A caveat on the caveat.

Spot the obvious obfuscation in this New York Times article:

While circumcision may help protect a man from catching the AIDS virus, men who are already infected and are then circumcised should refrain from sex until they have fully healed, researchers said last week.

That’s not the full story, is it? Is the Times suggesting that circumcised men, once healed, can then engage in risky, unprotected sex after the healing process finishes? I doubt it. I fully expect the Times to mention condoms at some point.

Further down in the article, it does, so the relevant question pops up. How effective are condoms at preventing HIV infection as compared to circumcision? Reasonable estimates place the success of condoms at 80-90% and above, when used correctly. Why not include this in the opening paragraph? Does it skew opinion too far to the rational understanding that there are better methods of HIV prevention than circumcision? (We haven’t even addressed the serious ethical questions involved.)

It’s useful to consider what the Times says on condoms:

In any case, Dr. Wawer said, men should practice abstinence or fidelity, and use condoms. All the men in the study, including 5,000 who were not infected when they were recruited, were given that advice and free condoms. But many clearly did not follow the recommendations.

Three studies in Africa in the last year have shown that circumcision cuts a man’s chances of catching the virus by 50 percent or more. If an AIDS vaccine that worked that well had just been invented, “the world would be jumping for joy,” Dr. Wawer said.

We already have a tool that reduces a man’s chances of catching the virus by significantly more than 50 percent. Yet, no one is jumping up and down. Instead, we get the condescending reminder of what civilized people are supposed to know about Africans. “Clearly” men are not following that advice. (That’s not what the Times wrote last April.) So start chopping. That’s amateurish and insulting.

Now note the emphasis placed in these two paragraphs:

Women who had sex with recently circumcised men who had not waited about four weeks to heal seemed to have a slightly higher risk of catching the virus from them, according to scientists conducting a circumcision trial in Rakai, Uganda. …

The researchers emphasized that their data were “very preliminary” and based on only 124 couples followed for only six months out of a study meant to last two years. They released the findings, they said, only because the World Health Organization was writing guidelines for circumcision in African countries with skyrocketing AIDS rates, and they felt obligated to raise the alarm about the risks of sex before healing.

I’m okay with skepticism, even when it makes it harder for me. I want to succeed in convincing people that circumcision is unnecessary and unacceptable, but lying or tweaking the truth won’t help. I’m even frustrated now when reports on this story leave out the fact that the newly circumcised men were already HIV-positive, which is where the risk to women ultimately comes from. There’s no reason to hide anything, helpful or harmful.

Excess skepticism, though, seems unjustified. The results, however preliminary, are common sense. A wound isn’t healed? Blood will be involved. HIV-tainted blood. I don’t understand the over-the-top caution on these findings. Again, is anyone going to suggest that the couples in this study shouldn’t use condoms?

The larger lesson from those paragraphs reveals a lot. How is this fact pattern any different than what media outlets have claimed since December (and before)? None of that skepticism existed when the studies showed a lower risk after a short time frame in studies designed to last two years, yet these crucial bits appear now in force. The overall results surrounding circumcision and HIV are not concrete to the point that we should just say circumcision is “good” and set aside the significant ethical concerns. This shows a bias that doesn’t address the scope of the topic. Clearly.

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