13 September 2007

Namibia: Circumcised Men Still At Risk

Windhoek — Circumcised men should not develop a sense of security that they are immune to HIV/Aids infection, the Minister of Health and Social Services, Dr Richard Kamwi, has warned.

Delivering a ministerial address in the National Assembly yesterday, Kamwi said despite the fact that the World Health Organisation and UNAIDS have concluded that safe male circumcision reduces the risk of heterosexual transmission of HIV infection from women to men by approximately 60 percent, men are still at risk. Kamwi said male circumcision provides only partial protection against HIV and because of its partial protective effect, male circumcision must be considered as part of a comprehensive package of HIV prevention interventions.

Circumcised men can still get infected, and men who are HIV-positive can infect their partners and there is no evidence that male circumcision in men who are already HIV-positive has any protective effect on their female partners. He said preliminary data from Ugandan trials suggest that recently circumcised HIV-positive men who resumed sexual activity before certified wound healing, could be more likely to transmit HIV than those who waited until complete wound healing.

"HIV-negative men who engage in sexual activity before wound healing is certified are also at increased risk of acquiring HIV." The Minister warned that all men who undergo circumcision should abstain from sex until complete wound healing, and therefore should use condoms correctly and consistently.

Kamwi said his ministry is planning research to get clarity on the knowledge, attitudes and perceptions various communities in Namibia have regarding circumcision. He noted that there are some communities where circumcision is a well-established traditional practice and other communities where HIV prevalence is very high and circumcision is not practised at all.

Kamwi said because male circumcision is a surgical intervention, safety must be ensured and the service should be integrated within the context of existing health care services, including the involvement of a range of Government, private sector and NGO partners. He said the Namibian health service does not have the capacity to cater for large numbers of potential clients requesting circumcision and scaling up safe male circumcision requires well-trained medical staff. Nudo Party president, Kuaima Riruako, advised Kamwi that circumcision should not take place at birth as the skin can grow again. He said it should at least take place eight days after birth.

The Minister of Safety and Security, Peter Tsheehama, said the ministry must clearly explain to the people the difference between castration and circumcision.

He narrated a story of a man who wanted to be circumcised and ended up being castrated because he could not distinguish between the two.

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