Circumcision (and HIV)

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HIV is the virus that causes AIDS. AIDS is a syndrome which, untreated, leads to death. If treated, it can be a chronic debilitating illness. It is contagious, and is spread through expose to body fluids, essentially. Those body fluids include blood, semen and menstrual fluids.

Male circumcision is the surgical process of removing the foreskin, which covers the end of the penis.

The foreskin, or prepuce, is highly sensitive tissue which protects the glans penis (in a way similar to the protection given to the eye by the eye-lid), and is a key part of the male sexual anatomy. It contains many nerve endings which add to the pleasure of sexual contact.

So much for defining the terms.

In recent years there has been quite a lot of discussion about some research which appears to indicate that male circumcision has a role in the prevention of HIV. This research is mostly based on some studies undertaken in sub-Saharan Africa. While the research is in some ways flawed, it does appear that there may be some weak statistical data supporting the suggestion that male circumcision has a preventative effect. What it appears to do is prevent transmission from a receptive infected partner to an insertive uninfected partner.

Media reports have made circumcision sound like a vaccine against transmission. There has been a lot of coverage of the reports, and a lot of discussion about statistics. There has also been a lot of generalisation of the import of the studies.

The effect is weak. In order to prevent one case of HIV transmission, it would be necessary to circumcise nearly 60 men. In some countries in Africa where circumcision is practiced, circumcised men have higher rates of infection than uncircumcised men.

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What the studies, and the apologists for them (and for circumcision) don’t appear to address are the cultural issues sitting behind the dynamics of disease transmission. Different sexual mores and habits will have an effect on how, and to whom, HIV is transmitted. Who does what to whom and when is an important question. Men who are removed from their families and have sex with sex workers are more likely to be infected. The terrain is far from straightforward:

For several years, researchers have been debating the relationship between male circumcision and HIV. Several studies have indicated that circumcised men are less likely to become infected with HIV than uncircumcised men. However, because circumcision is usually linked to culture or religion, it has been argued that the apparent protective effect of the procedure is likely to be related not to removal of the foreskin but to the behaviours prevalent in the ethnic or religious groups in which male circumcision is practised. In addition, some researchers have assumed that any association between circumcision and HIV must be complicated by the presence of other sexually transmitted infections, which have been found to be more common among uncircumcised men.

Clearly, the correlations are not straightforward. In the higher income countries, the rates of HIV infection among men who have sex with men do not vary greatly even though the circumcision rates do: few men in Europe and Japan but four-fifths of men in the United States are circumcised. In Africa, however, circumcision seems to confer some protection. A study in Nyanza Province, Kenya, among men from the same ethnic group, the Luo, found that one-quarter of uncircumcised men were infected with HIV, compared with just under one-tenth of circumcised men. The protective effect remained even after other factors, such as sexual behaviour and sexually transmitted infections, had been taken into account. A study of over 6800 men in rural Uganda has suggested that the timing of circumcision is important: HIV infection was found in 16% of men who were circumcised after the age of 21 and in only 7% of those circumcised before puberty. A recent review of 27 published studies on the association between HIV and male circumcision in Africa found that, on average, circumcised men were half as likely to be infected with HIV as uncircumcised men. When African men with similar socio-demographic, behavioural and other factors were compared, circumcised men were nearly 60% less likely than uncircumcised men to be infected with HIV.

Even though the weight of evidence increasingly suggests that circumcising men before they become sexually active does provide some protection against HIV, the practical implications for AIDS prevention are not obvious. Circumcision, where it is practised, usually has links to religious or ethnic identities and life-cycle ceremonies, and may customarily be done after puberty. If the same scalpel were used without sterilization on a number of boys, this could actually contribute to the transmission of HIV. Finally, if circumcision were promoted as a way of preventing HIV infection, people might abandon other safe sexual practices, such as condom use. This risk is far from negligible – already, rumours abound in some communities that circumcision acts as a “natural condom”. A sex worker interviewed in the city of Kisumu in Kenya summed up this misconception, saying: “I can sleep with circumcised men without a condom because they don’t carry a lot of dirt on their penis”. While circumcision may reduce the likelihood of HIV infection, it does not eliminate it. In one study in South Africa, for example, two out of five circumcised men were infected with HIV, compared with three out of five uncircumcised men. Relying on circumcision for protection is, in these circumstances, a bit like playing Russian roulette with two bullets in the gun rather than three.

