Utter nonsense. There are 54 nations in Africa and most of them have
never even collected stats on the issue. What fatuous anti-circ
website did you copy and paste this drivel from?
Post by Ron Low This includes nations like
Swaziland and Rwanda who have been sold mass circumcision campaigns.
Yes both those countries are conducting circumcision campaigns that
ultimately may rid their entire populations of foreskins. They are
in the thick of an AIDS epidemic and believe it or not, they know all
about HIV and foreskins. In your remote arrogance, you think they
have no idea what they are doing and were "sold" the campaigns, rather
than that they made a rational choice. The fact is that the
governments there are familiar with the scientific literature -- a lot
more so than you are, if I may so so. The also notice that if you
overlay maps of HIV rates and uncut rates in Africa, you find that
that the two overlap almost perfectly. And they know that because of
confounding factors, observational studies will sometimes turn up some
findings that are inconsistent with the rest. In the two countries
you cite, the indigenous populations do not practice circumcision at
all, hence data on circumcised males there is likely contaminated by
foreign refugees from Congo in the case of Rwanda and from Zimbabwe in
the case of Swaziland, who have completely different histories than
the host populations. It may be hard for you to believe that African
scientists know more about how to handle lethal disease in their
countries than you sitting in Chicago, but it's a fact. To you its
just a game of copy and paste. To them its a matter of life and
death.
Post by Ron LowPost by windinghighwayTHREE random controlled trials
were done, and all showed conclusively that foreskins DO contribute to
the spread of AIDS.
NOT conclusive at all, as you would see if you read the critiques
published by medical experts.
Of course they are conclusive - - that's why they are accepted by the
WHO and most governments in the worst affected areas. Your
"critiques published by medical experts" are often by rank amateurs
and appear mostly on foreskin lover websites and in a handful of
obscure publications that the medical community doesn't take
seriously. The medical community knows that most of these people are
cranks (and that much of the impetus for these websites comes from
homosexual foreskin fetishists). In many ways the HIV-foreskin
denialist position is similar to that of the HIV-AIDs denialist
position -- similar little incestuous groups publishing ignorant
critiques and junk science to a tiny circle of credulous enthusiasts.
These groups would just be a joke, or at worst an irritant, except
for the danger that somebody in power might actually listen to them.
That happened in South Africa when President Mbeki bought into the HIV-
AIDS denialist myth, with truly tragic consequences for his country.
Let us hope that national leaders dont make the same mistake with the
HIV-foreskin link. Fortunately most of them are on the right track
and Africa is experiencing a welcome wave of circumcision campaigns.
Post by Ron Low- The men were not a random sample
Oooooh? We need a random sample for a study to be valid, do we?
Tell me, does this apply to the anti circumcision studies too?
Because if it does, out goes most of the "studies" that the anti circ
side quotes here so approvingly, doesnt it? I take it this means, at
a minimum, that you reject studies by Dan Bollinger et al that rely on
members of foreskin lover organizations and other unspecified
subjects? Please confirm.
By the way, have you thought about how you would persuade a random
sample of the population to get circumcised? Of course you havent.
If you think about it you will see what a ridiculous objection that
is.
Anyway you misunderstand the nature of a RCT. If you were doing a
study like an opinion poll you would need a random sample. For an RCT
like this you would actually be better off if you could study a sample
of a few hundred identical genetic clones, who you would then assign
randomly to be circumcised or not, rather than a random sample of the
population with all the baggage they would bring. In an RCT its
actually preferable that the subjects be as similar as possible in all
respects OTHER than the variable you are studying.
Post by Ron Lowbut a self-selected group
This is true of virtually all medical trials but I dont see you
objecting to our leading drugs for hypertension, cholesterol,
migraine, chemotherapy, etc, which were tested the same way. It's
just foreskins that get your goat, isnt it? What a silly objection
-- but no doubt it's copied and pasted from one of those dumb sites.
Post by Ron Lowwho ALL
wanted to be circumcised for cultural reasons, which include being
seen as more of a responsible adult after submitting to circumcision.
Uh huh. And so your argument must be, that made more of the
uncircumcised ones go out and get AIDS. Do you have any idea how
ridiculous that is?
Post by Ron Low- In all three trials at least three times as many men were lost to
follow-up (status unknown) as were infected.
