IIRC, the main hypothesis is that the presence of the foreskin increases the surface area of nonkeratinized epithelium in the region, which contains large numbers of CD4+ dendritic cells. Since CD4 is one of the main target molecules for HIV, this increases the likelihood of infection.
Once circumcised, a large proportion of the nonkeratinized epithelial surface is gone, and the epithelium of the glans keratinizes, which probably makes it more resistant to viral penetration.
Just because Alex Dubinsky is not a fool, but perhaps a little lazy with cites:
As far as his more sensational claims
I know it’s not your job to do his research for him, but a little bit of looking would reveal that he’s not coming from left field.
In case you’re wondering, I’m cut, and my boys are, too.
Although the AAP does not recommend routine infant circumcision, they also don’t not recommend it, if you know what I mean. In their official policy statement, they state that there are legitimate reasons parents may choose to circumcise their sons and even list medical benefits to circumcision (and also list drawbacks).
Here is the AAP statement: Error | AAP
I found it interesting that the Sydney Morning Herald, when reporting on the same story in the OP, stated that the Australian version of the AAP would not comment and that they were reviewing their policy on circumcision (it is currently not recommended). A “leading AIDS scientist” thinks Australia should recommend infant circumcision. Here is the link to the SMH article, but I think you have to register (for free) to see it: Top scientist urges circumcision to beat AIDS
Thanks, saoirse. I don’t understand why I always seem to inspire such a hostile reaction. Is it because of what I’m saying, or how I say it? (It is probably the latter, yet even if I am at fault my opponents aren’t acting with utmost objectivity).
Anyway, my main point is:
Male circumcision IS like cutting off the four lips (and may or may not be worse, since, while the lips serve the same function of keeping the clitoris/glans sensitive, they, as far as I understand, don’t contribute as much to sensitivity directly). Yet there is a sea of difference in the way people would respond to female circumcision (and, I repeat, we’re not talking about the clitoris) and male circumcision. You people cannot address this debate properly until you resolve this paradox in attitude.
And to anyone who suggests that discussing the ethics of circumcision is inappropriate in a thread about circumcision being a treatment for HIV… anyway, you’re probably only saying it because you’d rather not talk about the ethics of circumcision.
Yeah, that was my main hypothesis also: that the callousification (another word for keratinization) makes the glans less susceptible to infection. However, perhaps keratinization may be induced chemically. Yet the issue remains whether calloused skin will always have the properties of calloused skin.
Uh-huh. The two are exactly equivalent! Because you say so!
Meanwhile, back in the reality portion of the conversation . . . . I’ve heard this claim for quite some time, of course, and I don’t doubt it. But what I wonder is whether any epidemiologists or whatever have actually done some analysis to see what the effects of routine infant circumcision would be in Subsaharan Africa. Would the decreased transmission rates from any individual sex act translate to significant reduction in the prevalence of HIV in the population? I don’t know anything about the mathematical models for this sort of thing, but I have to imagine that it’s not exactly straightforward to project from a lowered transmission rate to a serious reduction in the general prevalence of the disease. After all, my understanding is that any individual sex act with someone infected is not all that likely to transmit the disease - so how much of a difference would it make if that likelihood is decreased?
(FTR, since we’re apparently doing this, I’m uncut, and prefer that in sex partners.)
Incidentally, Google only finds one example of “callousification”, and it’s someone speculating on whether or not it’s a word. So I don’t think it’s quite safe to claim that it’s “another word for keratinization”.
“Callousification” (by which I assume you mean “becoming callused”) is by no means the same thing as keratinization. All of your skin is keratinized. Non-keratinized surfaces include what we commonly refer to as “mucous membranes”.
A (skin) callus is a particular reaction to an area of chronic irritation, which generally results in thickening of the epidermis overall as well as a thickening of the keratinized layer.
ISTR that although keratinized epithelium may be more resistant to viral penetration (which is why sexual contact, for instance, is much riskier than getting a fluid splash on intact skin), another important aspect is that the prepuce contains more CD4+ macrophages than typical skin, thus providing any invading HIV with a larger number of binding sites.
Alex_Dubinsky, I invite you to continue your discussion on the importance of the foreskin vs. human life here.
Uh, no. If you want to reproduce male circumcision in females, then you’d cut off the clitoral hood - the bit of skin that covers the clitoris when it’s not erect.
Female circumcision (cutting of the lips) is like cutting off the shaft of the penis - that’s the analagous tissue, developmentally and neurologically.
Obviously, you don’t even know the basics of female anatomy, so I don’t see the point in discussing this with you any longer.
i made up the word. if “callous” was a technical word, some doctor would have done the deed for me long ago. what is wrong with adding sufixes to produce a medical word that everyone will easily understand?
But anyway, as you say, “a callous is a…reaction to chronic irritation… which…results in…thickening of the keratinized layer.” Perhaps a keratinization of the eithelium after rubbing of your head against undies doesn’t add up to a callous. Maybe. But I would have to see your study to be able to keep arguing on its use of this language.