So, what are we to think?

And what are you, if you’re a parent of a boy and are thinking of circumcision for him, to do?

There are some reality checks to be had. If you’re in the west, it is important to know that the studies done on western men don’t support the same generalisations. Remember, the male population of the US is overwhelmingly circumcised, and HIV spread like wild-fire there, among insertive and receptive men alike. Remember, the effect is weak. It isn’t a vaccine, and the effect of behavioural modifications (using condoms, reducing promiscuity etc) is much more effective in the prevention of HIV.

Yes, it is true, circumcision may give some weak benefit, but there are costs, too.

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The Total Gift – Meditation as a response to Christ’s Love

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On Saturday I went to the Australian National Forum for the Australian Christian Meditation Community. Laurence Freeman is the Director of the World Community for Christian Meditation, and he presented the talks.

He spoke about the nature of Christ’s love, and how, through Christian meditation, we respond and are formed. It was a lovely day. I’d guess that the talks will be out on CD soon.

Christian meditation is a great gift to me. It is a way of contemplative prayer that is nurturing and supportive. I think particularly important is the sense of community engendered by participation in the world community of meditators. I was touched by this, particularly, as I made my life profession on Saturday. It was a privilege to be surrounded by other oblates who are also called to this as a life path. The feeling of love, care and joy was overwhelming.

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It’s been so long, O Blog

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Hi Blog

Apologies for the delay posting. Work interferes somewhat with things like that, but here I am, blogging again.

We’ve moved into the house in Korumburra. Korumburra is a small, sleepy town in South Gippsland. It is quite pretty, especially the hills around the town. The street we live on is lined with deciduous trees, and they’re beginning to lose their leaves for the winter. We’ve been quite active houseowners, and have been gardening, painting, putting up fences, cleaning walls (inside and out), cleaning gutters – the list goes on. It’s a good place to live.

The local church is also quiet. It is a beautiful church – very much in the gothic revival tradition of architecture. At the moment there isn’t a parish priest – the last one retired in September and a new one hasn’t yet been appointed. That’s a bit sad. There are three retired priests who are ministering as locums, but the community is showing the signs of being without a leader.

Work is good. I’m surprised that I’ve been here for three months now. It seems to be progressing well. I get tired easily, but I seem to be coping with it OK. I’m beginning to understand the industry, and see where the various bits and pieces, acronyms and abbreviations all fit in.

Doctor Who has begun again in the UK. I haven’t seen the first two episodes, but I’m looking forward to them. I’ll be interested to see how Catherine Tate goes as Donna when there is a sustained role to play.

Biff the Dog and Molly the Dog are well. It is fascinating to see how their personalities have changed since we moved. They seem much more balanced and relaxed. Perhaps that’s just because the routine at home is much more settled now.

Tomorrow I’m going to the Australian Christian Meditation Community’s National Forum, which is being held in Melbourne. Fr Laurence Freeman will be there, as will a lot of other people! I’ll be making my life profession tomorrow afternoon.

Health is OK. I spent yesterday at Peter Mac having intravenous immunoglobulins, rituxamab, and a unit of blood. I have a slew of minor complaints – sinusitis (a course of antibiotics and treatment for allergic rhinitis), diarrhoea (a referral to a gastroenterologist), a fungal patch on my leg (some topical antifungal lotion) and weight loss. Mysteriously, or semi-mysteriously, I’ve lost 5kg in about 3 weeks. That’s certainly partly because I’m doing more incidental exercise and eating better. We’ll see if it continues.

That’s about all!

Col

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Drought

I’m embarrassed that it has been so long since I last posted! A posting drought!In my partial defence, we’ve moved, I’ve started working in earnest, and all of the other things that life generally brings have happened.Moving has been good. It took much longer than expected, but is now all done. The new house is just about complete, except for a lounge suite. That will come on Wednesday. Peter has been working on the garden, and it is taking shape.Work is going OK. It is tiring and taxing, but things are heading mostly in the right direction.Health is fine, except for sinusitis. I was re-vaccinated the other day. So my body has been a festering hell of antibodies, hopefully.More to come. Soon I hope! 

