dass das mit der prophylaktischen Kinder/Jugendlichen/Männerverstümmelung nicht funktioniert. Man muss bloß zwischen den Zeilen lesen, z.B. in der nature.

..because the conditions of a clinical trial are not the same as those in real life.

Hört, hört! SPÄTE EINSICHT!

Genau, das ist der Unterschied zwischen "real" und "fiktiv", der Fiktion von Auvert. In seiner Studie hatte Auvert alles unter Kontrolle, und es kam - welch Zufall! - das gewünschte Ergebnis heraus. "Real life" ist etwas komplizierter.

One problem is that circumcision is a surgical procedure and so requires different expertise and resources from those in current HIV programmes. And setting up stand-alone circumcision programmes diverts resources from existing surgery, which is already under-resourced. .

Die machen mit dem Mist alles noch schlimmer, siehe GEO. Und dann sterben Männer und Frauen, weil die Chirurgen und Krankenschwestern gerade irgendwo im Busch am Kinder/Jugendlichen/Männer-Verstümmeln sind - gibt mehr Knete, Billy Boy sei dank - ganz toll!

nature.com/news/how-to-beat-hiv-1.17929

PS. Aber selbst, wenn da jetzt einigen Leuten Zweifel kommen, oder sogar Einsicht in den großen Irrtum - das Massenverstümmelungsprogramm hat sich längst verselbstständigt. Das ist inzwischen ein sich selbsterhaltender Prozess. Da leben schon zu viele Leute davon, da haben sich zu viele Leute mit eingerichtet. Man wird diese Pfründe mit Zähnen und Klauen verteidigen, man wird mit immer neuen Ausflüchten kommen, warum es im "real life" mit der HIV-Prophylaxe durch das "unsichtbare Kondom" einfach nicht klappen will.
Und in Wahrheit, da steckt ja auch etwas ganz anderes hinter dem Programm als der Wunsch, HIV zu bekämpfen. In Wahrheit geht es um die Absicherung der Tradition. Je mehr Männer genitalreduziert sind, desto unwahrscheinlicher wird es, dass die Jungenverstümmelung eines Tages verboten wird. Das ist es, was hinter der ganzen Quacksalberei (the disease of the day) steckt, das ist das Kalkül.

Die Resourcen, die in der Massverstümmelung verballert werden fehlen genau da, wo es wirklich helfen würde und bitter nötig wäre:

he '90-90-90' target: getting a diagnosis for 90% of people infected with HIV; putting 90% of those on antiretroviral therapy; and getting 90% of those virally suppressed, meaning that they have an undetectable level of HIV in their bodies.

patients attending an HIV clinic in the township of Khayelitsha in Cape Town, South Africa, were finding it increasingly difficult to get their medication. To pick up their pills, they had to visit the clinic for frequent check-ups and tests of their viral load and T-cell count — indications of the progression of the infection. But at every appointment, they faced hours-long waits to see overburdened nurses. And people frequently left empty-handed owing to a shortage of the drugs.

Ja wenn so viele "nurses" bei der MGM-Kampagne eingespannt sind.....

Reaching the 80% goal could cut the number of new HIV infections in the target countries by as much as half, says Bertran Auvert, a public-health specialist at the University of Versailles Saint-Quentin-en-Yvelines in Paris.

Fiction meets reaility!

But some scientists worry that the benefits reported for circumcision in clinical trials will not bear out to the same degree when scaled up to tackle a messy epidemic that is spread as much through behaviour as biology. In particular, they say that men are getting mixed messages about the benefits of circumcision. Another concern is the effect on women, who gain no direct protection from the circumcision campaign, and may even face greater risk. Critics say the programmes could increase the risk of HIV infection in some populations by encouraging people to engage in risky sexual behaviours, such as forgoing condoms.

“It's only been shown to decrease to some degree transmission from the female to the male, and yet we are acting as if it's the only thing to do,” says Philip Thuma, a doctor who runs the Malaria Institute at Macha in southern Zambia. “Our job as scientists is to step back and be a bit sceptical. Should we really be putting this much emphasis on something at the expense of other things that are just as important?”

Nicht "just as important", sondern Dinge, die tatsächlich Nutzen bringen.

But critics ask whether the message is getting through. There is certainly room for confusion. Although Kabanda's presentation is thorough, one page of the flip chart, titled 'MC does not offer 100% protection' shows a picture of a man chasing two women down the street while throwing his condoms away

Zu traurig, um wirklich komisch zu sein!

Some women also assumed — incorrectly — that the reduced risk of contracting HIV applied to women, too. As one woman who was interviewed for the study put it: “Circumcised men who are HIV-positive can have sex with women and the women will not get the infection easily.”

And mobile clinics travel to hard-to-reach areas to recruit men. “There's a lot of pressure right now in this country because of PEPFAR and others,” says Thuma.

nature.com/news/aids-preventio…mcision-challenge-1.14156