Remember: when in doubt, blame Belgium and Britain.
To be fair, the British acquitted themselves much better than the French and Belgians in Africa.
Hah, despite better public relations, the British still did an enormous amount of shit in places like Uganda - I'd really dispute the 'much' in your statement. The reason former British colonies in Africa have done slightly better post-colonialism is that Britain cherry picked the most economically productive areas in the first place.
Yeah, Botswana is one of those "wait, how are you still in one piece?" mysteries. Although it is worst hit by the HIV epidemic.
What mystery? Near mono-ethnic, that mono-ethnicity doesn't have a arsehole culture, a fertile and populated area that is much more compact than the whole country and easy to make infrastructure for, good natural resources but not ones that need foreign expertise, though most of it is desert the fertile bits are more suitable for west agricultural technology than most of Africa, right next to the continents largest economy in south Africa...
Botswana seems a fairly obvious set of good conditions that led to its success.
Botswana is far from monoethnic, and being landlocked and a heavy disease burden are heavy strikes. Dependence on diamond exports and the frankly not generally altruistic De Beers company is also significant.
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HonkHonk is this poster.Registered User, __BANNED USERSregular
Botswana is far from monoethnic, and being landlocked and a heavy disease burden are heavy strikes. Dependence on diamond exports and the frankly not generally altruistic De Beers company is also significant.
Its 80% Tswana, more than enough to ensure an unchallenged and relaxed lock on power. At least unlike many places the government is an actual partner to DeBeers rather than client. Whilst future reliance on diamonds may not be the greatest idea its providing wealth now.
I'm just responding to the 'mystery' part of your statement, Botswana's success seems pretty explicable.
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zepherinRussian warship, go fuck yourselfRegistered Userregular
god if there is any group I want to try for warcrimes DeBeers is right on the list.
Africa: Got dealt a shitty hand, and then found every conceivable way to misplay it.
Yes. They collectively went all-in on 7/2 off-suit with aces-full-of-kings on the table.
And the dealer is looking at them after cards are shown like, "Man, do you even know what the fuck game this is?"
And then Africa is all, "Hells yes I do," and then opens fire on the whole table with secondhand machine guns bought from China.
The metaphor works better if the other players are their fellow Africans... since instablity in Africa mainly only seems to be noticed in the rest of the world when it affects commodity prices.
Anyway, in the War on Women thread, zepherin said that people in Africa should decrease their breeding, and it went downhill from there.
Originally I said that advances in birth control would end the abortion debate by almost eliminating unplanned pregnancies and that it would be applicable to the third world. Then various others before I said that Africa would be better off if they decreased breeding.
The last time we tried to interfere with birth rates on other continents, it led to a nasty gender ratio imbalance. I don't think we should do it again.
Also, saying "let's reduce the birth rate" is targeting the symptom, not the cause.
You know what the number 1 way to reduce birth rate is? Education of women. In every part of the world where female education and formal workforce participation goes up, the birth rate starts dropping. The trend accelerates with an increasing standard of living (median GDP per citizen going up, as opposed to average).
Sure, there are things we should obviously interfere with, like trying to discredit the Catholic church's inner city efforts, but even stuff like that is irrelevant compared to the vast importance of getting people, specifically women, educated and working (for actual pay as opposed to household chores).
This is all absolutely right, but it goes even further. It's not just educating women. It is giving women rights, equal rights, that could one day allow them to be educated. You don't even have to get to the education stage, that's just an inevitable outcome of already in place doctrine.
In every case where women are given rights to vote, to own homes and contribute to a community, rights of law and justice, birth rates plummet. That's even before these 'freed' women are educated on things such as birth control or reproduction. You go even further and teach them general things like maths, science and such like, and you basically get a first world population standard.
You want to talk about Africa, you go to the guy who knows everything:
The problem is not just with dictators and corrupt governments. It's with our own perceptions.
Look at the title of this thread. The State of Africa. The notion that such a broad and diverse continent could have a coherent state is ludicrous. You wouldn't say 'The State of Asia' or 'The State of The Americas'. Africa is a massive continent with every possible combination of government, religion and society. Perhaps before we start trying to solve their problems, we first solve ours. The generalization of the third world does as much harm as any disease or famine.
Then you're simply mistaken. We have more than enough aid resources to mitigate famines and HIV epidemics, and in the African nations with open borders and strong UN relations, we have done just that. Heck, America has three times the HIV rate as Somalia, and double that of Libya. These are African nations, do you honestly believe it is fair, or effective, for them to be grouped in with Uganda or Nigeria under the catch-all phrase of 'Africa'. They are worlds apart and do not require the same solutions, because they face massively different problems. And painting the entire continent with the same brush means that countries that do not need aid receive it, and those who need it most get less as a result. And we, the benevolent first world as we like to see ourselves, squander and waste resources because we simply don't take the time to analyze the problem in detail. We think we can just carpet bomb the continent in aid and that will solve their problems. This is not the case. It requires a surgical strike, and every day that we lazily don't bother to do so, it does harm to the people that live there. More so than any famine ever could.
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Captain Marcusnow arrives the hour of actionRegistered Userregular
every day that we lazily don't bother to do so, it does harm to the people that live there. More so than any famine ever could.
Really? Really? You know, the people living there don't give one shit about whether they are generalized or lumped in with the rest of Africa. Why? Because they are having to pick which child they want to keep because they only have enough food for one person. Now, you can make the argument that blanketing the continent in aid encourages corruption, laziness, and cripples its economies, and I would agree with you. But as far as they people living there goes, I'm pretty sure they (and the rest of the world) care about famines and HIV a lot more.
