@GiveWell Thanks for being in touch. Given current & likely future campaigns, that's like saying "Assuming pigs could fly ..." When men understand they must continue 2 wear condoms, that women receive no direct benefit (& have increased risk of infection during wound healing), that the 1/
@GiveWell sexual effects have been studied in a piss-poor fashion w/ non-validated Likert-style survey questions, no attempt to control socially desirable responding, & limited follow-up (so desensitization over time not studied); that 60% is relative risk reduction per coital act, not 2/
@GiveWell absolute risk reduction overall; that a small group of unflappable pro-circumcision advocates have been driving the science-to-policy pipeline from the beginning, shutting out dissenting voices & quashing critiques, etc., they would not likely consent to penile surgery. Hence 3/
@GiveWell the focus of current campaigns on "demand creation" using explicit body-shaming & false advertising, & shifting 2 targeting mothers & newborn boys who cannot say no, b/c men are - as it is (i.e., even w/ 'marketing' tactics, not honest discussion)- not signing up 2 meet quotas 4/
@GiveWell When evaluating a *mass campaign* 2 perform millions of *genital surgeries* on African men & boys - w/ thick cultural meanings & fraught power dynamics - the PRELIMINARY research should be sociological & ethical, not number-crunching based on hypothetical informed consent. 5/
@GiveWell That the prelim report & expert meetings show no evidence of *any* awareness of or concern w sociocultural or ethical factors, or the fact that the intervention being proposed - as mass-scale preventive medicine - is penis surgery (when condoms, ART are avail) is worrying; 6/
@GiveWell if the proposal were instead to export American-style labiaplasty to millions of African women as a 'biomedical' solution to HIV (w/o even having properly studied potential long-term adverse effects), there would quite rightly be extreme scrutiny of ethics, power dynamics, 7/
@GiveWell and, above all, emphasis on effective, non-invasive alternatives to *mass genital surgery* performed on vulnerable populations through coercive marketing campaigns. This stuff should come FIRST, not after the fact. Here are some random references: 8/
@GiveWell samj.org.za/index.php/samj…; researchgate.net/profile/Brian_…; ncbi.nlm.nih.gov/pubmed/27684495; ncbi.nlm.nih.gov/pubmed/24720343; arclaw.org/sites/default/…; tandfonline.com/doi/abs/10.101…; anthrosource.onlinelibrary.wiley.com/doi/abs/10.152…; tandfonline.com/doi/abs/10.108…; documentation.ird.fr/hor/fdi:010061… (I can email this one; it's a chapter)
