Wednesday, September 26, 2012

In Kenya: Circumcision Protects All From HIV, Except Luos...and Women


There are many anomalies in arguments claiming that mass male circumcision can be used to reduce HIV transmission. But in Kenya, the biggest anomaly relates to the Luo tribe; over 20% of Luos are already circumcised, yet HIV prevalence is almost the same among circumcised (16.4%) and uncircumcised men (17.3%). These figures were available to those who have been promoting the current Voluntary Medical Male Circumcision (VMMC) program, which has been going on for 4 years and reports that 450,000 men (though most of them are said to be boys) out of a target of 850,000 have already been circumcised, and the program has another 6 years to run.


Those promoting VMMC are not just feeding people the convenient bits of data, they are papering over the gaps in the data with hot air.

Even the randomized controlled trials did not exclude from their figures the people who were infected non-sexually. This is crucial, because VMMC assumes that almost every HIV positive person in Kenya was infected sexually and that the main risks HIV negative people face are sexual. The trials did not establish this, they simply assumed it. Therefore, proponents of VMMC are not in any position to make promises about protection against sexual HIV transmission; they don't even know what proportion of HIV transmission among participants in the randomized controlled trial were infected sexually, let alone in the population as a whole.

Far from being an shining beacon to the uncircumcised populations of high HIV prevalence African countries, the VMMC program in Kenya should serve as a horrific example of what can result from public health programs that are based on selective use of data and lies. There are billions of dollars behind this program, but the Luo people should not be participants in an experiment to which they did not give their consent, and for which the outcome was already known before the program started.


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