If you even bothered to read your cherry picked quotes, you'd realize the trials were stopped because circumcision proved to be so effective that it was unethical to continue to have a non-circumcised control group.
Totes refuted the idea with your well though out post though, congrats.
Right. "Differing conclusions" means that circumcision really is effective? Or maybe ""insufficient evidence that male circumcision protects against HIV infection or other STIs" means circumcision is effective? Oh wait, no it doesn't. It shows that there is no connection between lower HIV rates and circumcision.
And now figures in the same table is unrelated? Seriously bubba...
If you even bothered to read your cherry picked quotes, you'd realize the trials were stopped because circumcision proved to be so effective that it was unethical to continue to have a non-circumcised control group.
Totes refuted the idea with your well though out post though, congrats.
Right. "Differing conclusions" means that circumcision really is effective? Or maybe ""insufficient evidence that male circumcision protects against HIV infection or other STIs" means circumcision is effective? Oh wait, no it doesn't. It shows that there is no connection between lower HIV rates and circumcision.
And now figures in the same table is unrelated? Seriously bubba...
But if circumcision is so effective (as you claim) why is Europe rocking less than half the infection rate of the US despite far less circumcisions taking place? Oh wait, that refutes your argument so we shouldn't pay attention to that study.
There are also differing conclusions about whether global climate change is real, or whether smoking cigarettes contributes to cancer. That doesn't mean the dissenting opinions necessarily have any value, or that the majority conclusions are infallibly correct. However, statistical support via rigorous peer-reviewed studies combined with widespread acceptance by leading health practitioners and organizations tend to lend a bit of credence to the hypothesis.
Now, I know you're just quoting off a wikipedia page, but if you went ahead and read any of those studies (secondhand studies, mind you) that you're quoting you'd realize that your characterization of their conclusions are inaccurate. For instance, the analysis that states "insufficient evidence that male circumcision protects against HIV infection or other STIs" is strictly in regard to homosexual men practicing unprotected anal sex. Which is a conclusion that is generally supported in first-hand studies.
I don't know if a foreskin ran over your dog when you were a kid or what, but good policy should take into account the best-known information, not "gut feelings" or poorly-constructed wikipedia pages.
I also didn't say the data points were unrelated to each other, just not immediately comparable without taking other contributing factors into account, and unrelated to the conclusion you were trying to draw from them.
adytum on
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surrealitychecklonely, but not unloveddreaming of faulty keys and latchesRegistered Userregular
The British on Africa? Yeah, read Caroline Elkins' 2006 book about Kenya (Imperial Reckoning, IIRC).
While the British were not full of puppies and sunshine, I'd be a little bit careful about reading that book and taking everything it says as gospel. And even if one pretends that even her ludicrously inflated casualty numbers were true, one merely needs to take the merest peek at the millions upon millions of deaths the Belgians were responsible for to see that while the British could be cunts, they were nowhere near as bad.
There are also differing conclusions about whether global climate change is real, or whether smoking cigarettes contributes to cancer. That doesn't mean the dissenting opinions necessarily have any value, or that the majority conclusions are infallibly correct. However, statistical support via rigorous peer-reviewed studies combined with widespread acceptance by the leading health practitioners and organizations tend to lend a bit of credence to the hypothesis.
Now, I know you're just quoting off a wikipedia page, but if you went ahead and read any of those studies (secondhand studies, mind you) that you're quoting you'd realize that your characterization of their conclusions are inaccurate. For instance, the analysis that states "insufficient evidence that male circumcision protects against HIV infection or other STIs" is strictly in regard to homosexual men practicing unprotected anal sex. Which is a conclusion that is generally supported in first-hand studies.
I don't know if a foreskin ran over your dog when you were a kid or what, but good policy should take into account the best-known information, not "gut feelings" or poorly-constructed wikipedia pages.
I also didn't say the data points were unrelated to each other, just not immediately comparable without taking other contributing factors into account, and unrelated to the conclusion you were trying to draw from them.
Yes, I did read them. And sorry, in my world "inconclusive results" means there is not a proven link, I don't know why your world would be any different.
And yes, my entire point is that there are other factors that drive HIV infection rates than circumcision as circumcision have no shown effect, and the studies that show it does are under questioning or are inconclusive when combined into meta studies. I find it amusing that when I show numbers that disproves the effectiveness of circumcision my numbers are useless due to other contributing factors, but the studies that you like does not.
And yes, public policy should be based on facts and not gut feeling. Which is why the whole circumcision protects from HIV stance should be dialed down as it is gut based.
I doubt you've actually read them, since you fundamentally misunderstand their conclusions. You've also repeatedly quoted research that contradicts the point you're trying to make.
The WHO disagrees with you. The UN disagrees with you. The CDC disagrees with you.
But you keep proving your points based on a poorly-worded wikipedia article you rebel you.
The British on Africa? Yeah, read Caroline Elkins' 2006 book about Kenya (Imperial Reckoning, IIRC).
While the British were not full of puppies and sunshine, I'd be a little bit careful about reading that book and taking everything it says as gospel. And even if one pretends that even her ludicrously inflated casualty numbers were true, one merely needs to take the merest peek at the millions upon millions of deaths the Belgians were responsible for to see that while the British could be cunts, they were nowhere near as bad.