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Prayer and Peace

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Dear Blog

Peace is hard to come by. The reality is, if we wait for the world to be peaceful in order for us to feel peace, we’ll be waiting for a long, long time.

The real, lasting peace comes from dwelling in, abiding in, God. This isn’t just a feeling, but rather a way of life and an orientation. The world offers illusions of peace through consumption and appeals to our needs for self-aggrandisment, but these tend to simply lead us into a spiral of consumption and emptiness. Peace and fulfillment are different things, and the world offers us neither.

Throughout its’ 2000 year history the church has offered various ways to find peace. I’d like to share three of them – each with very ancient roots. Each is a well-trodden path, and when combined with oneanother, and with a fundamental orientation towards God, lead to a life of peace through abiding in God.

Wise teachers in the way of spiritual formation remind us that simply wandering along to worship once a week won’t result in a deep and long-lasting growth in relationship with God. Each of these practices means a commitment to a daily practice. In the lives of many they form the ‘hinges’ of the day – a way to begin and end the day which results in real life, rooted in God.

To be sure, pursuing a way of life that includes these practices means making a choice to commit yourself to God, and to pursuing a relationship with God. That choice and commitment is an important and powerful thing. By choosing, day after day, to spend time with God and devoted to God results in a real change of orientation in life. It isn’t a romantic choice, by any stretch of the imagination, and it runs completely counter to what the world says is important. But in the end, it is an absolutely vital choice – to take seriously the call to be a follower of Jesus, or to merely make a sort of notional and lukewarm assent to following a social religion. Spirituality, and a spiritual life, is not a road merely for ‘the super-Christian’ – it is a way that we’re all called to, in fulfillment of God’s promise to us to give us true and enduring life and peace.

The first practice I want to suggest to you, and the one I’d say is the most important if you have to choose to do one and not the others, is lectio divina. ‘Lectio divina’ is often translated spiritual reading, but it has a much deeper and wider sense than that. Lectio is essentially sitting with a text from the Bible, and waiting on God. It is a quiet, reflective practice which involves time and patience. Much has been written about lectio, but it can be distilled into a few steps. Once you’ve mastered these steps, dig deeper, read more about it, and use it to modify your practice. First, set aside some time and space. Preferably around the same time each day, in the same space. Resolve not to allow yourself to be distracted or drawn away. If you live with others, let them know that you’re praying at this time, and you’d prefer not to be disturbed. Give this time the importance it deserved. Then pray – ask God to be with you, and give you all that God wants to give you through this time. Offer the time to God, and God alone. Take a short piece of Scripture – possibly just a verse, or a couple of verses. Just read the verse and remain with it. Don’t ponder on it, or study it. You’re not aiming to do Bible study, but to wait on God. Read it out loud, repeat it, reflect on it. Let it sink deeply into your heart and mind. Slow down – remain with the verses. In the silence, continue to turn over the verses in your mind. Ask God to speak to you through the verses, to show you what he’s offering through them. Sometimes you’ll find that God speaks clearly, at other times you may receive nothing. Either way, be grateful for the time you’ve spent. Pray as you end. Thank God for the Scriptures. Practice lectio each day.

The second practice is fixed-hour prayer. The Church, from ancient times, has observed the discipline of praying at particular times, in a liturgical framework. In monasticism this is often called opus dei – the work of God. Monks and nuns often pray up to seven times a day, using the Divine Office – a liturgical guide to reading the psalms and scriptures. Christians living in the world rarely have the opportunity to pray seven times a day, but we all have the possibility of setting aside regular fixed times to pray to God. There are a number of tools to help this – the ones I’d suggest are all liturgical in nature. I come from a liturgical tradition, and find this helpful. Liturgy is a tried and tested way of building prayer. Without the right intention, though, it is empty. Fixed hour prayer often consists of prayer in the morning, prayer around the middle of the day, prayer in the evening and prayer before bed. If you can keep this schedule, all well and good. If it doesn’t work in your life, then try to observe a couple of the offices – morning and before bed, perhaps, or in the middle of the day and before bed. I find the discipline of praying at particular times very helpful, and a great privilege. I remind myself that I’m offering my prayer not only for me, but also for those who can’t, don’t or won’t pray. My prayer joins with the prayer of others, and ultimately the prayer of Jesus. The Book of Common Prayer, An Australian Prayer Book, Common Worship and A Prayer Book for Australia all contain liturgies for morning and evening prayer. AAPB and APBA have daily prayer services and an order for prayer at the end of the day. Alternatively, you can find liturgies in books or online. There are several excellent contemporary liturgies that you can source if the language of breviary or prayer book doesn’t speak to you. If you want to follow the cycle of readings and psalms used in the Church you’ll need to source a lectionary. The important thing is to be faithful to the practice, and stick to it. Offer the time to God. Read aloud – even if you’re alone and it feels silly. If you’re on the train, form the words in your mind.

