Circumcision to Fight HIV Transmission

Voluntary male circumcisions (VMMC) in high-risk areas reduce HIV acquisition among men by approximately 60%, for only about $6 per treatment. The evidence is strong enough that the treatment has gotten heavy hitters like the CDC, WHO, the Gates Foundation, and the White House (at least the last one …) onboard.

Kenya made it its long-term goal to circumcise 80% of its male population in 2008. In the first couple years, they circumcised almost 400,000 people. Since then, 13 African countries have followed suit, getting 3 million done from 2008 to 2012, and doubling from 2011 to 2012.

Image Credit: UN AIDS Global Report 2013


Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa.
Public Library of Science

 

Kenya’s 4-year VMMC target is to circumcise 860,000 (80%) of uncircumcised males aged 15–49 years by 2013. During 2008–2011, trained clinicians performed 391,383 VMMCs for HIV prevention in Kenya, of which 340,958 (87.1%) were conducted in 260 MOH sites supported by CDC-funded partners, from which the data were obtained
The CDC

 

“Providing men with information about male circumcision and HIV risk can encourage safer sexual behavior among uncircumcised men, and fears that information will lead to riskier behavior among circumcised men may be overstated. The 2008 information campaign led uncircumcised men to adopt safer sexual behavior one year after a short information session, suggesting that VMMC information can have longer-term effects on sexual behavior.”
Jameel Poverty Action Lab

 

While challenges persist in preventing new infections, opportunities to dramatically lower HIV incidence have never been more promising. In recent years, evidence has emerged that antiretroviral therapies can reduce the risk of HIV transmission by as much as 96%, voluntary medical male circumcision by approximately 60% […]
The UN

 

The number of those responding positively is below the ages of 18. Maybe this is due to peer pressure. Once school children are circumcised, they tend to influence others to undergo the procedure. I think there is need to teach everyone a lot about these programmes.
VOA Zimbabwe

The Dark History Behind the High Five

If you were born in or after the 1980s, you may take the “high five” for granted. I certainly did. But the high five has a much more recent (and sordid) history than you might think.

Despite several myths, the true origin of the high five is a spontaneous celebratory gesture from the charismatic baseball player Glenn Burke.

Burke adopted the high five as his personal greeting, high-fiving people all over the place for the rest of his life. A life that was made quite difficult afterward. Burke was gay, and in the late 1970s, that was trouble for professional sports. Homophobia led to an abrupt trade from the Dodgers to the lackluster Oakland As. The discrimination followed him there, and eventually forced Burke into retirement. His life spiraled out of control, leading to a drug habit. He died of complications related to HIV/AIDs in 1995. 

Meanwhile, the high five had been adopted as a symbol of gay pride, and as a promotional trademark of the Dodgers – Burke’s old teammates. As Burke’s life fell apart, the gesture that became his legacy took off. 

Photo Source Copyrighted, under fair use for visual identification of the person in question, at the top of his/her biographical article 


Burke, waiting on deck, thrust his hand enthusiastically over his head to greet his friend at the plate. Baker, not knowing what to do, smacked it. “His hand was up in the air, and he was arching way back,” says Baker, now 62 and managing the Reds. “So I reached up and hit his hand. It seemed like the thing to do.”
ESPN: History of the High Five

 

He couldn’t hold a job. He went broke. He did some time at San Quentin for grand theft. Then in 1993, he tested positive for HIV. He passed away on May 30, 1995, after a sharp and grisly decline. One obituary noted that, at the end, the man who invented the high five “could barely lift his arm.”
ESPN: History of the High Five

 

Podcast on Glenn Burke and his life from The Dollop.

How “Sugar Daddy Training” Saves Lives

The power imbalance and age imbalance in “sugar daddy” relationships – where a better-off older male has a sexual relationship with a young woman – are particularly bad for STD transmission rates and unplanned single-parent pregnancies.

The women don’t have the power in the relationship to demand safe sex, and the man is more likely to have multiple partners. A simple program implemented in Kenya, and since replicated elsewhere, lowered teenage pregnancies from relationships with adult men by more than half just by replacing existing abstinence training with training that specifically pointed out the dangers of going out with older men.

This is a big deal. And all it takes is telling teenagers at risk “hey, maybe date someone your own age.”

Image Source: By Adam Jones, Ph.D. (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)%5D, via Wikimedia Commons


All these types of asymmetries are associated with nonuse of condoms. Increasing women’s power within asymmetric sexual relationships could improve their ability to negotiate safer sexual behaviors, such as condom use.
http://www.jstor.org/stable/3649496?seq=1#page_scan_tab_contents

We use a randomized experiment to test whether and what information changes teenagers’ sexual behavior in Kenya. Providing information on the relative risk of HIV infection by partner’s age led to a 28 percent decrease in teen pregnancy, an objective proxy for the incidence of unprotected sex. Self-reported sexual behavior data suggests substitution away from older (riskier) partners and toward same-age partners. In contrast, the official abstinence-only HIV curriculum had no impact on teen pregnancy.
https://www.aeaweb.org/articles?id=10.1257/app.3.1.1

An information campaign that provided Kenyan teenagers in randomly selected schools with the information that HIV prevalence was much higher among adult men and their partners than among teenage boys led to a 65% decrease in the incidence of pregnancies by adult partners among teenage girls in the treatment group relative to the comparison. This suggests a large reduction in the incidence of unprotected cross-generational sex. The information campaign did not increase pregnancies among teenage couples.
https://mpra.ub.uni-muenchen.de/248/1/MPRA_paper_248.pdf

It shows that 43 percent of men over 40 years of age in Botswana carry HIV, far higher than the 4 to 5 percent infection rate of men in their teens and early 20s.
Jaws drop. “Oh my gosh!” blurts out one girl.
http://www.npr.org/sections/goatsandsoda/2015/07/30/419565650/how-to-convince-teen-girls-to-stay-away-from-sugar-daddies