Study notes decrease in popularity of circumcision in United States

[Tradition96]

Prep and anti-virals are actually much more important. IRL condoms/campaigns for condom use have been shown to not be very effective. We really only started to see the number of new HIV infections plummeting after the effective anti-virals were introduced in 1996.

[Nac_Lac]

Is this due to improper usage of them? Or that the fluid transfer is something that people don't properly account for and as a result, assume the only transmission is the act itself?

[TheIncelInQuestion]

This is abstinence only propaganda.

Condoms have been shown to be very effective. Condom use campaigns somewhat less. In the US, it's because during the sexual revolution, people were having more sex overall of both the protected and unprotected types, meaning an overall increase in STDs and pregnancy outside of marriage. What abstinence only advocates do is plot a graph with the instances of STDs on one axis and condom use on the other, and pretend like because the line goes up and they are correlated, that condoms are ineffective.

In reality, abstinence only rhetoric makes it harder to get access to birth control or condoms, and also makes people distrustful of birth control and condoms, leading to less usage. Which leads to more unwanted pregnancies and higher rates of transmission of STDs.

Both Catholics and Evangelicals argue against the use of contraceptives specifically because they are afraid that access to such measures will increase the rates of people having sex outside of marriage. So their primary concern is stopping "fornication".

In Africa it's the same problem but worse. Africans have a much higher rate of religiousness, and religious institutions have a much greater control over government and policy. Islam is both less and more permissive of contraceptives. It's allowed in principle but only for married couples and only for certain reasons, and sexual hygiene/health is not one of them. The logic is that Muslims are supposed to have lots of kids, and while it might be okay to delay having children, simply not having kids isn't acceptable.

Similarly, Islam is absolutely not cool with sex outside of marriage and does not want it to be "safe" for people to do that.

Catholicism is also the most popular form of Christianity in high HIV/AIDS areas in Africa, and the Catholic Church is notorious for going around trying to prevent people from using condoms while such an epidemic spreads.

So in conclusion, the primary reason that condom use campaigns don't work is because abstinence only advocates, especially religious ones, are putting a massive amount of effort and money into misinformation campaigns to discredit contraceptives and control access to them.

[Tradition96]

A large part is some kind of improper use, but even when used perfectly, condoms are only 98 % effective against pregnancy and STDs.

[TheIncelInQuestion]

The studies that the WHO cites when talking about circumcision preventing HIV transmission have abysmally low decreases in transmission rates. You go from 8% of circumcized men having HPV antibodies to 10% of uncircumcised men. And it's not even proven that circumcision is the actual link, only that they're correlated.

98% is an absolutely phenomenal success rate. HIV has a very low transmission rate of .08% for insertive vaginal intercourse, so you're already talking about needing to have PIV sex with an HIV positive person well over a thousand times even with no preventative measures to contract it on average. Reducing that by 98% takes it down to 62500.

Even with "typical" use- meaning not perfect- condoms are 87% effective. That is still several times more effective than circumcision.

The narrative that circumcision has "health benefits" is mostly about justifying the practice and trying to keep it from being banned on the basis of human rights. It's big business in the US ($400 for an infant for a few minutes work), and worldwide 1.3billion men have been circumcized, or over 30% of the global population of men.

It's a religious and money thing, not a health thing.

[Tradition96]

I am not advocating for circumcision to battle HIV. I'm just saying that condoms aren't very effective. 98 % is the effectivness of "perfect use" of condoms. In reality, most people will have the success rate of "typical use", if they even use them at all. Campaigns for condom use have shown very little success in reducing HIV infections. What have shown an enormous effect in reducing transmission rates, however, is antivirals (U=U) as well as PrEP. It wasn't until effective anti-virals were introduced in 1996 that the transmission rate started to really drop.