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This is an old revision of this page, as edited by Jakew (talk | contribs) at 17:14, 17 June 2009 (→FGC/Stallings: reply). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

HIV/AIDS topics

First of all, beautefully done, Jakew. To me, what you just did is magic! I added a See Also section. I hope this time there are no issues with it? Anyway, there is a HIV/AIDS topics template(I think?) with many links to HIV/AIDS related articles. I think this article belongs with them but am not sure, and have no clue how to make it happen in any case. --Nakerlund (talk) 17:38, 23 March 2009 (UTC)

Thank you, Nakerlund. The template is {{AIDS}}. It would be straightforward to include it, but I'm not sure whether this article should be included in the template. I've requested input from other editors at Talk:HIV#Input requested. Jakew (talk) 18:48, 23 March 2009 (UTC)

FGC/Stallings

This edit, which introduces a conference presentation by Stallings, is problematic, for several reasons.

First, every source in this article discusses the relationship between penile circumcision (that is, the removal of the penile foreskin) and HIV. Stallings' paper, in contrast, is about female genital cutting. Thus, there is no logical reason for including this material here.

Second, the edit appears to be very poorly thought out. For example, the material was placed in the section entitled "Langerhans cells and HIV transmission", in spite of the material having no obvious connection with that subject.

Third, the edit is misleading. For example, it begins "Stallings (2005) cited 3 prior studies which showed a correlation between female circumcision and a lower risk of HIV...". The words "showed a correlation" imply that a statistically significant correlation was observed. Slide 11 of Stallings' presentation, however, shows the opposite to be true: the 95% confidence intervals for the odds ratios for all three studies include 1.0, so in fact it would be more accurate to say "...showing no correlation...". (To be precise, one shows a non-significant association between FGC and lower risk of HIV, the other two show a non-significant association between FGC and higher risk.) Further, the conclusions are quoted somewhat selectively. For example, the following conclusion (from slide 38) seems rather important: "As no biological mechanism seems plausible, we conclude that it is due to irreducible confounding."

For these reasons, I'm reverting the change. Jakew (talk) 15:57, 17 June 2009 (UTC)

The title is "Circumcision and HIV", rather than "Male Circumcision and HIV", and the Stallings paper mentions both "circumcision" and "HIV" in the title. You might regard male and female circumcision as being fundamentally different, but many people don't, including most of the people who actually practise female circumcision. I know this isn't something we're going to agree on any time soon, but I placed the Stallings study there because the preceding paragraph discusses FC/FGC/FGM: <<Dowsett (2007) questioned why it was just males that were being encouraged to circumcise: "Langerhans cells occur in the clitoris, the labia and in other parts of both male and female genitals, and no one is talking of removing these in the name of HIV prevention.">>

You're right about the 3 prior studies not showing a significant correlation. My mistake. The Stallings paper itself does though, and whilst it doesn't mention Langerhans cells, I think it belongs there. Either that, or maybe there should be a separate section or even a new page for "Female Circumcision and HIV" (or "FGC and HIV" or "FGM and HIV").

I don't think it makes much difference whether the correlation is explained away as a "conundrum" or due to "irreducible confounding".

I have made another change, and I would like this to be moderated by a third party rather than just reverted. I know we have very differing views on circumcision, but I hope we can find something for the Wiki page we can both agree on.

regards, Mark --Ml66uk2 (talk) 16:50, 17 June 2009 (UTC)

Stallings may well mention both "circumcision" and "HIV", but that's a very poor basis for randomly inserting material about a different procedure into the article. This is suppossed to be an encyclopaedia article, not a collection of sources that mention at least two words. The fact that circumcision and FGC are different is really beyond dispute. Some people believe that there are similarities between the two, but I think that nobody would deny that they are performed with different methods, on different anatomy, and with different consequences. Thus, female genital cutting is a far more appropriate place for this material.

Dowsett made a comparison between circumcision and FGC within the context of Langerhans cells. Such a comparison cannot be used as an excuse to include otherwise unrelated material; see WP:SYN.

Thank you for acknowledging your mistake about the 3 studies cited by Stallings, but your apparent solution (deleting all mention of the other studies) is — if anything — worse. Including Stallings findings, we know of a total of four studies of FGC and HIV, and all but one of these found no statistically significant difference. Knowing this, why on earth would we want to cite an anomaly? This is actively misleading to the reader, because it creates the impression that such an association exists, when the majority of the literature that we know of is to the contrary. If FGC and HIV is to be discussed anywhere, then we should cite all known studies to avoid giving undue weight to anomalous results.

Similarly, selective quotation still remains. It paints a misleading picture to quote "A lowered risk of HIV infection among circumcised women was not attributable to confounding with another risk factor in these data." but not "As no biological mechanism seems plausible, we conclude that it is due to irreducible confounding." Jakew (talk) 17:14, 17 June 2009 (UTC)