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| Scientists divided over male circumcision |
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| Written by Arthur Okwemba | |
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While several scientists and leading research institutions continue to vouch for male circumcision as an effective way of preventing HIV infections, there are those who are warning against rushing to adopt it as a strategy. Those who think circumcision may not be the answer to reducing HIV infections argue that there is no significant difference in HIV prevalence rates between communities that circumcise and those which do not. A study presented at the 16th International AIDS Conference, 2006, by Dr Vinod Mishra, director of research at ORC Macro, Calverton, Maryland cautioned against adopting the strategy in the war against the disease without intense debate and consideration. Examining the association between male circumcision and HIV infection in eight sub-Saharan countries, Mishra found that HIV prevalence was not lower in populations having higher male circumcision rates. The researcher argues that the crucial component in HIV acquisition and transmission is not the presence of foreskin but because of the absence of a condom and associated lack of knowledge. Other researchers have too expressed fears that circumcised males are going to be less willing to use condoms and engage in risky sexual behaviour if they consider themselves insulated from HIV infection. This development is going to work against women as men engage in unprotective sex with multiple partners. Instead of circumcising males, some women organizations want their lot to be empowered through increased investments in female condoms and microbicide research. In the United States, human rights organizations are calling on those propagating circumcision to balance the rights of children when it comes to popular government interventions such as male circumcision. Questions such as the right of the child to consent to an operation like this when done while the child is an infant abound. These concerns are emerging when several studies indicate that circumcision of infants is simpler, less complicated and risky compared to when it is done to young boys, adolescents or adults. Hence countries are encouraged to promote neonate circumcision in a safe and culturally acceptable manner. Only what needs to happen is to provide parents willing to circumcise their infants with all the pro and cons of the operation. But human rights groups say the decisions that affect a child must be in the best interest of that child. By circumcising a child, who might even choose to live a life of celibacy, assumes the child is going to engage in risky sexual behaviours. This goes against the child’s rights, they argue. Hence the child has to be involved in the decisions made by his family about his circumcision. Tom Ambicha, a local child rights advocate says while over 80 percent of the Americans have been circumcised in the infant stages, there is no positive correlation with reduction in HIV acquisition. These are weighty issues needing attention when considering circumcision of infants or children below 18 years. In a recent British Medical Journal, critics of the operation as an HIV prevention strategy were quoted as saying male circumcision will not be the quick fix for HIV prevention unless cultural beliefs are included in the prevention equation. Male Circumcision and Comprehensive HIV Prevention Programming: Guidance for Decision-Maker on Human Rights, Ethical and Legal Consideration, a publication prepared by UNAIDS and AIDS Law Project of South Africa, too wants male circumcision to be treated cautiously. It says: “Because the protective effect of male circumcision is only partial, male circumcision must be promoted in combination with other methods to reduce the risk of sexual transmission of HIV.” These other methods include reduced number of sexual partners, correct and consistent use of condoms, visiting voluntary and counseling centres, and delayed sexual debut. Arthur Okwemba              |