The third practice, and perhaps the one that binds them together, is Christian meditation. Much is written about meditation. Some suggest it is an esoteric practice that doesn’t have anything to do with Christianity, but rather draws people away from God. In the end, I think Christian meditation (or another very similar practice, known as centering prayer) are ways of sitting in the silence waiting for God. Whatever method you choose, stick to it. Use it morning and evening. Don’t expect ‘results’, ‘changes’ or some sort of esoteric experience. Perhaps they’ll come, perhaps not. In any case, their presence or absence says nothing about you or your faithfulness to the practice.

Meditating is simple, and easily learned. Try this method:

Find a quiet place. Sit down with your back upright. Sit still.

Gently close your eyes and begin to recite your prayer-word, or mantra, silently, interiorly and lovingly throughout the time of your meditation: “Ma-ra-na-tha.” Say it as four equally-stressed syllables. It is an Aramaic word (which is the language that Jesus spoke) and it means “Come, Lord.” It is found in the Scriptures and is one of the earliest prayers in the Christian tradition.

Do not think about the meaning of the word. Just give your attention to the sound of it throughout the time of your meditation, from the beginning to the end. Whenever distractions arise, simply return to your mantra. Meditate for 30 minutes each morning and each evening, every day of your life. Father John Main always said: “Just say your word.” Meditation is a way of pure prayer marked by silence, stillness, and simplicity. (From the WCCM website)

Centering prayer is a little different

Choose a sacred word as the symbol of your intention to consent to God’s presence and action within.

Sitting comfortably and with eyes closed, settle briefly and silently introduce the sacred word as the symbol of your consent to God’s presence and action within.

When engaged with your thoughts, return ever-so gently to the sacred word.

At the end of the prayer period, remain in silence with eyes closed for a couple of minutes. (From the Contemplative Outreach website)

I can’t promise that, if you follow these guidelines, you’ll feel peace. But in my experience using them, and helping others to use them, I do see peace growing in my life and theirs. The way is hard and challenging, as Jesus said it would be, but it is also very rewarding. The ultimate reward, of course, is not a warm glow as a result of being good, but growing in the love and knowledge of God – and it is from God that love and peace will spill out of us. These disciplines allow us to be in a ‘space’ which will allow God to use us.

So – what will you choose?

C

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Change your life – God’s kingdom is here

When Jesus got word that John had been arrested, he returned to Galilee. He moved from his hometown, Nazareth, to the lakeside village Capernaum, nestled at the base of the Zebulun and Naphtali hills. This move completed Isaiah’s sermon:

Land of Zebulun, land of Naphtali,
road to the sea, over Jordan,
Galilee, crossroads for the nations.
People sitting out their lives in the dark
saw a huge light;
Sitting in that dark, dark country of death,
they watched the sun come up.

This Isaiah-prophesied sermon came to life in Galilee the moment Jesus started preaching. He picked up where John left off: “Change your life. God’s kingdom is here.”

Walking along the beach of Lake Galilee, Jesus saw two brothers: Simon (later called Peter) and Andrew. They were fishing, throwing their nets into the lake. It was their regular work. Jesus said to them, “Come with me. I’ll make a new kind of fisherman out of you. I’ll show you how to catch men and women instead of perch and bass.” They didn’t ask questions, but simply dropped their nets and followed.

A short distance down the beach they came upon another pair of brothers, James and John, Zebedee’s sons. These two were sitting in a boat with their father, Zebedee, mending their fishnets. Jesus made the same offer to them, and they were just as quick to follow, abandoning boat and father.

