The dollar, circumcision and AIDS PDF  | Print |  E-mail
Written by Elijah Marangu   
Friday, 24 August 2007 01:00
R eaders will no doubt have seen the new American strategy on combating HIV/Aids in Kenya and the wider the region as is reported in the local press (Daily Nation 23/08/2007).

The reason for the change in strategy is said to have been occasioned by the recent studies in Kenya and South Africa that indicate that Male circumcision more than halves the chance of contracting HIV/Aids among males (by up to 60%).

The names of the United Nations and the World Health Organization are thrown around to give credibility to these claims even as it is obvious that the information has not been subjected to the peer review process nor been published in a reputable refereed journa. But why go to all the trouble, this is Kenya and Africa we are talking about, they are addicted to instructions from on high and if the ‘cut' is the offered answer, let them all suffer it. That at least that appears to be the attitude.

This is unsettling primarily because it comes at a time when Kenya in particular and the East and Central African region in general are reporting gains in war against HIV/Aids . These gains, unheralded as they are have come about through increased education on STIs and AIDS, increased ARV availability and the widespread use of health education and Voluntary Counseling services, including for those already infected.

What is disturbing about this new tack is;

Ø There is no recognition of the need to encourage homegrown strategies to combat HIV/Aids, we have medical scientists and I cannot see that they have been involved in any of this.

Ø Going by current statistics, over 20 million people have HIV/Aids in Africa, I doubt very much that lining up the men in this group for a prepuce nip will be much help.

Ø No effectiveness tests have been carried out on circumcision as a preventative strategy, what is cited is anecdotal evidence that could be due to any number of factors including malaria prevalence, water borne diseases and pure bias.

Ø Circumcision is an issue that polarizes Kenyans, Africans and people the world over, especially as it comes attached to cultural and identity issues. If circumcision were a vaccine with some proven efficacy, we could debate this some more; it is not. Instead,  it's merely one of the many things that play a part in reducing the incidence.

Ø Is this likely to be a distraction from the current efforts in fighting the pandemic? As such is it not a step in the wrong direction.

Ø Where else in the world would you be so insensitive, as to single out a community like the Luo people have been singled out without risking a major backlash.

aids.jpg


It is also important to reflect on how, we in Africa got the high infection rates that we have now, part of the problem was denial that HIV/ Aids was a problem - until it was too late, poverty is a major factor and the flagging health infrastructure were all factors that helped fuel the pandemic that Aids has become.

 

Hopefully my writing will not come across as opposition to the idea that male circumcision has health benefits,  but rather that we should not spend scarce resources on unproven measures as a HIV/Aids management and preventative strategy. An alternative would be to include it in standard health promotion awareness and to prosecute such efforts in a culturally sensitive manner.

An important point to note is that the majority of the communities do not circumcise, exposure to HIV in these countries dates back to the same periods that is took hold in Africa but they have not been nearly as affected by the scourge. It's time to look at what other dynamics are at play, without getting distracted by what is like to be an emotive and a counterproductive debate.

This is yet another example of donors using their purse strings to tweak and experiment on local cultural practices they neither appreciate nor understand.

 


Written on Friday, 24 August 2007 01:00 by Elijah Marangu

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ignorance
written by Mr.Kay , August 24, 2007
If circumcision can seriously reduce the chance of contracting the disease, why attack it? Let's not be in ignorance.
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tulia
written by emmo opoti , August 24, 2007
Bw. Kay,
Seems to me what Marangu is decrying is the sudden prominence this movement to circumcise is being given, especially with all the potential pitfalls it is likely to face.

On my part, I would say the greatest danger in all of this is that the newly circumcised may think of themselves as innoculated against AIDS and thus a measure that was meant to save lives, rolls back the progress made over the last two decades.
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Marangu Pleaaase!
written by Hon , August 24, 2007
I agree 150% with Mr. Kay.
Elijah, no offence but your argument puts the 'a' in weak!

