Body alteration recovery periods

Mon, 2007-07-30 10:54

Follow-up on yesterday’s post about circumcision and HIV: the studies that seemed to demonstrate that at least for African men who were circumcised for the study the rate at which they contracted HIV went down and the rate at which they passed it to their partners appeared to go down even further.

Yesterday I mentioned Kelly Cogswell of A dyke abroad’s bitter point that “Forgotten also are all the circumcised men in the States that dropped dead before ARV’s came on the scene. A foreskin more or less didn’t help them. Or don’t faggots count when you’re counting heads?” And in comments to that post A of A traveling spouse, who’s no slouch when it comes to research, said she couldn’t find an explanation for why American gay men clearly weren’t protected by circumcision.

Quick digression: years before I started writing about sex I participated in the old Usenet pregnancy and parenting forums. While there were lots of things to talk about there were two that, no matter what just. Wouldn’t. Go. Away: breast vs. bottle and circumcision vs no circumcision. My conclusion after listening to way too much of that debate was that we’d leave it up to our (then newborn) son to decide, with the bonus observation that at least in our neighborhood back then tattoo and piercing parlors were opening faster than coffee shops and that I was sure that by the time he was of age piercers would be offering not just plain but fancy circumcisions.

Anyway, thinking about that got me thinking about body piercing in general, and that reminded me of a couple of bloggers who talked about the recovery period for their cock piercings and ampallings (I think I spelled that right.) Anyway the short answer was that recovery for piercings takes months. And months.

Months during which I’m guessing that even with a condom to keep everything from pulling and tugging you’re not going to want to be doing anything where friction’s going to be involved. Like, say, sex.

And so my next questions about the study (and don’t get me wrong, I’m pretty sure the researchers would taken these things into account) are:

- Just how long does it take for an adult man to recover from a circumcision anyway? Enough to be interested in sex again, for instance. Especially in the kind of dry, high-abrasion style intercourse allegedly (and I mean that, allegedly) too-often favored by tradition in sub-Saharan Africa. For instance.

- How long were the studies that led to the circumcision recommendations? (Remember that at least one such study was cut short because the success rate for circumcised men was so high.)

Anyway, the point being that the men in the study were all freshly circumcised as part of the program, and you’d want to make sure the results weren’t skewed by, say, reluctant celibacy while the wounds and/or secondary infections related to the wound heal. If, and I’m only saying if, that was a factor, and I’m not saying it was, then the long-term benefits might not be so high and, especially, it would account for the perceived lack of protection for men (American gay men, North African straight men) who are traditionally circumcised in infancy.

The old punchline has it that we know almost all circumcised infants are unable to walk for up to a year after the procedure. But how long for an adult?

Submitted by 1518 (not verified) on Tue, 2007-07-31 23:11.

If the truth be known, I already had those articles to hand, so to speak, so very little effort was required on my part :) It's a small contribution compared with yours.

[As if having them at hand diminished the contribution! Let's just say, then, that every little bit helps... a lot. Thank you, A. --fl]

Submitted by 1518 (not verified) on Tue, 2007-07-31 12:23.

To answer your questions figleaf, yes they did take the healing period into consideration. The South African study took over 3,000 men through 3, 12 and 21 month follow ups. Almost 650 did not reach the 21 month before the trial was halted.

The Ugandan trial took almost 5,000 men through 1, 6, 12 and 24 month follow ups. All men reached the 12 month stage and 44% reached 24 months before it had to be halted.

In Kenya they recruited over 2500 men and they had follow ups at 1, 3, 6, 12, 18 and 24 months. Follow up was incomplete for 240 men.

5% of men reported not having complied with the 30 day abstinence period after circumcision, and at that follow up only 1% were judged not to have healed completely. That might go some way to answer your question on healing time.

By the way, all three trials were stopped by the recommendation of the data and safety monitoring board so that circumcision could be offered to the control group.

[On the one hand I feel lazy for asking, on the other I'm totally grateful for your amazing research skills, A. Thank you so much. --fl]

Submitted by 1518 (not verified) on Mon, 2007-07-30 18:37.

Maybe this is a little off topic, but I would like those studies to be a little more scientific. I know that there are three known variations of the virus, if you were to compare, might that be something you would want to know the difference if any between African and American. Is one strain more inclined to piggy back not only venereal diseases, but malnutrition and other maladies that effect some parts of Africa? The result of the epidemiological studies that show reduction in HIV because of circumcision, but it needs to be eradicated. With the genome project complete, this is all we get?

[As luck would have it I had dinner last weekend with a CDC doctor who's been working in HIV prevention research in Africa nearly as long as I've known him. He's pretty clear that each of the factors you mention makes the problem there bigger. Add in the fact that HIV infects the primary cells for fighting infection to the situation in Africa where all manner of illnesses have had literally millions of years to get around our body's defenses *and* the abysmal investment in healthcare and yeah, you've got a recipe for disaster. For what it's worth my friend says the Gates Foundation is effectively pressuring NGOs and other organizations to actually get results instead of just take in or spend money. I can't be sure about everybody but I know some people who can really do something about it are deadly serious about working it out both medically and socially. And I guess we just have to keep our fingers crossed for them. Thank you, Five. --fl]

Submitted by 1518 (not verified) on Mon, 2007-07-30 15:13.

Am I missing something, isn't sex between gay men different than heterosexual sex, excluding fellatio. She should compare gay men to gay men in other parts of the world.

[Maybe she should but I'm not positive it makes a difference. I agree that the way most, though obviously not all, gay Americans contract HIV seems to be through receptive anal sex whereas the African studies suggest men there are somehow getting it under their foreskins from heterosexual partners (perhaps piggybacking on herpes infections or other leisons.) So sure, maybe it's apples and oranges. But women of HIV+ partners here seem to be at risk but *way lower* risk than in Africa and that's part of why people are looking anywhere and everywhere for correlations. Thanks, Five. --fl]

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