Actually, although I guess I can’t prove it, I made the more accurate analogy to the hood in the other thread before I had the chance to read your post. I do have knowledge of female anatomy. However, the hood doesn’t serve nearly the same sensory function and is much smaller in size, so it is very far from a perfect analogy either. But that doesn’t matter. What are your feelings on cutting off hoods? Or have you already preemptively shut down your thinking, as your last sentence implies?
WTF? :smack:
Is it really too much to ask of you to make arguments from some point of supportable factual evidence?
What are your feelings about cutting off earlobes or pinky toes?
So far your arguments are consistant with the intellectual equivalent of sticking your fingers in your ears and running around the room yelling “LA LA LA LA - I CAN’T HEAT YOU! LA LA LA!!!”
How much more mileage do you expect to get from that approach before you’ve been entirely dismissed as an ignorant loon? Because I can tell you, if that’s your objective, you’re doing fine. Keep it up. :rolleyes:
I saw a documentary in a Rural Soc. class (I think) in college where they took actual, real foreskin from adult circumcisions and exposed it to HIV. The inside has very thin skin and, when exposed to HIV, becomes infected very easily. The skin does not have to be irritated or already have an open wound like most skin does to allow the HIV to invade. I can’t say as how they got into the role of CD4 in infection. This actually isn’t new news, because I rememeber that documentary also showing a school in Kenya where little kids (boys and girls) being taught that circumcised males were less likely to die get AIDS. It was probably filmed 10 years ago. Regardless of your feelings about circumcision, it is a viable way (though not the best way) to reduce the risk of HIV transmission. In Africa, it is a hard sell because so many groups have circumcision or lack therof as part of their self-identification pattern. Some groups are actually changing decades and centuries of tribal tradition to try to protect their children from AIDS.
Depends I suppose if a country like recommends it over and above any other more proven remedy to cut costs 
South Africa recommends some sort of garlic mixture to sort AIDS/HIV infection from what I heard on the news.
Regrettably, yes, as history has shown.
If this hypothesis is correct, does it mean circumcision reduce the risk of other viral STDs as well, or just HIV?
I don’t really understand your argument here. As I said before, all of the skin on your body is keratinized. If keratinized epidermis were simply equivalent to callus, how would you identify a callus? It would just be “normal skin”.
BTW, “callous” is an adjective.
Exactly. Because (as I’m futilely trying to explain above) the squamous epithelium of the inner portions of the foreskin and the uncircumcised glans doesn’t keratinize, it’s more similar to a mucous membrane than it is like skin.
I think I saw the reference to the increased numbers of macrophages in some relatively recent journal article (American Journal of Clinical Pathology, maybe).
Well, according to a New England Journal of Medicine article from 2002, circumcised men seem to contract human papillomavirus (HPV) at a lower rate than uncircumcised men (odds ratio 0.37 in that study). Of course, HPV doesn’t use CD4 as a receptor, so there’s presumably a different protective effect at work there.
Here’s another study that looks at herpes, syphilis, and chancroid infection in circumcised men and suggests that circumcision may be protective in those situations as well (granted, Treponema pallidum and Hemophilus ducreyi are bacteria, not viruses).
Food for thought.
What the Fuck are you talking about? A “callus” (the proper medical spelling of the noun) is well defined. You were already given the definition. Need a cite?
1.a. A localized thickening and enlargement of the horny layer of the skin. Also called callosity.
b. The hard bony tissue that develops around the ends of a fractured bone during healing.
THERE IS NO CALLUS ON YOUR DICK!!! Or any man’s, that I’ve ever known. Kerantinization/=callus. My baby’s skin is all wonderfully soft and sensitive, and it’s kerantinized.
The clitoral hood is the homologous organ to the foreskin. It develops from the same in utero tissues, AFTER the nerve endings have formed. It is exactly and precisely the same as the foreskin. While it doesn’t have an inordinate number of nerve endings, neither does the foreskin - both of them cover the organ with the far greater number of nerve endings - the clitoris and the glans.
If studies consistently showed that cutting off the clitoral hood and allowing the clitoris to kerantinize reduced the transmission of HIV and AIDS by 60% without a great reduction of sensation or other sexual or health side effects, of course I would support the cutting off of the clitoral hood*. Why ever would you think I wouldn’t?
BECAUSE ALL YOUR ARGUMENTS ARE STRAW MEN, THAT’S WHY!
No one has said we should force men to get circumcised.
No one has said we should do it with dirty instruments.
No one has said we should act on this one study alone.
No one has said that genital surgery on women is anathema but genital surgery on men is a-ok.
I haven’t shut down my thinking one bit. I’m reading carefully, and following cites where given, and I’m swinging around to the circumcision is Not Evil side of the debate, partly because of good medical statistics on their side, but mostly because of utterly fallacious, emotional and ridiculous arguments on your side.
*And, by the way, “cutting off the clitoral hood” is not the same thing as Female Genital Mutilation. No one is simply cutting of the clitoral hood in a sterile manner. They’re scrapping off labia, cutting out clitorises and sewing shut vaginas, all without good medical research to back it up.