From there he went all over Galilee. He used synagogues for meeting places and taught people the truth of God. God’s kingdom was his theme—that beginning right now they were under God’s government, a good government! He also healed people of their diseases and of the bad effects of their bad lives. Word got around the entire Roman province of Syria. People brought anybody with an ailment, whether mental, emotional, or physical. Jesus healed them, one and all. More and more people came, the momentum gathering. Besides those from Galilee, crowds came from the “Ten Towns” across the lake, others up from Jerusalem and Judea, still others from across the Jordan. (Matthew 4:12-25, The Message)

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Who, or what, are you listening to?

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Dear Blog,

In many Native American cultures, this story is told to the young adults just before they leave for their vision quest. Between the ages of 13 and 22, young men and women of the tribe decide that they are ready to become adults. They go on a vision quest for three days and three nights, fasting from food and drink and sleep, and wait for a vision. They are given a vision and a gift – what they are to be for the community in the future. And often, when they return they are given a name as well. They are now adult members of the tribe, they belong, and they know that they are called to live on behalf of the community, using all that the Great Spirit has given them for others. This is the story many of them hear just before they set off on their vision quest.

Once upon a time, there was an eagle. She soared and hunted and built her nest high on a mountain fastness and then settled down to sit on her three eggs until they hatched. But a storm approached and she was hungry. Off she went to find food and, while she was gone, the storm hit, her nest was thrown off the side of the mountain and two of her eggs destroyed. But by some miracle, one fell unharmed to the ground, safely landing in tumbleweed but unseen by the mother eagle. She returned, mourning her children.

On the ground a prairie chicken was returning from hunting. The storm had overturned her nest, too, scattering her eggs everywhere. She rolled them all back in, stumbling over a very large egg. Being rather stupid, she figured it was also hers and rolled the eagle egg into her nest. She returned to sitting on the nest and, one by one, the prairie chickens hatched, except for the big egg. She sat and sat and finally the biggest, ugliest prairie chicken she’d ever seen came forth. It was ungainly, with huge wings that dragged on the ground. And it was incredibly hungry all the time. The other prairie chickens pecked about in the dirt, found seeds and insects, and flew around about three feet off the ground. This one, however, couldn’t fly, couldn’t talk, and couldn’t do anything like the others. It was pecked at and pushed around, and it was sickly and felt awful all the time. It took to going off by itself and being miserable alone, dragging its wings along behind it.

One day, out in the canyon it saw a great shadow on the ground and, as it looked up, it saw the most magnificent bird flying above it. It swooped and soared, great and graceful. Then it swooped down and grabbed on of the prairie chicken brothers, breaking its neck and eating it as it flew off. The eagle that thought it was a prairie chicken watched all this in fascination. It wanted to fly like that, hunt like that and eat like that! But then it remembered that it had been told always to eat only bugs and seeds – that was the way of prairie chickens. Immediately, it went to tell everyone about this. Most of the chickens ignored it, accusing the eagle of making up the story. One of the grandfather prairie chickens said, “No, listen to the strange one – it has seen an eagle, a great bird of the sky, one closest to the Great Spirit. Whenever you see that great shadow on the ground, run for your lives, for the eagle likes to eat prairie chickens.” But the eagle that thought it was a prairie chicken did not obey. It went back often to the canyon and waited for the eagle to come. It watched it fly and wanted toimitate it. It dreamed of such gracefulness and freedom and power.

Then one day it climbed to the highest part of the mesa, dragging its heavy wings slowly behind, in pain. It stood just on the edge of the cliff and thought, “If I just fall off into the air, I’ll fly. Even if I fall to the canyon floor and die, at least for a while I will know what it’s like to be free and fly gracefully. It was just about to fall over the edge when it remembered all the things its parents and family and older ones had spoken. You’re just a prairie chicken and that’s all you’ll ever be. Don’t try to be something you’re not. Just be the best prairie chicken you can be. He hesitated, then slowly came down from the mesa. But sometimes he’d climb back up, think about flying, and then remember that prairie chickens couldn’t fly. As days and weeks passed, it became more and more painful for the eagle to even think about flying. Growing weaker and weaker, one day the eagle that thought it was a prairie chicken died.

It died, an earth-bound unhappy prairie chicken because it listened to the wrong wisdom. (Author unknown, public domain)

What wisdom are you listening to? Is it real wisdom, or just some invented fad? Does it really speak to your heart, or just appeal to your mind or vanity? Does The Secret really feed your soul?

C

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