Yeah. With the exception of Tanzania, the British set up colonies to maximize self-sufficiency to minimize the amount of effort expended in getting the resources over the long haul. By contrast, the French treated African holdings as an extension of the French state and pressed French culture on the inhabitants without setting up local administrations, the Germans committed genocide to get the local populations out of the way, Belgian Africa was a giant forced labour camp, and Italian Africa was outfitted with local governments just as effective as the ruling nation, which is to say they were total clusterfucks.
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surrealitychecklonely, but not unloveddreaming of faulty keys and latchesRegistered Userregular
I mean really they should be thankful... wait I'm stealing Niall Ferguson's lines again...
I doubt you've actually read them, since you fundamentally misunderstand their conclusions. You've also repeatedly quoted research that contradicts the point you're trying to make.
The WHO disagrees with you. The UN disagrees with you. The CDC disagrees with you.
But you keep proving your points based on a poorly-worded wikipedia article you rebel you.
So "inconclusive" now means "definite proof" then? In that case I definitely misread them. Tell me, does up now mean down? Does left mean right? I apparently missed a large shift in the English language.
And a lower infection rate in uncircumcised regions compared to similar circumcised regions contradicts my point? Sure.
Of course WHO and the UN disagrees with me, because that is policy based on gut feeling. What they have is tons of research showing no negative or positive effects, and a few questionable ones showing a positive effect. Yeah, I wonder what their stance will be for a dangerous and uncontrolled disease. It couldn't possibly be to support anything that have no negative effects and might possibly, if you squint, pretend, and pray quite a bit, have some positive effect mostly due to unforeseen causation.
Which still eaves us with the fact that their numbers agree with me. But of course, as you have stated, those numbers should just be thrown out because we should have policy based on facts and not gut feeling. And we all know that numbers are gut feelings... right? since inconclusive means definite proof and all.
But you keep proving your point by changing the meaning of words. I have to admit that to be quite rebellious.
At this point, should we go back to discuss the state of Africa?
I didn't realize that there was a circumcision variation of anti-vaxxers. If you honestly cannot be bothered to read or comprehend the medical journals and statistics that you're misunderstanding and misquoting, then no amount of pointing out where you're incorrect will help. It's clear that you have a strong opinion, but it's an opinion not based on any observed facts and rooted in some warped anti-science ideology where you distort facts to fit the conclusion you want to prove.
Yes, the WHO and UN are both in on a big conspiracy to overstate the efficacy of circumcision in preventing the transmission of HIV during heterosexual intercourse. Clearly they have been infiltrated by the Moyle-Industrial Complex.
I didn't realize that there was a circumcision variation of anti-vaxxers. If you honestly cannot be bothered to read or comprehend the medical journals and statistics that you're misunderstanding and misquoting, then no amount of pointing out where you're incorrect will help. It's clear that you have a strong opinion, but it's an opinion not based on any observed facts and rooted in some warped anti-science ideology where you distort facts to fit the conclusion you want to prove.
Yes, the WHO and UN are both in on a big conspiracy to overstate the efficacy of circumcision in preventing the transmission of HIV during heterosexual intercourse. Clearly they have been infiltrated by the Moyle-Industrial Complex.
Keep that crazy train going.
So going round in circles is all you got then, regurgitation the same points over and over again and assigning me opinions that I have never uttered? Again, please tell me when the meaning of "inconclusive" became "definite scientific proof". Because that is some serious "crazy train" that needs explaining. I would say it is especially important that you prove this point since it is the only point you apparently got.
I have posted numbers that support my point that the link between HIV infection and circumcision is spurious at best, I have also shown that surveys support this opinion. Of course you claim they don't apply because they don't fit whatever gut feeling you have. According to you the only observed "facts" we should allow and follow are those currently under challenge for being inaccurate. But yeah, I am the one with the opinion not based on observed facts.
And you might want to read up on how policies are created. I will give you a hint: Doing something is better than doing nothing, makes people think you are making progress.
EDIT: But if it is so clear-cut as you claim, why aren't doctors worldwide pushing for circumcisions being made like they push vaccinations? Not even in the US is the official claim that circumcision should be made for health benefits. Hmm... it is like there is something about your opinion that just doesn't add up...
You haven't posted any numbers except the unrelated ones you pulled out of a report that are without context and aren't applicable to the argument you're trying to make. There's nothing to respond to; you haven't made a substantive argument or used numbers that make sense for what you're arguing. Find an academic analysis that quotes and discusses those figures and I'll be happy to actually take a look at them. But you won't, since they're irrelevant as presented no matter how they're twisted.
Further, you're referencing a poorly-edited wikipedia article and misunderstanding what you're quoting. I even pointed out where your quotes are misattributed or out of context. That gets you an F for effort. If you can't be bothered to find substantive support for your position, then it's not worth the time to do so in reply.
It's true that there's not an iron-clad link, and further investigation is required. But what research has been done is not junk science, and most of the critiques that you point to as disputing the data do not involve original clinical trials, but rather surveys or reviews that are non-scientific. The meta-analysis generally agree that there is a positive link, but that further study is required. Except, that is, in the case of MSM, for which it is widely regarded as ineffectual. MSM, of course, represents a minority of transmissions, and does not refute the usefulness with regard to heterosexual intercourse.
It is certainly not the only method to combat HIV/AIDS, nor is it necessarily most effective or the most practical. And like all methods, it is best used in combination with other avenues of treatment and prevention. In all likelihood it will not see widespread use- regardless of its merits or lack thereof- because of ideologically-based dissent that ignores or discourages further study. But the research done up to this point is solid, and it's obnoxious to dismiss it based on your ideology. Which, in this case, makes it abundantly clear that you are not arguing in good faith due to your beliefs on the matter. You are either ignorant of the research on the subject, or intentionally misrepresenting it. In either case, it's not possible to have a meaningful discussion with you on the matter, and I will consider it dropped.
