Women in Swaziland are reporting that men who have been circumcised as part of the government’s anti-HIV drive are refusing to use condoms during sex because they believe the ‘snip’ means it is impossible for them to spread the virus.
Many of the women did not realise that men who have recently been circumcised must not have sex for six weeks after the operation.
And six in ten women believe they will be victims of gender violence, because men would refuse to use condoms after being circumcised.
These are some of the findings in a report published this month (December 2010) by the Women’s HIV Prevention Tracking Project (WHiPT).
WHiPT, a project that brings community perspectives, particularly women’s voices, to the forefront of the HIV and AIDS response, concluded that the Swazi Government was ignoring the impact its circumcision policy was having on women in the kingdom.
There has been much reported about how male circumcision can supposedly reduce the risk of spreading HIV. In Swaziland, the Government has whole-heartedly bought into the idea that all sexually-active males should get the snip, even though there is ample evidence that circumcision doesn’t prevent the spread of HIV, or at best it makes no difference one way or another.
The WHiPT report called Making Medical Male Circumcision Work for Women is believed to be the first attempt to find out from Swazi women what their experiences are with men who have been circumcised.
WHiPT says that although the Swaziland Government’s policy of male circumcision includes monitoring and evaluating how the policy is working there is nothing in place to see whether women are benefiting, being harmed or not being affected at all, by the policy.
WHiPT interviewed a total of 73 women in 10 communities in rural and semi-urban areas of Swaziland. Of these 73 women, 64 had heard about the Medical Male Circumcision (MMC) project.
When asked if they were aware that there is need for consistent condom use after MMC, only 61 percent (39 out of the 64 women who knew about the project) said: Yes. This same percentage of respondents was aware that MMC does not provide 100-percent protection. Only 52 percent (33/64) knew that men need to abstain from sex for six weeks after MMC.
There’s a fear that men would increase their sexual risk-taking behaviors because they feel more or completely protected by MMC. This fear was expressed by 55 percent (22/40) of the women.
One of the women interviewed told the researchers, ‘Men would think they are 100 percent protected and they will continue to have sex without condoms with multiple partners putting me as wife at risk of getting HIV.
Only 47 percent (30/64) of the women said they talk about MMC with their partners. However, 86 percent (55/64) of the women were willing to be involved in the decision-making process to support their male partners during the healing process and to discuss circumcising their male children.
Fifty-two percent (33/64) of the women reported they are not comfortable asking their male partners to use male or female condoms, as men are the sexual decision-makers.
Only 33 percent (21/64) of the women said that they are currently and consistently using condoms.
WHiPT reported, ‘This number may be higher than other cohorts in Swaziland, given that the women surveyed were assumed to be predominantly HIV-positive.’
The women who are currently not using condoms said that their male partners would refuse to use condoms even when circumcised because they’ll falsely believe that they are 100-percent protected.
One woman told the researchers, ‘My partner does not want to use condoms even now. Nothing will make him to change his mind to use it. Men are difficult to convince.’
About 61 percent of the women said MMC would negatively impact gender-based violence, because men would refuse to use condoms after being circumcised. Condom negotiation would be even more difficult after MMC, given its current challenges, the women reported.
One woman told the researchers, ‘We were asked to use condoms and now circumcision. We are confused. Men are refusing to use condoms and we are not in the position to defend or negotiate for safe sex.’
WHiPT recommended, ‘Swaziland’s HIV/AIDS policy makers along with implementers and civil society advocates must address gender implications of MMC in the current policy by identifying, messaging and monitoring for potentially harmful outcomes of promoting MMC, such as increased behavior risks and sexual violence against women.’
The WHiPT report surveys women in five African nations, including Swaziland. To read the full report, click here.