As far as circumcision decreasing male pleasure, I wonder if these studies asked circumcised and uncircumcised males to rate their pleasure, or if they asked men who had circumcisions late in life to rate their pleasure before and after.

Likewise I wonder what cultural factors might have influenced these studies.

Speaking as a circumcised man, I can only say the sex seems fine to me.

Perhaps my uncircumcised brothers are reaching some level of orgasm or potency that I can only dream of, but having my penis circumcised has not diminished in any way my quest for sex nor my enjoyment (as far as I am aware) of the act itself.

All this being said, there was a far more important recent finding on AIDS in the developing world that I did not see commented on in Salon.

It seems that Malaria infections have an exacerbating effect on the HIV and may in fact be the primary culprit in the astronomical spread of HIV across the developed world.

Now not to wax conservative here, but a primary cause for malaria still being a devastating disease in the developed world is our urge to preserve wetlands (where mosquitoes breed) and our refusal to allow DDT to be used to wipe out infected malaria mosquito populations.

In many ways it seems that western colonial interference still to this day causes death and destruction throughout the developing world, even when it is only with good intentions that we act.

This observation is somewhat off:

<<Male circumcision typically does not destroy sexual function -- it isn't designed to stamp out a man's sexual pleasure or identity.>>

It may not destroy sexual function but it absolutely does decrease the sensitivity of the penis, since the foreskin was "designed" to cover and protect the glans. The exposed head becomes de-sensitized, how could it not? Ask men who were circumcised as adults. And in the 19th century, circumcision was a treatment for masturbation, meant to decrease interest by decreasing sensitivity.

This study is a lot of bullshit.

There is no placebo study done within the same culture. The only TRUE measure of this would be to have a the number of times each participant had sex, to record the duration of those sexual encounters, and to know the HIV status of the each sexual partner. Even then, mutilated men GET INFECTED.

The study was done in a Muslim area with circumcisions vs non-Muslim areas. There was no factoring out of culture or sexual sensory issues. It's a study who's outcome was predetermined by those whose theory says that there is more chance of Sexual Diseases of those men not mutilated so that this organ mutilation can perpetuate.

There is one simple fact: men uncut have more sexual pleasure than those who are cut. Ask any adult who went from one to the other - even those who have undergone reconstruction notice the difference.

Read the study, it's ripe with bad science and bad logic.

Fact: Mutilated men get infected. Check the infection rates around the world, and countries with cut men still get infected.

If an adult male is given all the facts and decides to mutilate himself, let him do it. But, if he's given all the facts about his loss of sexual desire and sexual function and sexual feelings, a smart man would decide to stay intact and put a condom on himself before sex. But we're talking about real education here and more important comprehension of the education and how that education ties in with sexual mores and cultural feelings toward sex.

When I covered the results of the first studies coming out of Orange Farm in Soweto a year ago for a major medical journal, one quote stood out for me, from Dr Francois Venter, clinical director of Reproductive Health and HIV Research Unit in South Africa, which has one of the highest AIDS rates in the country.

He said, “If we had an AIDS vaccine this good, we would roll it out tomorrow,” he says. “There wouldn’t be a debate. We would vaccinate the whole country.”

Adult men should be given the chance to make a thoroughly informed choice which outlines all the risks and benefits of circumcision as PART of their preventative strategy, which absolutely should still include condoms.

The real issue is ensuring that circumcisions are done in clinically sterile conditions with proper aftercare, especially for those groups like the Xhosa and the Pedi (in South Africa) who include circumcision in their initiation rituals. Over 100 young men a year die in South Africa from secondary infections or botched circumcisions.

Circumcision is not a magic bullet, but it could make a huge impact on the disease that is killing Africa.

Give adults information. Let them make their own choices about how to best take care of their health.

Duh anal sex is more dangerous than vaginal sex for many reasons. What I learned in sex ed is that the anal tissue is more likely to tear thereby causing semen to come into contact with blood.

Eliminating anal sex is not the answer. You CAN use a condom with anal sex just for the purpose of preventing this disease! Also condoms help prevent UTIs in the "top" partner, even if both are perfectly healthy. Have tons of anal sex, just wrap it first.

Also, routine infant circumcision is barbaric. There's no good reason to do it. A normal baby boy is perfect just the way he is. If a man wants to do it of his own volition for any reason that's one thing; doing it to a baby is quite another.

Obviously foreskin removal in a hospital is not equivalent to some of the butchery practiced on girls, like clitoridectomy or sewing up the vagina. BUT that doesn't make it okay. If infant circumcision of boys is okay with you, than African families who want to notch a girl baby's labia in a hospital setting should be okay with you too.

Some of these letters sound like creationist arguments, "I just don't buy it, even though I haven't bothered to learn the last thing about it." Dude, use the internet. PubMed, WHO, UNAIDS, NIH, something.

One suspected biological mechanism for why circumcision reduces HIV transmission is that the foreskin has a high count of CD4 cells, the white blood cells that HIV latches onto and uses to replicate itself. That's the major idea in play right now. It's been observed for a while that HIV transmission rates were lower in places that had higher rates of circumcison, but people thought there were other factors related to both that might explain the relationship. That's why they did these randomized trials, to isolate that it was, in fact, the circumcision.

The ethics of doing it on babies are certainly worth discussing -- the main problem with waiting is that it's a bit more complicated to do in adults because there are more blood vessels in the adult foreskin. There's also another question about when "adulthood" begins for deciding: Just before people start having sex? Or when we commonly think people can make their own decisions?

The behavioral issues are also worth discussing. We all balance the risks we're willing to take, and so it's challenging to get across the message that circumcision still means condom use and other protective behavior (abstinence, fewer sex partners). But it's giant drop in transmission akin to what researchers expect to see from a good vaccine (the nature of HIV makes a super effective vaccine pretty unlikely). It can't be ignored.

And it hasn't been ignored. Since the first trial ended, there has been rising demand for male circumcision (http://www.who.int/bulletin/volumes/84/7/news10706/en/), and that demand will only increase. Encouragement is hardly necessary. What is necessary is ensuring that males have access to safe, sterile, hygenic surgeries that they want.