High drop out rates are common and expected in many long term medical
trials and dont matter, unless you have some reason to suppose that
the randomly chosen ones who stayed in are different in some critical
respect from the randomly chosen ones who dropped out. You seem to
be saying that those who dropped out would have different or even
opposite results to those who stayed in, which is pretty ridiculous.
Post by Ron Low- The cut men had a long period of abstinence after surgery.
You really cant be sure of that, but what I find interesting here is
the reversal of the usual anti circ argument. A favorite claim of
the anti circers is that circumcised men will run out and have sex
before their wounds are healed, therefore circumcision increases the
likelihood of getting HIV. Gee, I dont see you copying and pasting
that one from the anti circ websites. I wonder why not? A bit too
inconvenient this time, perhaps, since youre trying to make the
opposite argument for once?
Post by Ron LowSince all
three of the studies were cut short to only 25% of their original
agreed-to protocol durations (akin to wagering on best 2 out of 3 in
dice but claiming your winnings after the first roll) this effect was
exaggerated.
It's called ethics. If it appears during the a medical trial that the
variable is having a marked effect in saving lives or improving severe
conditions, the researchers are ethically obligated to stop the trial
and offer the intervention to all the participants. It happens all
the time. Just last week an AIDS trial was stopped because the
variable (a viricidal gel) was not working and might actually be
causing a dangerous vaginal irritation. I suppose you would want that
trial to continue too? Or not?
Post by Ron Low- The cut men had multiple follow-up visits with the clinic, receiving
safe-sex counseling and condoms at each visit.
So did the uncut men. This raises an interesting question. Did you
know that fact, so that you were deliberately making a deceptive
statement? Or didn't you know that fact, so you were making an
invalid critique out of ignorance? My guess if that you have never
read the originals and just copied and pasted from one of your anti
circ websites, which leaves you looking, well.....ridiculous, at
best.
Post by Ron Low- The men were all paid for their participation
So what? Are you saying that if they were all paid, then the uncut
men OF COURSE would go out and get infected at a higher rate than the
cut men? Are you implying that if they WERENT paid, you would get the
reverse effect, and, the cut men would get higher infection rates? Or
what? You really don't have a clue, do you?
Post by Ron Lowand they knew that
their benefactors were trying to prove the value of circumcising.
Actually they knew the experimenters wanted to find out if
circumcision had any protective effect against HIV infection. But
again, so what? Anybody who enters an RCT for an antidepressant or a
stent or a shingles vaccine is in the same position. Are you saying
you have a problem with almost all research on medical interventions?
Or again, it is just foreskins that get your goat? And if so, you
must be claiming that knowledge of the goal of the experiment made
uncircumcised men go out and get more than their fair share of HIV.
Which frankly, is ridiculous.
Let me try again. Listen up now, you might learn something. It
DOESNT MATTER if all of the men were paid, or all were not paid, or
all were vegetarians, or all were not vegetarians, or all wore pink
ribbons in their hair, or all didnt wear pink ribbons in their hair --
just so long as they all shared that characteristic before they were
randomly divided into two groups, one of which was subjected to the
variable, and one not. That's what a random controlled trial IS, you
see. It might matter if the cut or uncut group was paid, or wore pink
robbons, while the other group wasnt. But that didn't happen because
the researchers did the experiment properly. This paragraph is not
difficult to understand and I earnestly suggest you read it a couple
more times to make sure you understand the nature of an RCT, because
its obvious from your comments that you have no clue at all.
Post by Ron Low- When study authors have a strong history of bias and advocacy
The researchers actually have histories of academically sound, peer
reviewed research findings, and if some of them have advocated
circumcision as a strategy against AIDS, it is because that is the
logical conclusion of their work and the ethical thing to do. The
same would apply to researchers who discovered a critical link for any
other disease, be it malaria or cancer.
,
Post by Ron Lowextraordinary measures are appropriate to ensure that the bias does
not affect the results of their work
Golly, does that apply to anti circ researchers too? Are there any
anti circ studies you would care to mention that meet your criteria
for perfection? I'd love to have a list so I can take a look at the
methodologies you admire.
Post by Ron Lowbut none were taken.
None? They took no measures to protect against bias? That's an
extraordinary claim. If you can back it up you can probably get the
journals that published the studies to retract them. Please list for
us the measures they didnt take -- this will be dynamite!!
Post by Ron Low- The supposed reduced HIV risk from being circumcised is NOT born out
in any real-world scenario.