Why are we attacking something that is cheap, and affordable by poor countries? A proactive measure, call it even hypothetical- that only has gains and no losses, except the myopic cultural musings. Polarizing issue? What happened to discarding repugnant/redundant ideas. Luos no longer pull out the six teeth. if they stopped that, they can adopt the cut too! Do we still make children afflicted by measles keep to the bushy paths lest they pass the malady...or we now know it is not medically sound?

And what stats are you reading from? Gains? How can you say gains when women from the age of 15-24 are loosing, with infection rates sky rocketing!

As for the efficacy of this circumcision therapy: get real, this disease has only been studied for less than 30 years, u of all people ought to know that it takes even centuries to know what therapy can do or not do!

This is no rocket science. Any of you men know that a tarumatized penis is susceptible to infection!

Emmo, you underestimate the peoples ability to understsnd their predicament.
People know much more!

I beleive this measure together with a religious approach will have more positive results as opposed to drug therapies (from begging) and condom approach!
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...
written by Timothy Wainaina , August 24, 2007
One could point out, if one were so inclined, that Thika has been at the top of the HIV leagues for a long time now, the specifics of its denizens' anatomies notwithstanding.

Marangu has made clear he is not against encouraging circumcision. What he is railing against is proposing it as a key component to HIV fighting measures. It is exactly the sort of thing that will stir up a storm, consume a lot of energy and resources ( because of resistance) and ultimately deliver less than would other methods given the same level of dedication.
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written by JorgeM , August 24, 2007
What's wrong with condoms? They're inexpensive, very effective, and protect men AND women.

Circumcision is much more costly, requires a surgeon, and clean surgical equipment. It provides no protection to women. Even the protection it provides to men isn't that great. Circumcised men get HIV. See: the United States.

Idiot Bush wants to spend $15 billion on AIDs and to focus on abstinence and genital cutting. That could buy 100 billion or more condoms, enough for every African male to have dozens for the year. No one has died from putting on a condom. How many have been infected by dirty surgical tools?

Everyone always seems to ignore that the United States has the highest circumcision rate in the developed world and also the highest per capita HIV rate in the developed world.
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written by Hon , August 24, 2007
Resistance to circumcision will only come as a result of misguided ideas planted in people's minds.

Condoms are inexpensive, yes, male condoms are. In a male dominated society like Kenya, how many women can demand that men put on condoms. How many drunk men demand sex from their wives every night in Kenya?
With a culture that encourages men to stay away in cities supposedly making money (and hunting for viruses on the sides), how many men own up to their philandering and try to protect their wives in the rurals!

To reduce infections in Africa, it is a simple way that befits poor people.

Do not start comparing infection rates of America, for this women are more sure of tomorrow, their children have a future, and they live just well.
Matter of fact, they are waiting for compensation from Viracept makers for putting them at risk of kidney damage.
How many Kenyans will be awarded that?

I support Bush hands down on that one. Religion and the cut.
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written by Hon , August 24, 2007
Costs of the female condom? And the intricacies of putting it on?
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Cut a bogus solution
written by Man R , August 24, 2007
Nice topic,

Circumcision is not the solution to the AIDS pandemic in Africa and we should stop giving it so much play.

Majority of the people infected with AIDS in Africa are circumcised. In fact, more communities in Africa practice and hold circumcision sacred and that has not stopped the spread of AIDS. It doesn't make much sense to make up a policy that targets a minority and totally ignores the majority. And what about women, what's the solution for them?

I totally agree with the author's brilliant analysis of this situation. It's amazing how this circumcision solution has rushed from a hypotheses to a viable solution in less than two years.

(Note: AIDS is still a disease without a clear definition more than 20 years after its discovery, the current name Acquired Immune Deficiency Syndrome, keyword Syndrome, is a consensus name, which basically means scientists are still baffled with the miraculous workings of the disease or they stopped looking.)

AIDS is a socio-economic problem not a genitalia status problem. Most of Europe is not circumcised yet we don't see people falling off dead because of AIDS or the governments there going on a circumcision spree...

Even in the U.S. the economically disadvantaged are disproportionately prominently represented among people with AIDS and HIV infection.

We have to be careful before adopting these Western solutions to our problems.

Like, Mr. Marangu has pointed out, there are real solutions to stopping this problem. We need to pump more money in our health care system to take care of the infected and improve our economy to provide people with the means to afford their lifestyles.