You haven't posted any numbers except the unrelated ones you pulled out of a report that are without context and aren't applicable to the argument you're trying to make. There's nothing to respond to; you haven't made a substantive argument or used numbers that make sense for what you're arguing. Find an academic analysis that quotes and discusses those figures and I'll be happy to actually take a look at them. But you won't, since they're irrelevant as presented no matter how they're twisted.
Further, you're referencing a poorly-edited wikipedia article and misunderstanding what you're quoting. I even pointed out where your quotes are misattributed or out of context. That gets you an F for effort. If you can't be bothered to find substantive support for your position, then it's not worth the time to do so in reply.
It's true that there's not an iron-clad link, and further investigation is required. But what research has been done is not junk science, and most of the critiques that you point to as disputing the data do not involve original clinical trials, but rather surveys or reviews that are non-scientific. The meta-analysis generally agree that there is a positive link, but that further study is required. Except, that is, in the case of MSM, for which it is widely regarded as ineffectual. MSM, of course, represents a minority of transmissions, and does not refute the usefulness with regard to heterosexual intercourse.
It is certainly not the only method to combat HIV/AIDS, nor is it necessarily most effective or the most practical. And like all methods, it is best used in combination with other avenues of treatment and prevention. In all likelihood it will not see widespread use- regardless of its merits or lack thereof- because of ideologically-based dissent that ignores or discourages further study. But the research done up to this point is solid, and it's obnoxious to dismiss it based on your ideology. Which, in this case, makes it abundantly clear that you are not arguing in good faith due to your beliefs on the matter. You are either ignorant of the research on the subject, or intentionally misrepresenting it. In either case, it's not possible to have a meaningful discussion with you on the matter, and I will consider it dropped.
And then there is you who have provided absolutely nothing to support your point, instead relaying on a metaphorical fingers-in-ears-shouting-lalala-I-can't-hear-you every time I show support for mine. Seriously, all you do is rephrase the same old accusations of "misquoting" (I use direct quotes) and "misunderstanding" (because "inconclusive" and "not scientifically sound" is apparently very ambiguous) and claiming that everything I post is "unrelated" and "out of context" as soon as it supports my point.
Btw, my point remains that it has not been proven that there is a link. A statement you even agree with. Which leads me to question why you are arguing in the first place. And no, "inconclusive" does not mean "yes we found something but need to look further". Because, unless the you can prove that the meaning of the word have changed, finding a positive link is not an inconclusive result. So I guess in this situation we have a direct quote supporting my point, and a paraphrasing supporting yours.
Again: A lot of research says it is inconclusive and no link can be established (funny how there is no challenges to those findings, isn't it?). The articles saying there is an established link are based on clinical studies now under challenge for being dishonest and originally posting misleading results. So yes, I read the same articles you did. The difference seems to be that when you found what you wanted to find you stopped researching, while I kept on reading. Which is why you blindly believe in surveys with a shown sampling bias (aka not solid science) while I don't.
So yeah, sorry, still no real proof that circumcision lowers your risk of infection. Still numbers that show that the procedure is ineffectual in this matter, and numbers that show that in regions with similar social setups and culture, the circumcision region draw the higher infection rate. And no, blindly claiming these numbers to be "out of context" or "unrelated" is not an argument, and neither is saying that any numbers not submitted in a format you approve of are "irrelevant".
Urcbub on
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JuliusCaptain of Serenityon my shipRegistered Userregular
Yes, the WHO and UN are both in on a big conspiracy to overstate the efficacy of circumcision in preventing the transmission of HIV during heterosexual intercourse. Clearly they have been infiltrated by the Moyle-Industrial Complex.
The WHO is not a magical organization, they can be wrong.
More importantly though, they are advocating the precautionary principle in a weird way. Circumcision is unlikely to increase the likelihood of HIV-infection so they're going with not discouraging it.
But they also say cellphones might cause cancer so don't use them. Which is just silly.
Just to be pedantic it wasn't Britain who messed up Rwanda it was Belgium.
Wasn't Belgium the one who fucked up the Congo with Leopold 2?
Rwanda too. Adam Curtis discusses it at some length in his documentary All watched over by machines of loving grace(third part).
Remember: when in doubt, blame Belgium and Britain. I'm still figuring out how they were involved in Iran/Contra and the current economy, but they were. They were.
Follow the trail to the Anglo-Persian Oil Company.
See what I did there? It's entirely possible that APOC had nothing to do with Iran-Contra, but it sounds pretty convincing because of how fucked up APOC would become.
I, for one, like to blame the Germans. They have gotten entirely too scott-free for the shit they pulled at the turn of the century in Africa because of the fact that it happened in Africa.
So, to elaborate--when it doubt: blame Belgium, Britain, and Germany.
Ethiopia shouldn't be a failed state. They have an enormous amount of arable land. They just need agricultural reform, a half-assed level of development, and they would be a huge food exporter very quickly. So the question there is who has a boot on their throat preventing this, and why.
Ethiopia shouldn't be a failed state. They have an enormous amount of arable land. They just need agricultural reform, a half-assed level of development, and they would be a huge food exporter very quickly. So the question there is who has a boot on their throat preventing this, and why.
Ethiopia's government was badly warped by being a Cold War proxy between the Soviets and the U.S. They liked to play themselves as the anti-colonial superstars of Africa - uncolonized and only African nation to beat a modern European army in the field (Italy, 1935).
