To most African communities, facing the knife is akin to being a “real man”. Male circumcision is an important rite of passage that moves the young man that undergoes it a notch higher towards marriage and earns him a respectable position in society. But to a few African tribes, like the Zulu warrior nation in South Africa and the Luo in Kenya, male circumcision is not in the books. But this may soon change.
Recent extensive medical research and studies on the prevalence of HIV/Aids in Africa indicate that male circumcision could help reduce the spread of the disease on the continent and elsewhere. A massive roll out of free male circumcision programs in Swaziland, Rwanda, Zambia and Kenya is underway and experts hope results will reflect the 60% reduction in new infection rates documented in the studies.
Circumcision is the surgical removal of part or the entire foreskin that covers the tip of the penis. Male circumcisions are traditionally carried out for a number of reasons – social, cultural, religious (mainly for Muslims and Jewish communities). Medical reasons may now compel most males worldwide to go for the knife.
In the US, the National Health and Nutrition Examination Surveys (NHANES) found that between 1999 and 2004, 79% of men reported being circumcised, including 88% of non-Hispanic white men, 73% of non-Hispanic black men, 42% of Mexican American men, and 50% of men of other races/ ethnicities. These figures showed a remarkable reduction on the rate of circumcision in recent years, from about 85% of all newborn males in the 1970s.
Reports indicate that a study in Kenya prompted the World Health Organization (WHO) to include circumcision in its prevention policies a year ago, and which compelled the Kenyan government to form a task force to promote voluntary, medically safe operations.
The trial in Kisumu, Kenya, of 2,784 HIV-negative men showed a 53 percent reduction of HIV acquisition in circumcised men relative to uncircumcised men, while a trial of 4,996 HIV-negative men in Rakai, Uganda, showed that HIV acquisition was reduced by 48 percent in circumcised men.
“Many studies have suggested that male circumcision plays a role in protecting against HIV acquisition, we now have confirmation—from large, carefully controlled, randomized clinical trials—showing definitively that medically performed circumcision can significantly lower the risk of adult males contracting HIV through heterosexual intercourse. While the initial benefit will be fewer HIV infections in men, ultimately adult male circumcision could lead to fewer infections in women in those areas of the world where HIV is spread primarily through heterosexual intercourse,” noted US National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony S. Fauci, M.D.
Male Circumcision Considerations for the United States
A Centers for Disease Control (CDC) document, Male Circumcision and Risk for HIV Transmission: Implications for the United States, says: A number of important differences from sub-Saharan African settings where the three male circumcision trials were conducted must be considered in determining the possible role for male circumcision in HIV prevention in the United States. Notably, the overall risk of HIV infection is considerably lower in the United States, changing risk-benefit and cost-effectiveness considerations.
Also, studies to date have demonstrated efficacy only for penile-vaginal sex, the predominant mode of HIV transmission in Africa, whereas the predominant mode of sexual HIV transmission in the United States is by penile-anal sex among MSM. There are as yet no convincing data to help determine whether male circumcision will have any effect on HIV risk for men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner. Receptive anal sex is associated with a substantially greater risk of HIV acquisition than is insertive anal sex.
But the African roll out programs may face cultural and traditional setbacks as acceptability of male circumcision will be an important factor that cannot be ignored. The Meru tribe in Kenya for instance differentiates between circumcisions in a modern hospital environment with the traditional communal knife by special “cut surgeons”.
The traditional one is of course more painful as it is done under no local anesthesia and also less hygienic as the knife is always shared among the candidates in a pompous, beer fest cutting ceremony. A “real” Meru man is one who has undergone the traditional cut.
Image Credit: Babasteve at Flickr under a Creative Commons license
Rwanda has almost double the rate of HIV in circed men than intact men, yet they’ve just started a nationwide circumcision campaign. Other countries where circumcised men are *more* likely to be HIV+ are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. That’s six countries where men are more likely to be HIV+ if they’ve been circumcised. Something is very wrong here. These people aren’t interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives.
Circumcised male virgins are more likely to be HIV+ than intact male virgins, as the operation sometimes infects men, especially if the same knife is used for several men. The latest news is that circumcised HIV+ men appear more likely to transmit the virus to women than intact HIV+ men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised.
Female circumcision seems to protect against HIV too btw, but we wouldn’t investigate cutting off women’s labia, and then start promoting that.
For a good summary of the case against promoting circumcision in Africa, see this link:
http://www.doctorsopposingcircumcision.org/info/HIVStatement.html
If circumcision is such a wonderful intervention against HIV/AIDS, just why is there no difference in the HIV acquistion rate in the US between circumcised and uncircumcised men? A recent study found that there is absolutely no difference. Separate studies in Australia and New Zealand found the same results, no difference! How can that be?
With an 85% circumcision rate among sexually mature men in The US, HIV would not have a chance if it did have the protective factor claimed. A similar intervention, the polio vaccine, virtually wiped out polio in just a few short years. Consider that the polio virus can be transmitted casually and exists in the natural environment. The polio vaccine is only 70% effective yet it wiped the virus from the population. To the contrary, the HIV virus does not exist in the natural environment and quickly dies outside the body of it’s host. If circumcision provides a 60% protective factor as claimed, why does The US have the highest infection rate among the industrialized countries?
The two just don’t jive. Circumcision in the battle against HIV is a dud. Further, it could give men a sense of false security leading them to take ill considered risks and that could actually drive the HIV infection rate up.
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They love quoting those huge percentages of (relative) HIV risk reduction – “53%”, “48%” and “up to 70%” – but what actually happened was that they circumcised 1,391 men in Kenya and 2,474 in Uganda and left similar numbers (control groups) alone.
After less than two years, 22 circumcised men in Kenya and 22 in Uganda had HIV, compared to 47 and 45 of the control groups. That’s an absolute difference of 1.8% and 0.9%. More important it’s 30 circumcisions in Kenya and 55 in Uganda to delay (not prevent) each HIV transmission.
Meanwhile 87 of the circumcised men in Kenya and 140 in Uganda were “lost from study”, their HIV status unknown. It wouldn’t take many of those being HIV+ to completely overthrow the “protection”.
circumcision has done nothing to prevent HIV in the United States. This is junk science, those African studies compared circumcised Muslim men to intact truck drivers who visited HIV infected prostitutes. Stop rationalizing male genital mutilation, stop it now.
all new world order really wants is to kill off all the blacks in africa. circumcision is a damn joke. how many guys who beat their wives were circumcised?
GOOD FIGHT WHAT OF WIFE INHERITANCE THAT ALSO LEADS TO THE MYSTERY LIKE INTHE UNCIRCUMISSED HERE AT HOME ALSO INHERIT WIVES.
Circumcision removes a major part of sexual pleasure, leaving only the most sensitive part, open. The results in sexual immediacy, followed in later life, with sexual disfunction due to; desensitivity of the once sensitive glans, removal of the sensitive inner part of the foreskin which provides a semi mucous membrane protecting and lubricating the head. The foreskin has nerve ridges inside the skin which enjoys to be stretched and pulled. This is essential sexual function. Please, this is human to have their sexual function willfully diminished. Why? My mother told me it stopped me playing with myself and i kept getting infections. Perhaps she should have taught me how to keep it clean.
All these studies in Africa are propaganda. Circumcision is just a cure searchnig for a disease.
Why do they make these studies in Africa ? Why not in Europe or US ?
Circumcision is a primitive, barbarous and gender-based atrocity.
And the USA leads the superstitious parade, as usual.