I don't want to get into the cultural stalemate this suggestion is likely to generate in Kenya, but I agree with Emmo's argument that some people, both circumcised and newly-circumcised, might get a false sense of security and engage in deadly behavior especially if this campaign is not handled right.

AIDS is a marathon, anything that can help stem the problem is welcome, but we need to find long-term solutions that don't seem to miss the point like this bogus solution.
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Pleeaase
written by Hon , August 24, 2007
I do not beleive anyone has a solution to AIDS yet. The Bush Initiative has not suggested by any means that circumscision is the solution, it is a means of reducing infection rates!

'Prevention is better than cure'...that is what physicians worth their taste will preach to all the doubting Thomases out there.

Point of correction, scientists are not baffled by the 'miraculous' workings of the disease, (what is miraculous about it, anyway...)they know the culprit microbes, they are yet to pin down how to stop its abilities. This is not strange, given that viruses are never known to perish. That this is a virulent deficiency, whose sub-species vary with region only adds to the twist. Unfortunately, some regions like Africa can not afford to do their own research.

In a country where people get anti-biotics for common colds, even children, which efficiency are we hoping for in the healthcare system?
Please enlighten me on the number of Doctors serving 80% of Kenyans in rural Kenya, or Africa at large.

Amajority of AIDS carriers in Kenya are in the non-circumsized zones of Kenya, and so are the majority of Cervical cancer sufferers, and it is Nyanza.

This socio-economic problem is directly related to genitalia, especially in Africa!

Wachana
with defensiveness and look at the idea objectively.

So what does Bush Know about certain tribes/minorities and their not cutting? We are talking about a guy who does not know the difference btwn Kenya and TZ!
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Hon
written by Man R , August 24, 2007
OK,

There is something called sarcasm. That's what I was using when I played the "miraculous" card-- it has a double meaning too... I'm aware of the impressive advances in AIDS research, I just find it curious that it still carries a consensus definition decades after and yet bogus solutions are not even allowed to simmer before getting applied on salivating ill-informed Africans.

(It's sad that some Africans still thinks the world cares about their plight.)

And circumcision is not prevention. Like I said, more circumcised people are infected with AIDS than uncircumcised people. You do the math.

And also Nyanza does not necessarily have the highest number of infection, there is a huge infection in many areas and the last time I checked Thika was leading the infamous trail. If you know something about Thika is most people there find circumcision sacred.

Another thing, circumcision is not cheap, it involves surgeons, time etc and at the end of the day the person faces the same risks because we'll not stop having sex. We should invest in real solutions, like improving health care and health education.

I also pointed out that most people in Europe don't get circumcised. Yet we don't see AIDS ravaging the continent or the European governments falling over each other to cut it's peoples' penises... Why is that? Simple... this solution is crude and not real.

You also seem to allude that I'm opposed to the idea for personal reasons, well, nothing could be further from the truth. I belong to a community that would cut your thing in public and put you on a mkokoteni if you're caught uncircumcised after a certain age.

This circumcision solution would make more sense if it prevented anything. But it does not. It just gives people a false sense of security.


Prevention is better than cure'...that is what physicians worth their taste will preach to all the doubting Thomases out there.

Point of correction, scientists are not baffled by the 'miraculous' workings of the disease, (what is miraculous about it, anyway...)they know the culprit microbes, they are yet to pin down how to stop its abilities. This is not strange, given that viruses are never known to perish. That this is a virulent deficiency, whose sub-species vary with region only adds to the twist. Unfortunately, some regions like Africa can not afford to do their own research.

In a country where people get anti-biotics for common colds, even children, which efficiency are we hoping for in the healthcare system?
Please enlighten me on the number of Doctors serving 80% of Kenyans in rural Kenya, or Africa at large.

Amajority of AIDS carriers in Kenya are in the non-circumsized zones of Kenya, and so are the majority of Cervical cancer sufferers, and it is Nyanza.

This socio-economic problem is directly related to genitalia, especially in Africa!

Wachana
with defensiveness and look at the idea objectively.