The result of this was dictatorial rulers who like to pretend that they were putting one over on the East and West, while the Soviets and U.S. turned their country and neighboring Eritrea and Somalia on each other in proxy wars, including the very silly Ogaden War. The nation - leadership and insurgencies - also perfected the use of famine as a political weapon.
Their willingness to ratchet the wars up far beyond what they could economically sustain--the Eritrea-Ethiopia War is an example of this--hasn't helped. Eritrea and Ethiopia were basically having high technology wars (from a worldwide aspect), with mass artillery, air strikes, and combined arms.
These sort of things regularly bankrupt nations that have had colonies to exploit for decades (or more).
Male circumcision is associated with a significantly reduced risk of HIV infection among men in sub-Saharan Africa, particularly those at high risk of HIV. These results suggest that consideration should be given to the acceptability and feasibility of providing safe services for male circumcision as an additional HIV prevention strategy in areas of Africa where men are not traditionally circumcised.
The results from this re-analysis thus support the contention that male circumcision may offer protection against HIV infection, particularly in high-risk groups where genital ulcers and other STDs 'drive' the HIV epidemic.
And that's just two of the articles cited by wikipedia. Unless by challenges you mean ideologically-based non-scientific arguments. Only one side of the debate uses those, and it's unsurprising that such a "challenge" exists, however meritless it may be.
Moreover, the meta-analysis cited by wikipedia that concludes it's ineffective is by far the oldest review, having been published in 1999. The more recent analyses- which take into account the substantial research conducted since 1999- contradict its conclusions.
The articles saying there is an established link are based on clinical studies now under challenge for being dishonest and originally posting misleading results.
Citation needed. Unless you mean the trials that were closed early because the treatment was so effective it was considered unethical to continue to have a control group. In which case, citation still needed.
So yes, I read the same articles you did. The difference seems to be that when you found what you wanted to find you stopped researching, while I kept on reading. Which is why you blindly believe in surveys with a shown sampling bias (aka not solid science) while I don't.
I doubt you actually read any of the literature because- again- you exhibit a fundamental lack of understanding.
So yeah, sorry, still no real proof that circumcision lowers your risk of infection. Still numbers that show that the procedure is ineffectual in this matter, and numbers that show that in regions with similar social setups and culture, the circumcision region draw the higher infection rate. And no, blindly claiming these numbers to be "out of context" or "unrelated" is not an argument, and neither is saying that any numbers not submitted in a format you approve of are "irrelevant".
The numbers from trials and direct observation don't actually show that, which you would know if you'd read and understood any of the literature. The only numbers you've shown that "support your conclusions" are infection percentages across regions of the world that have huge discrepancies in attitudes towards reproductive rights, sexual education, etc. It doesn't matter how you try and twist the words around, gross infection rates on different continents are not directly comparable and most certainly do not reveal anything about the efficacy of circumcision. And, again, non-scientific, non-observational surveys- which make up the bulk of the dissenting data- are nigh-useless in comparison to actual clinical observation and research. So unless you have some actual, meaningful, non-wikipedia-article references to make..?
Here's some more cites- and only those cited by the wikipedia article that you refuse to look beyond. It's really not worth the time to pull up more in-depth information from journals since your argument still consists of cites from a wikipedia article- which still don't count as actual research or arguments, mind you.
There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months. Incidence of adverse events is very low, indicating that male circumcision, when conducted under these conditions, is a safe procedure. Inclusion of male circumcision into current HIV prevention measures guidelines is warranted, with further research required to assess the feasibility, desirability, and cost-effectiveness of implementing the procedure within local contexts.
There were 20 HIV infections (incidence rate = 0.85 per 100 person-years) in the intervention group and 49 (2.1 per 100 person-years) in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001). This RR corresponds to a protection of 60% (95% CI: 32%-76%).
The two year HIV incidence was 2.1% (95% CI 1.2-3.0) in the circumcision group and 4.2% (3.0-5.4) in the control group (p=0.0065); the relative risk of HIV infection in circumcised men was 0.47 (0.28-0.78), which corresponds to a reduction in the risk of acquiring an HIV infection of 53% (22-72).
In the modified intention-to-treat analysis, HIV incidence over 24 months was 0.66 cases per 100 person-years in the intervention group and 1.33 cases per 100 person-years in the control group (estimated efficacy of intervention 51%, 95% CI 16-72; p=0.006). The as-treated efficacy was 55% (95% CI 22-75; p=0.002); efficacy from the Kaplan-Meier time-to-HIV-detection as-treated analysis was 60% (30-77; p=0.003).
@Julius - Of course they're not magical, and it's silly to think that such organizations are without fault. However, it's a hugely contentious issue, and their half-in stance already generated a ton of heat from those with an ideology to push. There's also pushback on further research- not because the current research shows no promise, but again because of ideology being pursued over scholarly research. The reasonable view is that it requires more research and understanding of the sociocultural and biological factors involved. The view that's bullied about is that because there is not a 100%, iron-clad and undeniable positive link based on the small amount of direct research that's actually been able to take place, that further research and understanding is unwarranted. Which is unfortunate.
I don't have skin in the game, I just hate to see research that might have a meaningful beneficial impact on the world sidelined because it doesn't fit in with someone's worldview.
I'm not going to pound my head against the wall anymore. It's impossible to have a conversation with someone that does not have even a cursory understanding of the subject matter, would rather score ideological points than have a debate, and cites wikipedia and out-of-context numbers as sources and arguments. If you really care, start a thread for it. Maybe someone will be willing to continue the conversation with you.