Check the real world map of Africa. Check the HIV rates in
circumcised v uncircumcised African countries. Im amazed you havent
done it before but when you do you will get a big surprise.
Post by Ron LowIn half the African nations it is the
circumcised who have markedly higher HIV incidence.
.
Utter nonsense, as I pointed out earlier. But hey, why not show YOU
arent ridiculous and make ME look ridiculous by listing the (minimum)
28 African countries that you say have a "markedly higher HIV
incidence". A definition of "markedly" would help too.
Here Ill make it easy for you. When you hit "reply" you can just
fill in the blanks, OK?
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Post by Ron LowThe US has three
times the HIV incidence Europe has despite most Europeans being intact
and most sexually active adults in the US being cut.
As has been pointed out to you here before, the US has a quite
different history and epidemiology from Europe, including an earlier
epidemic arrival and peak, a different initial government response, a
mass orgiastic gay culture in the seventies such as never existed in
Europe, a much higher rate of non-sexual infection via IV drugs, a
population that practices more unsafe sex, etc. Despite all this the
US rate is below the world average. It is notable that the HIV rates
in the US are significantly higher among the disproportionally
uncircumcised black and hispanic populations than among the more
circumcised white population. Finally, the almost completely
circumcised white heterosexual American population has a negligible
HIV rate, even after 30 years of an epidemic raging about them. How do
you explain that? All this has been patiently explained to you
before and you have never had a response to it, yet you still bring it
up. I suppose it just goes over your head.
Post by Ron LowMost of the US
men who have died of AIDS were circumcised at birth.
Hardly surprising, since almost of the men in that age group were
circumcised. This is a thoroughly disingenuous argument which you
should really be ashamed of. I could smugly assert that "Most of the
men who have died of AIDS in Norway were left uncircumcised from
birth", but I have enough intellectual honesty not to make such an
argument. And I have enough facts that I don't need to resort to
anything so tawdry.
Post by Ron Low- Follow-up studies by the SAME researchers refute the findings
Hold on, are these the SAME researchers that you have claimed all
along are biased and whose findings cannot be trusted?
I'm trying to work out your position on this, so tell me if I have got
this right:
1. Any researcher whose findings support foreskins is to be trusted
and their findings accepted without question.
2. Any researcher whose findings support circumcision is probably
biased and the results were probably rigged.
3. Except that any researcher whose findings normally support
circumcision, but who produces some results that support foreskins, is
definitely correct in respect of that research, but that research
only.
If I didn't get that right, please correct me and let me know where
you stand on this.
Here's where I stand. I look at the quality of the research and judge
it accordingly. Heres the proof. If you go back through the archives
here, you will see that when observational studies started showing the
HIV-foreskin connection, every anti circer here who expressed an
opinion declared WITHOUT EXCEPTION that the findings must be wrong!
They couldnt say why, except to suggest unknown confounding factors,
but they were unanimous that the findings must be wrong, even as study
after study came to the same conclusion. But I didn't take a firm
position, because there wasnt enough evidence and I wanted to keep an
open mind. I started by using words like "may" and "might". As the
evidence mounted, I started saying the link was "possible" and then
"likely". As it mounted further, I started using words like
"probably" and then "almost certainly". But I wanted to wait until
there was a RCT to settle the issue. The anti circers, led Hugh Young
and Dan Bollinger, constantly demanded an RCT because they were 100
percent sure -- BEFORE the experiment was even done -- that it would
support their position. At the time I predicted that if an RCT did
prove a link beween HIV and foreskins, they would immediately refuse
to accept it. And that's what happened. I follow the science, you
see, and when we had three RCTs I knew the issue was settled. But the
anti circers suddenly did a total about-face and became great critics
of RCTs -- and now claim that occasional incongruent observational
studies trump everything else, confounding factors be damned! Theres
a phrase for this, Rob, and its "intellectual dishonesty".
Post by Ron Low: Wawer/
Gray 2009 found that the Ugandan men they circumcised were 50% MORE
likely to infect their female partners with deadly HIV than the men
they left intact were. Bailey 2010 reported the men of Kisumu were no
less likely to have HIV if circumcised.
Yes. They do their research and they publish their findings, whatever
they might be. Thats good science, and exactly what I would expect
from them.
However as Jake Waskett has pointed out, you got your facts about
these studies wrong or interpreted them incorrectly.
So now, Rob Low aka TLC Tugger -- who is ridiculous?