So what does Bush Know about certain tribes/minorities and their not cutting? We are talking about a guy who does not know the difference btwn Kenya and TZ!


I don't know where you're getting your stats, but you need to be critical about them. Also trusting George Bush's judgment doesn't really strike me as smart.
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written by Stephen Wanyama , August 24, 2007
Everyone who knows anything knows that prevalence rates in Kenya are coming down. There's criticism, there's cynicism and then there's refusing to see the facts. I am not sure what it is, but as Marangu points out progress has been made, so something is being done right.
My ancestors' people are also obsessed with circumcision, but they still seem to contract HIV and AIDS as much as anyone else.

The argument however should not be about whether circumcision works or not, there seems to be evidence that it does. Perhaps we should be asking oursleves if there really is a need to tinker with what is clearly a regime that works, education, condoms and better primary health care. As Emmo and Man R point out, men may begin to think that they are sheathed against AIDS when they get circumcised.
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Cultural Ignorance
written by Kimani S. Njoroge , August 25, 2007
Circumcision, at least to me, creates a sense of sexual freedom among the youth. This is when most of them start enjoying the fruit ovyo-ovyo, which, of course, increases chances of contracting HIV. What will dollars-for-the-cut; campaigners say on this? Stop circumcising Kikuyus, Merus and the rest?
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written by Marangu , August 25, 2007
Hon:
I accept your argument to a point, and that is in as far as you have the right to put that view accross in this forum, there are many that agree with you, probably, but they have not voiced their opinions here. You refute the fact that this issue polarizes people, it does, can't you see the evidence right here? I am only glad though that the nature of that polarity now is extremely weighted on the side of the argument that wholesale circumsion is no solution, that there are many other known preventative measures we can invest in including our flagging health infrastructure which can be of benefit tho those already afflicted. As for where the source of my statistics and evidence are:I agree with Stephen and I take no responsiblity for your ignorance of the same and stress that there is enough evidence our there. That although many are still getting infected and the war is far from won, we have made some progress. Progress here does not imply zero infection rates or decline in incidence, rather a change in knowledge, attitude and sexual practices, this through easier access to available preventive measures (including male and female condoms you so despise) ARV therapy, education and Counseling services. All these in the long run will and have equated to decreasing prevalence, it first happened accross the boader in Uganda and Kenya is catching up.
Man R:
And yes, you are right, circumcion is neither cheap nor free. There is significant morbidity associated with circumcision, even deaths. Knowing well the tools of the trade in some communities, I just wonder whether this would not help to fuel the epidemic it's meant to curb.
I note that Hon does not buy into your American examples on the status of HIV/Aids in that continent but on the same breath supports George Bush "hands down" on Religion and the cut .. did I miss something?
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Director\'s Cut
written by Jayawardene , August 25, 2007
Someone up there (think it was ManR) said nice topic which evidently it is. It is gratifying to see writers here making it quite clear that they are not impressed about the strings attached to the dollars.

Mr Marangu has done a brilliant job in pointing out that this new US "strategy" may have disastrous consequences,(as ever) diverting resources from programmes that are steadily delivering results and ofcourse giving false ideas of immunity to newly-cuts.

There are 2 other points that I feel are worthy of mention.

Someone kindly noted the good work of the Voluntary counselling service. Let me give this service its full name to drive home a point: Vouluntary Counselling and Testing centres. What do you think of the idea that it should the duty of every able Kenyan to know their HIV status?

Second. I seem to have missed something here: I know that Americans may have landed on the moon and all that but they are putting the socks over their shoes on this one. By narrow focusing on how to halve male infection and rejecting condom protection it looks like they have given up the bigger war in order to win a small battle. Consequently, too bad if you're a woman.
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written by Marangu , August 25, 2007
Jayawardene:
Not only do I like your 'name' but I agree with you on this one, a population wide approach is more desirable. While it is a fact that men are culpable of much of HIV spread in Africa, any effective preventative strategy would have to target as much men as it does women. I would argue if we concentrate on equiping women both in terms of education and every available HIV prevention resource, we will most likely achieve more.
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Credibility.
written by Hon , August 26, 2007
I respect your opinions fellaz, but thats about it!. I strongly disagree on your take on the matter.