Worth noting that Ethiopia has already returned to being a regional economic force
as for what kept Ethiopia poor - reformist monarchy got tied up by conservatives in the church and local power bases, communism became popular, Soviets supported a communist revolution in 1977 and Ethiopia would remain communist until 1991. The wars with Eritea and the purging of suspected enemies probably didn't help.
Worth noting that Ethiopia has already returned to being a regional economic force
as for what kept Ethiopia poor - reformist monarchy got tied up by conservatives in the church and local power bases, communism became popular, Soviets supported a communist revolution in 1977 and Ethiopia would remain communist until 1991. The wars with Eritea and the purging of suspected enemies probably didn't help.
There's also the fact that the last (and first) time anyone in the US heard about Ethiopia was a short period of shitholedom in the 1990's.
Worth noting that Ethiopia has already returned to being a regional economic force
as for what kept Ethiopia poor - reformist monarchy got tied up by conservatives in the church and local power bases, communism became popular, Soviets supported a communist revolution in 1977 and Ethiopia would remain communist until 1991. The wars with Eritea and the purging of suspected enemies probably didn't help.
There's also the fact that the last (and first) time anyone in the US heard about Ethiopia was a short period of shitholedom in the 1990's.
African states have a pretty wide body of economic and industrial supporters/backers, not limited to the United States (Ethiopia is a good demonstration of that). In any case, regardless of who, the outcomes have hardly been stellar.
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Hah, despite better public relations, the British still did an enormous amount of shit in places like Uganda - I'd really dispute the 'much' in your statement. The reason former British colonies in Africa have done slightly better post-colonialism is that Britain cherry picked the most economically productive areas in the first place.
What mystery? Near mono-ethnic, that mono-ethnicity doesn't have a arsehole culture, a fertile and populated area that is much more compact than the whole country and easy to make infrastructure for, good natural resources but not ones that need foreign expertise, though most of it is desert the fertile bits are more suitable for west agricultural technology than most of Africa, right next to the continents largest economy in south Africa...
Botswana seems a fairly obvious set of good conditions that led to its success.
Its 80% Tswana, more than enough to ensure an unchallenged and relaxed lock on power. At least unlike many places the government is an actual partner to DeBeers rather than client. Whilst future reliance on diamonds may not be the greatest idea its providing wealth now.
I'm just responding to the 'mystery' part of your statement, Botswana's success seems pretty explicable.
Yes. They collectively went all-in on 7/2 off-suit with aces-full-of-kings on the table.
And the dealer is looking at them after cards are shown like, "Man, do you even know what the fuck game this is?"
And then Africa is all, "Hells yes I do," and then opens fire on the whole table with secondhand machine guns bought from China.
The metaphor works better if the other players are their fellow Africans... since instablity in Africa mainly only seems to be noticed in the rest of the world when it affects commodity prices.
This is all absolutely right, but it goes even further. It's not just educating women. It is giving women rights, equal rights, that could one day allow them to be educated. You don't even have to get to the education stage, that's just an inevitable outcome of already in place doctrine.
In every case where women are given rights to vote, to own homes and contribute to a community, rights of law and justice, birth rates plummet. That's even before these 'freed' women are educated on things such as birth control or reproduction. You go even further and teach them general things like maths, science and such like, and you basically get a first world population standard.
You want to talk about Africa, you go to the guy who knows everything:
The problem is not just with dictators and corrupt governments. It's with our own perceptions.
Look at the title of this thread. The State of Africa. The notion that such a broad and diverse continent could have a coherent state is ludicrous. You wouldn't say 'The State of Asia' or 'The State of The Americas'. Africa is a massive continent with every possible combination of government, religion and society. Perhaps before we start trying to solve their problems, we first solve ours. The generalization of the third world does as much harm as any disease or famine.
Really? Really? You know, the people living there don't give one shit about whether they are generalized or lumped in with the rest of Africa. Why? Because they are having to pick which child they want to keep because they only have enough food for one person. Now, you can make the argument that blanketing the continent in aid encourages corruption, laziness, and cripples its economies, and I would agree with you. But as far as they people living there goes, I'm pretty sure they (and the rest of the world) care about famines and HIV a lot more.
Famine in the News:
Famine in Somalia still continuing, despite its "open borders"
Looks like we don't have enough aid resources after all
Generalizing Africa in the News:
*crickets*
Right. "Differing conclusions" means that circumcision really is effective? Or maybe ""insufficient evidence that male circumcision protects against HIV infection or other STIs" means circumcision is effective? Oh wait, no it doesn't. It shows that there is no connection between lower HIV rates and circumcision.
And now figures in the same table is unrelated? Seriously bubba...
Yes, btw, three quotes in the first four paragraphs is "cherry picking". While as you provide nothing
Now, I know you're just quoting off a wikipedia page, but if you went ahead and read any of those studies (secondhand studies, mind you) that you're quoting you'd realize that your characterization of their conclusions are inaccurate. For instance, the analysis that states "insufficient evidence that male circumcision protects against HIV infection or other STIs" is strictly in regard to homosexual men practicing unprotected anal sex. Which is a conclusion that is generally supported in first-hand studies.
I don't know if a foreskin ran over your dog when you were a kid or what, but good policy should take into account the best-known information, not "gut feelings" or poorly-constructed wikipedia pages.
I also didn't say the data points were unrelated to each other, just not immediately comparable without taking other contributing factors into account, and unrelated to the conclusion you were trying to draw from them.
