WHO states that male circumcision provided by well trained health professionals reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Recommendations emphasize that male circumcision should be considered an efficacious intervention for prevention resulting in significant investment in the promotion in male circumcision in Africa. What I want to know is how is this message interpreted by the people it is meant to protect because I fear the implications if we do not get it right at the implementation stage?
A False Sense of Security
Fantastic news for men! A one-time medical intervention can provide men with life-long partial protection against HIV as well as other sexually transmitted infections. What about the rest of the population? Women are not directly protected by this intervention and could potentially put us at higher risk. It can already be difficult to negotiate with a man to use a condom. My concerned is that if men believe they are protected against HIV/AIDS, women will be left with reasonable less clout in the already sexually charged everyday debates.
Reasonable Doubt
Many professionals have questioned the reliability and validity of studies claiming that circumcision reduces HIV transmission. African national population surveys in eight countries found a higher rate of HIV infection among circumcised men compared to men who were not circumcised and there are at least 17 studies that have not found any benefit from male circumcision. Some studies suggest it is counterproductive. Misconceptions about the procedure – specifically the widespread notion that circumcision alone, without taking additional precautions, significantly protects people from HIV/AIDS – was actually encouraging the disease to spread in Uganda where the circumcision campaigns have been piloted since 2010.
‘Circumcision Industrial Complex’
UN and WHO, foreign and national governments, and a variety of NGOs have spent billions of dollars on circumcision promotion diverting resources for more effective measures. It is big business for those involved. I pray that this flood of money has not made donor dependant NGOs comprise prevention for profit.
Cost Benefit?
Condoms are more than 99% effective, prevent other sexually transmitted diseases and unwanted pregnancies, they are less invasive, and the cost of one circumcision in Africa can pay for 3000 condoms. Even pro-circumcision studies recommend using condoms in addition to circumcisions. In that case, circumcision adds no significant additional protection value.