To begin, the circumcision idea has not been floated 'yesterday', and it is neither Bush's idea. It has been around for a very long time, been resisted long enough until
it was agreed upon recently as an effective measure.Warning: Before starting to yap here, lets check the latest medical journals, they can be easily accesed in any health research center. Scientists are always trying to outdo each other in these matters, so what you came across a decade ago may well have been disputed 3 years later, after a better theory was stumbled upon!
Most of contributors here are full of stale info!

Next, ManR's and Marangu's stats are heresy, both on America and Kenya itself. Evidence 'out there' from Wikipedia is not credible material. Who deliberates over Wikipedia references?. I refuse to buy his examples because I know how it works. Here, for along time, genitalia was not the main route of passing the virus. The top killer here is heart disease, not AIDS! Point me where you got your stats from, and who perfomed the study. Let me know if the research is at KEMRI, and I will pull it up and confirm. I drean health and think Health 24/7. As for circumcision, I will be more than willing to show you the current study. It has a chance of reducing infection upto 60%. This is the same research result revealed over a decade ago, resisted vehemently, now accepted. I may be ignorant in your grandiose Mcdreamy solutions, but I know what works and what does not.
(Just to add, am pro-Bush (on this one) Pro-life, pro-America, Pro-capitalism, anti-poverty, anti-socialism).

Uganda made gains in the early 90's, gains that have been reversed. FYI, Bush's initiative was arrived at after realizing Uganda's gains were being reversed very fast. It is Uganda's health officials that directed towards religion and the cut, insisting that it works. Religious leaders in Uganda support it. Five years of study, and Bush's officials thought it good for other regions.

Circumcision is less expensive compared to the ARV's, Healthcare, and condoms t that Kenya is going to depend on donors for delivery.
Just to add to the twist, some scientits argue that ARVs do not help reduce the viral load, instead it is more behavioral...
Ah! beggars with choices!

False security by people can only be reached at when forists like yourself here pass it on as a 'solution', like you have it embedded in your minds that it was a solution. Why are you peeps calling it a solution?

As for donations with strings attached? CARE intrnational has just turned down $30 million US dollars because of the said strings!
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re: Credibility.
written by Marangu , August 26, 2007
Hon:
The posts in this forum do not equate to an academic debate, this is commentary on an issue that concerns our community. Our opinions are just that, opinions, based on what we know, what we have read mainly on the media or experienced in the course of what we do. I cant remember seeing Wikipedia untill you mentioned it on this debate, not that I see anything wrong in acknowleding that source for discussions like these. If the source of your information is the Lancet or any other reputable medical journal, that is perfectly ok, it helps to enrich the information we have here. I dont see any evidence of that in your posts though.
Hon wrote:
Circumcision is less expensive compared to the ARV's, Healthcare, and condoms t that Kenya is going to depend on donors for delivery.
Just to add to the twist, some scientits argue that ARVs do not help reduce the viral load, instead it is more behavioral...
Ah! beggars with choices

I really doubt we could start comparing 'circumcision' with ARVs, and determine funding based on that, for one is clearly treatment with some known efficacy and the other is a suggested preventative measure. They target different populations, one infected the other one uninfected. As for those scientist who say ARVs do not reduce the viral load because it is more behavioural... I completely lost you on that one, sounds like a very good one by you from Wikipedia Hon.
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Me Begs you Pardon
written by Hon , August 26, 2007
Marangu;
Please be informed that am a keen reader of current pharmaceutical/medical journals courtesy o my employer...and have a very strong interest in Public/global health!
I follow HIV and its drug therapies closely.

No, I do not quote Wikipedia on matters touching on science. I do not evn google. Pay to read papers onlin, or know people who have authority to access them, better still know those who deal with this issues.
I am on solid ground here, in Kenya and the US!

Of 'CUT' vs. 'ARVs'...one contains the malady (cut) the other manages the symptoms. Disregarding cost, what makes sense?
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opportunity cost
written by emmo opoti , August 26, 2007
As Man R and everyone else except Bush's Honey has pointed out, there are not too many certainties in the battle against AIDS. The condition and many aspects of it still baffle scientists and there will be opinions on both sides for many HIV-AIDS questions.