While the British were not full of puppies and sunshine, I'd be a little bit careful about reading that book and taking everything it says as gospel. And even if one pretends that even her ludicrously inflated casualty numbers were true, one merely needs to take the merest peek at the millions upon millions of deaths the Belgians were responsible for to see that while the British could be cunts, they were nowhere near as bad.
Yes, I did read them. And sorry, in my world "inconclusive results" means there is not a proven link, I don't know why your world would be any different.
And yes, my entire point is that there are other factors that drive HIV infection rates than circumcision as circumcision have no shown effect, and the studies that show it does are under questioning or are inconclusive when combined into meta studies. I find it amusing that when I show numbers that disproves the effectiveness of circumcision my numbers are useless due to other contributing factors, but the studies that you like does not.
And yes, public policy should be based on facts and not gut feeling. Which is why the whole circumcision protects from HIV stance should be dialed down as it is gut based.
The WHO disagrees with you. The UN disagrees with you. The CDC disagrees with you.
But you keep proving your points based on a poorly-worded wikipedia article you rebel you.
Yeah. With the exception of Tanzania, the British set up colonies to maximize self-sufficiency to minimize the amount of effort expended in getting the resources over the long haul. By contrast, the French treated African holdings as an extension of the French state and pressed French culture on the inhabitants without setting up local administrations, the Germans committed genocide to get the local populations out of the way, Belgian Africa was a giant forced labour camp, and Italian Africa was outfitted with local governments just as effective as the ruling nation, which is to say they were total clusterfucks.
So "inconclusive" now means "definite proof" then? In that case I definitely misread them. Tell me, does up now mean down? Does left mean right? I apparently missed a large shift in the English language.
And a lower infection rate in uncircumcised regions compared to similar circumcised regions contradicts my point? Sure.
Of course WHO and the UN disagrees with me, because that is policy based on gut feeling. What they have is tons of research showing no negative or positive effects, and a few questionable ones showing a positive effect. Yeah, I wonder what their stance will be for a dangerous and uncontrolled disease. It couldn't possibly be to support anything that have no negative effects and might possibly, if you squint, pretend, and pray quite a bit, have some positive effect mostly due to unforeseen causation.
Which still eaves us with the fact that their numbers agree with me. But of course, as you have stated, those numbers should just be thrown out because we should have policy based on facts and not gut feeling. And we all know that numbers are gut feelings... right? since inconclusive means definite proof and all.
But you keep proving your point by changing the meaning of words. I have to admit that to be quite rebellious.
At this point, should we go back to discuss the state of Africa?
Yes, the WHO and UN are both in on a big conspiracy to overstate the efficacy of circumcision in preventing the transmission of HIV during heterosexual intercourse. Clearly they have been infiltrated by the Moyle-Industrial Complex.
Keep that crazy train going.
So going round in circles is all you got then, regurgitation the same points over and over again and assigning me opinions that I have never uttered? Again, please tell me when the meaning of "inconclusive" became "definite scientific proof". Because that is some serious "crazy train" that needs explaining. I would say it is especially important that you prove this point since it is the only point you apparently got.
I have posted numbers that support my point that the link between HIV infection and circumcision is spurious at best, I have also shown that surveys support this opinion. Of course you claim they don't apply because they don't fit whatever gut feeling you have. According to you the only observed "facts" we should allow and follow are those currently under challenge for being inaccurate. But yeah, I am the one with the opinion not based on observed facts.
And you might want to read up on how policies are created. I will give you a hint: Doing something is better than doing nothing, makes people think you are making progress.
EDIT: But if it is so clear-cut as you claim, why aren't doctors worldwide pushing for circumcisions being made like they push vaccinations? Not even in the US is the official claim that circumcision should be made for health benefits. Hmm... it is like there is something about your opinion that just doesn't add up...
Further, you're referencing a poorly-edited wikipedia article and misunderstanding what you're quoting. I even pointed out where your quotes are misattributed or out of context. That gets you an F for effort. If you can't be bothered to find substantive support for your position, then it's not worth the time to do so in reply.
It's true that there's not an iron-clad link, and further investigation is required. But what research has been done is not junk science, and most of the critiques that you point to as disputing the data do not involve original clinical trials, but rather surveys or reviews that are non-scientific. The meta-analysis generally agree that there is a positive link, but that further study is required. Except, that is, in the case of MSM, for which it is widely regarded as ineffectual. MSM, of course, represents a minority of transmissions, and does not refute the usefulness with regard to heterosexual intercourse.
It is certainly not the only method to combat HIV/AIDS, nor is it necessarily most effective or the most practical. And like all methods, it is best used in combination with other avenues of treatment and prevention. In all likelihood it will not see widespread use- regardless of its merits or lack thereof- because of ideologically-based dissent that ignores or discourages further study. But the research done up to this point is solid, and it's obnoxious to dismiss it based on your ideology. Which, in this case, makes it abundantly clear that you are not arguing in good faith due to your beliefs on the matter. You are either ignorant of the research on the subject, or intentionally misrepresenting it. In either case, it's not possible to have a meaningful discussion with you on the matter, and I will consider it dropped.
And then there is you who have provided absolutely nothing to support your point, instead relaying on a metaphorical fingers-in-ears-shouting-lalala-I-can't-hear-you every time I show support for mine. Seriously, all you do is rephrase the same old accusations of "misquoting" (I use direct quotes) and "misunderstanding" (because "inconclusive" and "not scientifically sound" is apparently very ambiguous) and claiming that everything I post is "unrelated" and "out of context" as soon as it supports my point.
