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Tuesday, 23 November 2010

CIRCUMCISION AND HIV PREVENTION

My post last week (16 November 2010) about the plan in Swaziland to get 80 percent of men circumcised to prevent HIV infection spreading provoked a lot of response from people who were in favour of the move.


I’m against it because the surgery is pointless. Evidence in Swaziland is that circumcision doesn’t work. But that hasn’t put off some people advocating for the snip.


Those in favour of circumcision rely on a small number of research reports that suggest that in Africa circumcision does work. I’ve written here about how these reports are contested by some scientists and doctors.


I am genuinely puzzled about why circumcision has become so popular in Africa. Why is surgery being offered, when there is a non surgical solution available for resolving this problem? Circumcision means cutting off healthy body parts, it has no medical benefit. Why are we being told we must cut off healthy body parts out of fears of HIV?


We are being told that circumcision reduces the risk of HIV infection being transmitted. But we are also told that circumcised men must still use a condom. That means that circumcision doesn’t stop HIV transmission but condoms do. The response to this is simple: use a condom whether you are circumcised or not. It therefore follows that there is no need to be circumcised – just use a condom.


It really is that simple.


Think carefully: why would a man cut off part of his penis to maybe slightly reduce the chances of getting HIV instead of using a condom, which dramatically decreases the risk?


A man doesn’t need to undergo mutilation instead of taking the sensible path of practising ‘safe sex’. This includes staying faithful to a single partner who is faithful to you.


Some people say that the HIV pandemic is so dangerous that we must try anything that might reduce its spread. Circumcision might work, these people say, so why not try it? Think again. I don’t want to be flippant, but cutting off a man’s penis completely would reduce the risk 100 percent, so shouldn’t we do that?

Studies done in Kenya, South Africa, suggested that men who were circumcised were less likely to contract HIV. But the United States has high rates of HIV and the highest rate of circumcision in the West (about 50 percent of males). Circumcision has failed miserably to stem HIV infection there. And why is it that countries such as New Zealand, where they abandoned infant circumcision 50 years ago, or European countries, where circumcision is rare, have low rates of HIV?

Not all countries in Africa have fallen for the circumcision myth. In September 2010 the government of Malawi rejected calls to promote circumcision as a prophylactic against HIV. At Malawi’s 2010 HIV & AIDS Research and Best Practices Conference, the chairman of the country’s National Aids Commission, Archbishop Bernard Malango, said that a comparison of the rates of infection in Muslim districts, where most men are circumcised, to that of Christian areas of Malawi, where circumcision is not practiced, showed no difference in the rate of infections.


‘We have no scientific evidence that circumcision is a sure way of slowing down the spread of AIDS,’ Dr. Mary Shaba, the government’s chief HIV/AIDS officer said.

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