What we most emphatically do not need are dogmatic solutions, or any attempts to put a gun to people's heads. We also do not need to be offering people false hopes and delusions about circumcision and its benefits.

What Marangu and all the non-fundamentalists seem to be arguing is not that circumcision is not useful, or that it has not been proven to work, but that it will be disruptive and will expend vital time and resources that could be useful elsewhere. Admittedly though, such nuances are unlikely to be discerned by anyone preaching religion as a solution to a health problem; when it is more likely that religion itself is a health problem.

We are discussing prevention, so I would think it best that as much as possible all means are put on the table. While it may not be easy to hand out specific probabilities and efficacies to your average teen, it would be kind also not to offer anything as a grand breakthrough.

Finally, condoms are NOT expensive, they are however very effective.
P.S. Talking of sources would you care to show the provenance of your 60% claim?
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written by Marangu , August 26, 2007
Hon Wrote:

Please be informed that am a keen reader of current pharmaceutical/medical journals courtesy o my employer...and have a very strong interest in Public/global health!
I follow HIV and its drug therapies closely.

Impressive - I have never doubted that you are well read, on this debate or any other, your ability to debate is legendary, sometimes turns volurent but nevertheless still stays with the issue and for that you earn many readers respect.
I am eagerly waiting to see a mass rollout of male circumcision especially in the Western World, as you might know, Bush and his buddies will surely want to reap the benefits before the rest of us do, after all they have done that on every issue, not just ARVs. Tell me which medical innovation made it's debut in Africa or any third world country/ especially if it was driven by Westerners? Not if we were being used as guinea pigs!
Those in Africa that circumcise will continue to do so for the same reasons they have done it for generations, and they will have to adapt and change their sexual practices if they are to survive HIV/Aids, which has so affected them inspite of this age-old practice.
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fallible humans
written by roki , August 27, 2007
once and again,religous intervention and its touted effects have been stated as a way of AIDS prevention.Does it come as a surprise that the stepping up of the evangelical teachings and its blatant refusal and condemnation of all things "condom"-for fear of sexual promotion and indulgence,havent done much to alleviate the AIDS scourge?All laws,be it religous,of the land,whatever are bound to be broken and it gets especially tricky when it comes to telling people not to involve in lascivious acts.Once and again,you are better of strapped,circumcised or not.Every other measure that follows after contracting HIV/AIDS is pretty much palliative....
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Cut or uncut
written by mshevwa , August 27, 2007
When you hear so and so has the big one , what is your first reaction?.Ooohh he /she has been sleeping around.AIDS is a sexualy transmitted disease and we should focus on discouraging carelsess sexual behaviour , you sleep around you take a chance with aids cut on uncut.I think there should be no grey area in this.In this case are we only fighting for men what action reduces females ? ,should they also go for FGM?(female circumsicion)
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Hon
written by Man R , August 27, 2007
Clearly we're not on the same wavelength on this matter.

But I must tell you that your argument is filled with false deductions and ad hominem.

And I never thought they'll come a day in the 21st century when I'll meet a person who'll admit he never uses google. (The google according to George W) That's just sad. Google, and such search engines for your information, are perhaps the best research resources in the history of the world.

Your argument would probably make more sense if you cast a wider net using the resources provided for free by google.

By the way, who talked about Wikipedia?

Hon, why don't you tell George W. to start a circumcision campaign in the U.S.

Can't believe this dude is saying circumcision is a preventive measure to AIDS... Unbelievable.
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cause and effect
written by Jayawardene , August 27, 2007
".........One research study found that HIV in the general population was in the order of 7% and growing. When they studied the HIV prevalence amongst Bulimians who were blind it was found to be 0.01%...."

Discuss.
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Hon- theory building
written by pndiangui , August 27, 2007
Honey on this one you really miss the point.

