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Posts for December, 2010

Another ill-contrived circumcision study

Timothy Kincaid

December 8th, 2010

Should there be any researchers reading, let me give you a bit of advice: gay sex and straight sex are not identical. While most heterosexual men do not have penises inserted into their anuses with regularity, this is not an uncommon part of the sexual practices of many gay men.

And further, the easiest way that a gay guy can become infected with HIV is through anally receptive unprotected sex. That isn’t new, surprising, or even contested.

Yep, HIV transmission among gay men in the US is primarily due to taking it bare up the butt. And any research which seeks to understand factors contributing to HIV transmission which does not consider that simple fact is a complete waste of money and time.

And today we get word of yet another Wasted Money Study on whether circumcision impacts HIV transmission between gay men. Reuters:

In a study of more than 1,800 men from the U.S. and Peru, researchers found that overall, the risk of contracting HIV over 18 months did not significantly differ between circumcised and uncircumcised men.

Over the study period, 5 percent of the 1,365 uncircumcised men became HIV-positive, as did 4 percent of the 457 circumcised men, according to findings published in the journal AIDS.

Well, gee, that information would be useful to know… if the study wasn’t conducted in a mind-numbingly stupid way.

Because, you see, that study doesn’t take into consideration whether the men were engaging in receptive or penetrative anal sex. I just assumes that gay men pass HIV to other gay men in some unknown and mysterious manner. Maybe by osmosis.

Well guess what? It really doesn’t matter one iota whether a bottom’s penis is circumcised, pierced, tattooed, or wearing a funny hat if he has semen up his butt. And any study that focuses only on whether a penis is circumcised – but not what you’re doing with it – is going to provide useless information.

I will give this study partial credit for even wondering, as a side note, whether circumcision impacts the transmission of guys who are using their penises in penetrative anal sex. And while they couldn’t bother to craft a study that looked at that issue, they did at least ask. Kinda.

And guess what?

The researchers did find some hints that circumcision could be protective among men who primarily had insertive sex with other men. Among men who said they’d had insertive sex with their last three male partners at least 60 percent of the time, circumcision was linked to a 69 percent lower HIV risk.

That difference, however, was not statistically significant, which means the finding could be due to chance.

But the truly stupid aspects of this Wasted Money Study isn’t limited to having no concept whatsoever about how HIV is transmitted. It also made these glaring errors:

Male circumcision is far more common in the U.S. than in most other countries, and 82 percent of the 462 American men in the study were circumcised, compared with just 6 percent of the 1,360 Peruvian men.

D’ya think that this may be a material difference in populations? That perhaps there are differences between the cultures, practices, or even extent of HIV exposure between the two countries?

All of the men in the study reported having sex with other men and were considered to be at increased risk of HIV infection because they were already infected with the genital herpes virus (herpes simplex type 2), which can make people more susceptible to HIV.

So we’re talking about men who potentially have open sores… which are known to be ways in which HIV enters the body… but all that can be ignored to discuss the results of circumcision.

None of which discouraged declarations based on the results of the “study”

Taken together, the results “indicate no overall protective benefit from male circumcision” when it comes to male-to-male HIV transmission, write the researchers, led by Dr. Jorge Sanchez of the research organization Impacta Peru, in Lima.

No, Dr. Sanchez, taken together the results indicate an incredibly stupid study which tells us absolutely nothing whatsoever about circumcision and HIV transmission and was a complete waste of time and money. I really hope that my tax dollars did not fund your folly.

We don’t really need studies that inform us that anally receptive men don’t reduce their HIV risk by becoming circumcised. They also aren’t benefited by having flocked wall-paper or a charming haircut.

But I, for one, would be interested in a study that looked at whether HIV transmission could be reduced by means of circumcision among anally penetrative men. That question has not been answered (this Wasted Money Study, notwithstanding) and it would be beneficial to know whether circumcision is a risk mitigator among this subset of gay men, and to what extent.

And, I guess they did add that recommendation to their nonsensical reporting of their results.

They add that studies should continue to look at whether circumcision affects HIV risk from insertive sex and do so in larger, more diverse study groups.

Yeah. Ya think?

Lack of Clarity in Reporting on HIV and Circumcision of Gay Males

Timothy Kincaid

August 26th, 2009

Several studies have shown that in African and Asian nations heavily impacted by HIV, circumcision can reduce infection rates in males by 50 – 60%. Now a CDC doctor has announced that while circumcision is effective in reducing female to male transmission during vaginal sex, it does not assist in resisting infection between gay males during anal sex. (U.S. News & World Report)

Circumcision “is not considered beneficial” for gay men concerned about lowering their risk of becoming infected with HIV, Dr. Peter Kilmarx of the CDC told the Associated Press. He released the study findings at a conference on Tuesday.

The finding are at odds with some studies conducted in Africa, which have suggested that circumcised males may be less prone to HIV infection during heterosexual sex. But circumcision may not offer the same protection when it comes to anal sex, Kilmarx said.

In the study, the CDC team tracked the HIV infection rate of nearly 4,900 men who had anal sex with an HIV-infected partner. The researchers found an HIV infection rate of 3.5 percent — whether the men were circumcised or not.

While this may appear informative to a heterosexual, this reporting leaves more questions than it answers.

  • Were these 4,900 tops who engage in insertive sex only? Because if not, how could the circumcision of a bottom (passive partner) possibly impact HIV transmission?
  • Does the 3.5% infection rate reflect a bottom to top transmission? Was this 3.5% in a year, a decade, when?
  • Were these “partners” in relationships or just sex-partners?
  • Or did they just say, “Here are some cut men and here are some uncut men. Let’s see to what extent they seroconvert”?

This story is but another illustration of why it is important that gay men and women are included in reporting stories that effect our lives. It would be interesting to know the extent to which bottom to top HIV transmissions occur and whether circumcision of the top could impact this transmission. But reporting like this tells us nothing of much use at all.