Sloppy Burial of Relevant News

How much media play will this news get in the United States?

Circumcision may reduce a man’s risk of infection with the AIDS virus by up to 60 percent if he is an African, but it does not appear to help American men of color, U.S. researchers reported on Monday.

Black and Latino men were just as likely to become infected with the AIDS virus whether they were circumcised or not, Greg Millett of the U.S. Centers for Disease Control and Prevention found.

“We also found no protective benefit for a subset of black MSM (men who have sex with men) who also had recent sex with female partners,” Millett told reporters in a telephone briefing.

Looking at the link, note that it appears filed in the “Africa” category. It’s filed from Washington, D.C., discusses the absence of protection black and latino men receive from circumcision, but it’s miraculously pushed to another country’s news. Why, if not to bury the article from U.S. readers?

Also, the article, in its opening phrase, uses the same lazy assumptions for Africans that nearly every previous story has spread. Nowhere does it mention that voluntary, adult circumcision may reduce a man’s risk of female-to-male transmission. It’s only important that readers be reminded that circumcision is now officially awesome.

The nonsense continues:

Doctors believe circumcision protects men because of specialized cells in the foreskin of the penis, which is removed in the procedure. The foreskin is filled with immune cells called Langerhans cells, which are the immune system’s sentinels and attach easily to viruses — including HIV.

In addition, sexual intercourse may cause tiny tears in the foreskin, allowing the virus into the bloodstream.

Aside from the incoherent mess of the first paragraph, note that doctors “believe” this is why circumcision appears to work. While I find such speculation absurd, speculating relies on ignoring the possibility that long-term results will not match the short-term results if behavior does not also change. And if behavior changes, circumcision becomes less important.

Nonsense like this complicates the ability to demonstrate the need to change behavior:

The data has been so clear that the World Health Organization now recommends circumcision as one of the ways to prevent HIV infection. But circumcision does not protect men 100 percent — the studies in Africa have suggested it is 50 to 60 percent protective.

This is an ignorant simplification of the data. From one of the three African studies commonly referenced, the trial included 1,393 adults voluntarily circumcised and 1,391 adults who remained intact. Within those two groups, 22 circumcised men contracted HIV in the study period, while 47 intact men contracted HIV. That’s a 1.6% infection rate for circumcised and 3.4% infection rate for intact. That means 69 new HIV cases resulted during the study among 2,784 men. That’s an absolute infection rate of just under 2.5%. That 50 to 60 percent figure is valid, but only in a context not being offered to readers of the news story. It’s not quite as egregious as this, but it makes such egregiousness more likely.

More importantly, that 2.5% infection rate in the study was significantly lower than the 6% infection rate in Kenya. Assuming that the presence of the study measured the actual population, with all extraneous factors controlled for apart from circumcision, the intact men should’ve seen an infection rate of 6%. They didn’t. What was different in the study for the participants that wasn’t as common among the general population of Kenya? I’d theorize the presence of safe sex education in the study helped, but the basic point is that something else was even more helpful than circumcision.

Bottom line: this news article isn’t reporting. It’s one nugget of common sense wrapped in a lazy regurgitation of propaganda.

In its own reporting, the Washington Post can only offer this incredulous reporting, in a larger story about HIV-positive gay men and unsafe sex:

And, in a finding that puzzled experts, another study showed that circumcision — long thought to reduce HIV infectivity — doesnothelp [sic] shield black or Latino men from the virus.

The Reuters story above reports the startling theory that the higher infection rate of HIV among black and Latino men in the U.S. exposes them to more risk, as a group. Since we’re theorizing, might the lower prevalence of HIV in other groups in the U.S. imply that there’s less HIV to be protected from through circumcision? I would call my theory a halfothesis because there’s more complexity than dividing by race, but the basic point is worth considering. The U.S. HIV epidemic does not mirror the epidemic in Africa. Why are we speculating with the bodies of males (children, particularly) based on incorrect assumptions and cultural comparisons of the United States and Africa? We should not be puzzled when the theory fails to transfer to our society.