What Marangu is saying is circumcision = prevention just being a descriptive theory that hasnt been 'causated' is a dangerous application for a one-size fits all approach. That it needs to be approached cautiously is no doubt the point in this debate.
No one denies it has some positive effects , but the lack of an exhaustive 'theory building' exercise to move it into a normative theory with some straight 'causation' makes its blind mass application wanting.
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Flabbergasted.
written by Hon , August 27, 2007
Yes I am.
I need some time to appreciate your misgivings on this idea, like a lifetime?

I dont know about missing the damn point. I beleive this is something which directly affects lives, we do not have decades and centuries coz people are getting infected and dying...thus facts and theories must be put in place, or we should be sent to the guillotine for playing around with the issue as people die.

(When it comes to an issue like insisting that men start adorning skirts to reduce the 'look good' pressue women face daily; we can give opinions and chat until kingdom come)

Yes again, we are certainly not on the same page. Being on my page requires that one dissociates coitus from the issue first, then views the pudendum and phallus as any other anatomical part that can be 'nipped and tucked', and lastly disregard cultural leanings. The vital point in all this should be the medical positives associated with the cut, nothing else. We are dealing with a deadly disease, and we need to reduce its infection rates.

And here I was thinking this was an across the board positive approach: cheap, familiar, and practical in all regions. I did not think it was to 'fit all', just that it has a better chance of more pros than cons.
The nitty-gritty details of every user occasionally runs thru the strainer!

Lets get a few things straight: I do not 'despise' condoms. They need help, that is what I should have said.
NO, pumping money into condoms and ARVs is not working quite well for the results fade in the light of the effort.

And Steve and company are right on proper governance; lakini, ours is a teething country. While the govt is trying to figure out who serves whom, people should do something about their lives too!

I analogize the application of condoms to 'chopping the bushy leaves at the tree top, and watering it at the roots', which sounds to me like a futile effort.

As of religion: well, there are religious leaders whose message is more bleak than positive, then there are those who are so positive that the message resonates with the human mind, working wonders.
It is not about condemning people, but giving people hope, and encouraging them.
Each denomination has its ideas, and every human being can decide what they wanna deal with!

Lets not discuss it any further, how about we give it a try for a while?
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...
written by Marangu , August 28, 2007
For those that enjoy a good debate, it always feels good when your opinion or argument prevails, for that is the essence of a debate anyway. But when the debate is about an issue as important as HIV/Aids, there is something wrong with deliving satisfaction from having the last word, winning the argument if you like. This because deep down we know that the war from this disease is far from won, and it will be a while yet before we can see a cure, a vaccine or any other effective preventative measure. Anyone infected or affected by this disease would wish some of what is said here is true, that by reading the commentry on this forum they can get some consolation from our collective knowledge and experiences. That is unlikely when we all hit boiling point for the sole sake of having the last and the loudest shout.
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the consequences
written by seline , August 29, 2007
as it is right now,there are still people out there who believe that having unprotected sex with a virgin girl cures one from AIDS, despite all the awareness that has been going on.Isn,t this circumcision strategy just going to spark another wave of misinformation and misguidance?
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I say
written by Hon , August 29, 2007
Who had the last word or won? You disagree with my view, meanwhile, I am baffled that you see it that way. Personally, I find it tiring talking for too long about something that we cannot do.I don't think anyone 'won' here.

It is agreeing to disagree. Or maybe, I need to see the practical failure of the idea. Am hung on proof. Lets first see if it indeed fails!
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research
written by emmo opoti , August 29, 2007
Man R,
Circumcision has been shown to reduce the probability of contracting the HIV virus, or more specifically, studies have shown a preponderance among those who have been circumcised to stay uninfected. See Google.
What I am opposed to, is marketing this as some breakthrough when in Kenya at least there is a clear need to keep improving primary health care, and the treatment of those already infected with ARVs. What the US is proposing is a diversion of funds from one priority to another.

Now as to Google and Wikipedia. I have made exactly your point before. Google is not a source, and neither is Wikipedia. If Google and Wikipedia can mislead you then anything can because they are quite simply tools. You use Google and Wikipedia to reach a source. At my university the Professors taught that only those able to filter should use Wikipedia. I would say the same for a library, which after all is what Google properly is.
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Last Updated on Friday, 24 August 2007 16:30