Mr O'Hara refers to a study presented at the 2006 AIDS conference that investigated circumcision and HIV in various African nations. While this study is as yet unpublished, a news report provides some information about it, including some weaknesses in the design². Unlike the Orange Farm randomised controlled trial, this study used an observational methodology, which a 2003 Cochrane Review described as "inherently limited by confounding which is unlikely to be fully adjusted for."³

The Cochrane Review found other studies finding little or no association, but found that on balance, "results from existing observational studies show a strong epidemiological association between male circumcision and prevention of HIV, especially among high-risk groups."

Mr O'Hara could be forgiven for failing to understand the importance of methodology, but what is inexcusable is that he even misrepresents the findings of the study that he cites! He claims that there was "no statistically significant difference." In fact, to quote from the news report, "with other factors controlled, male circumcision had some protective effect in 5 of the 8 countries, but the effect was statistically significant only in Tanzania."²

Mr O'Hara then proceeds to accuse Drs Halperin and Bailey of bias and lack of integrity in their work. If these professionals had actually been involved in the Orange Farm study, this would merely be a disgusting attempt at character assassination. However, if Mr O'Hara had actually checked the authors on the study itself⁴, he would see that in fact they were not authors at all!

Perhaps Mr O'Hara should check his facts in future before accusing others of spreading misinformation.

Jake Waskett
Founder
Circumcision Independent Reference and Commentary Service
Manchester, UK

1. caribbeannetnews.com

2. docguide.com

3. cirp.org

4. medicine.plosjournals.org