Rude bits

Over the last week, three stories caught my attention:

1.  Avoiding pregnancy.   Teenage pregnancy rates have dropped pretty sharply in the US, and this Slate article asks how and why.

The first partial explanation is a bit of a surprise:    teenage virginity is on the rise.

According to federal surveys of teenage girls, 49 percent reported they were virgins in 1995, but 57 percent said they were in 2010. (The trend was even more pronounced among black teens, whose rate of abstinence rose from 40 percent to 54 percent.) However, these modest changes don’t fully explain the dramatic drop in teen pregnancy.

So the main explanation:

...the key to lower pregnancy rates has been a shift from condom use alone to more effective hormonal methods like the pill. It turns out that not all contraception is the same. No matter how well-educated they are, teens who do use birth control can’t reliably use condoms every time. To be sure, condoms prevent sexually transmitted diseases and are an important public health tool. But we now realize they should never, ever be the sole method of birth control for teens. They find condoms too much of hassle to use time after time—so they don’t.

 However, the article then goes on to point out that the pill is far from perfect:

Earlier this year, Washington University researchers led by Jeff Peipert reported in the New England Journal of Medicine that 5 percent of women in a study who were on the pill got pregnant within a year. Among those under 21 years of age, almost twice as many did. Take a moment to reflect on that. Imagine you are a concerned parent who accepts that your high school senior has sex. You take her to the doctor and she starts taking the pill. The data show that this is much better than just telling her to use a condom during intercourse. However, before graduation, 1 in 10 such girls will be headed for the delivery room or abortion clinic. That is a breathtaking failure rate.

Well, this just supports one of Steve's Rules For Life:   hey, if you're not prepared for a possible pregnancy, don't get into a sexual relationship.   

Of course, the Slate article then ruins my rule by pointing out that modern IUDs are a really effective way to avoid pregnancy:  

 ...the risk of contraceptive failure was 22 times higher with the pill than with IUDs in adult women, and double that for teens.

 I didn't realise IUDs were so effective.  Don't tell the kids.  Just stick to my Rule instead.

2.   The circumcision wars continue, this time with a push from a couple of Australian medical figures saying that the medical profession's solid turn against it in the 2000's was not really evidence based.   I always suspected this was the case.   It seemed to me that, for whatever reason, there was a turn against it going back to about the 1980's that was more cultural than anything else, and now the health benefits side is making a comeback.   We'll see how this develops.

Speaking of circumcision and culture, while Googling the topic, I stumbled across stories about how, in the Philippines, some cities put on "circumcision parties" to provide the operation safely for pre-teen boys.  As a government news agency explains:

Hornido attributed this phenomenon to the preference of the boys to have their circumcision done during the long summer vacation.

Circumcision is being done in the Philippines mainly for cultural reasons and not so much because of its health concerns. Among the Filipinos, the practice symbolizes the rite of passage into manhood.

However, Hornido urged parents to have their boys undergo safe medical circumcision by health professionals instead of the crude method of circumcision practiced in the Philippines known as ‘pukpok,’ performed mostly in rural villages by a local surgeon called "manunuli (one who circumcises)."

Well, I didn't know that.   Actually, like most Australians, there is very little I know about the Philippines culturally, which is odd considering its proximity to us.

3.  What's that doing there?    It turns out that human papilloma  virus is in a lot of prostate cancer.   (Mind you, it's in a lot of healthy ones too.)   But still:

“Recent unpublished experimental evidence by other researchers suggests that HPV and EBV can collaborate to promote the survival and proliferation of cancer cells, so our findings may well have important implications for understanding and preventing prostate cancer,” said Professor Whitaker.

“Significantly, in our prostate samples we found a high-risk strain known as HPV 18, which is known to be associated with other human cancers.

“HPV 18 is a common high-risk strain in Australia and is a specific target of the Gardasil vaccine now offered free to teenage girls to protect against cervical cancer.

“We note recent proposals to offer Gardasil to Australian teenage boys as well, with the aim of preventing the spread of the virus to women through sexual contact. 

“If HPV 18 is also associated with prostate cancers, as our research suggests, vaccinating boys may yet prove to have an unexpected direct benefit for them as well.”

It does sound a decent reason to extend the vaccine to boys.