Btw, my point remains that it has not been proven that there is a link. A statement you even agree with. Which leads me to question why you are arguing in the first place. And no, "inconclusive" does not mean "yes we found something but need to look further". Because, unless the you can prove that the meaning of the word have changed, finding a positive link is not an inconclusive result. So I guess in this situation we have a direct quote supporting my point, and a paraphrasing supporting yours.
Again: A lot of research says it is inconclusive and no link can be established (funny how there is no challenges to those findings, isn't it?). The articles saying there is an established link are based on clinical studies now under challenge for being dishonest and originally posting misleading results. So yes, I read the same articles you did. The difference seems to be that when you found what you wanted to find you stopped researching, while I kept on reading. Which is why you blindly believe in surveys with a shown sampling bias (aka not solid science) while I don't.
So yeah, sorry, still no real proof that circumcision lowers your risk of infection. Still numbers that show that the procedure is ineffectual in this matter, and numbers that show that in regions with similar social setups and culture, the circumcision region draw the higher infection rate. And no, blindly claiming these numbers to be "out of context" or "unrelated" is not an argument, and neither is saying that any numbers not submitted in a format you approve of are "irrelevant".
More importantly though, they are advocating the precautionary principle in a weird way. Circumcision is unlikely to increase the likelihood of HIV-infection so they're going with not discouraging it.
But they also say cellphones might cause cancer so don't use them. Which is just silly.
Follow the trail to the Anglo-Persian Oil Company.
See what I did there? It's entirely possible that APOC had nothing to do with Iran-Contra, but it sounds pretty convincing because of how fucked up APOC would become.
I, for one, like to blame the Germans. They have gotten entirely too scott-free for the shit they pulled at the turn of the century in Africa because of the fact that it happened in Africa.
So, to elaborate--when it doubt: blame Belgium, Britain, and Germany.
Ethiopia's government was badly warped by being a Cold War proxy between the Soviets and the U.S. They liked to play themselves as the anti-colonial superstars of Africa - uncolonized and only African nation to beat a modern European army in the field (Italy, 1935).
The result of this was dictatorial rulers who like to pretend that they were putting one over on the East and West, while the Soviets and U.S. turned their country and neighboring Eritrea and Somalia on each other in proxy wars, including the very silly Ogaden War. The nation - leadership and insurgencies - also perfected the use of famine as a political weapon.
Things haven't gotten better since.
These sort of things regularly bankrupt nations that have had colonies to exploit for decades (or more).
Actually, there are challenges! If you'd read the literature, you'd know that!
And that's just two of the articles cited by wikipedia. Unless by challenges you mean ideologically-based non-scientific arguments. Only one side of the debate uses those, and it's unsurprising that such a "challenge" exists, however meritless it may be.
Moreover, the meta-analysis cited by wikipedia that concludes it's ineffective is by far the oldest review, having been published in 1999. The more recent analyses- which take into account the substantial research conducted since 1999- contradict its conclusions.
Citation needed. Unless you mean the trials that were closed early because the treatment was so effective it was considered unethical to continue to have a control group. In which case, citation still needed.
I doubt you actually read any of the literature because- again- you exhibit a fundamental lack of understanding.
The numbers from trials and direct observation don't actually show that, which you would know if you'd read and understood any of the literature. The only numbers you've shown that "support your conclusions" are infection percentages across regions of the world that have huge discrepancies in attitudes towards reproductive rights, sexual education, etc. It doesn't matter how you try and twist the words around, gross infection rates on different continents are not directly comparable and most certainly do not reveal anything about the efficacy of circumcision. And, again, non-scientific, non-observational surveys- which make up the bulk of the dissenting data- are nigh-useless in comparison to actual clinical observation and research. So unless you have some actual, meaningful, non-wikipedia-article references to make..?
Here's some more cites- and only those cited by the wikipedia article that you refuse to look beyond. It's really not worth the time to pull up more in-depth information from journals since your argument still consists of cites from a wikipedia article- which still don't count as actual research or arguments, mind you.
@Julius - Of course they're not magical, and it's silly to think that such organizations are without fault. However, it's a hugely contentious issue, and their half-in stance already generated a ton of heat from those with an ideology to push. There's also pushback on further research- not because the current research shows no promise, but again because of ideology being pursued over scholarly research. The reasonable view is that it requires more research and understanding of the sociocultural and biological factors involved. The view that's bullied about is that because there is not a 100%, iron-clad and undeniable positive link based on the small amount of direct research that's actually been able to take place, that further research and understanding is unwarranted. Which is unfortunate.
I don't have skin in the game, I just hate to see research that might have a meaningful beneficial impact on the world sidelined because it doesn't fit in with someone's worldview.
I'm not going to pound my head against the wall anymore. It's impossible to have a conversation with someone that does not have even a cursory understanding of the subject matter, would rather score ideological points than have a debate, and cites wikipedia and out-of-context numbers as sources and arguments. If you really care, start a thread for it. Maybe someone will be willing to continue the conversation with you.
as for what kept Ethiopia poor - reformist monarchy got tied up by conservatives in the church and local power bases, communism became popular, Soviets supported a communist revolution in 1977 and Ethiopia would remain communist until 1991. The wars with Eritea and the purging of suspected enemies probably didn't help.
There's also the fact that the last (and first) time anyone in the US heard about Ethiopia was a short period of shitholedom in the 1990's.
African states have a pretty wide body of economic and industrial supporters/backers, not limited to the United States (Ethiopia is a good demonstration of that). In any case, regardless of who, the outcomes have hardly been stellar.