13 June 2009

Zimbabwe: Male Circumcision Combats Spread of HIV

TWO major planks are emerging as possibly the best responses to curbing the spread of HIV and AIDS.

The first is promotion of the practice of circumcision among boys and men, while the second relates to focusing efforts on ending the practice of multiple concurrent partners.

Recent studies in the Southern African region and in East Africa demonstrate the impact of circumcision on reducing HIV-prevalence rates.

A multiple and concurrent partnership is a situation where sexual relationships overlap in time. A sexual partnership is considered to be concurrent if a person reports having two or more sexual partners in the previous month.

The concurrency issue is very important in the fight against HIV/AIDS as it increases one's risk of exposing themselves to HIV infection, through exposure to invisible sexual networks which enable the rapid spread of HIV when it is introduced

Ten days ago Zimbabwe joined a regional campaign that focuses on the reduction of multiple and concurrent sexual partnerships (MCPs), seen as one of the key drivers of the HIV pandemic in the region.

The national campaign is called OneLove. Its aim is to scale up information about the risks of multiple and concurrent partnerships in the hope of bringing about behaviour change.

The United States last week said it backs efforts by Zimbabwe to pioneer male circumcision as part of a comprehensive HIV prevention and reproductive health package in preventing the spread of HIV.

James McGee, the US Ambassador to Zimbabwe last week announced the US support for this new campaign.

"I heartily support this important intervention," McGee said during a tour of the Zimbabwe National Family Planning Council -- the first male circumcision training and service delivery pilot site.

The project is supported by Population Services International (PSI) and the US Agency for International Development's (USAID) Technical Working Group (TWG) on Male Circumcision Service Delivery and Training.

"Unlike other prevention methods, male circumcision is a one-time procedure that provides life-long protection. I am sold on this simple life-saving procedure," said McGee, who was also accompanied by officials from PSI and USAID.

Officials from the ZNFPC, Ministry of Health and Child Welfare and the Iinstitute of Continuing Health Education University of Zimbabwe College of Health Sciences also attended the tour.

Echoing lessons learned from his previous post in Madagascar, McGee pointed to the prevailing cultural practice of male circumcision at birth as one reason for Madagascar's very low HIV prevalence rate.

He noted that public-private partnerships are essential in addressing various developmental challenges, including HIV and AIDS.

Congratulating the nurses and doctors undergoing the six-day training McGee said they "are all important pioneers in this emerging activity".

PSI's Male Circumcision Project Director, Karen Hatzold, said that during the training the doctors had treated 79 patients and were scheduled to complete 140 circumcisions by the end of the week. She explained that counselling is a big part of the procedure and the nurses recruited will initially focus on this area.

"With time, nurses will also perform the procedure," said Hatzold.

A recent publication from the Southern Africa HIV and AIDS Information Disemination Service (SAfAIDS) says there is overwhelming scientific evidence of the efficacy of male circumcision for HIV prevention.

According to SAFAIDS, over 50 studies have concluded that male circumcision significantly reduces the risk of heterosexual HIV infection. Recent trials confirmed that male circumcision, when done safely, could reduce the risk of men being infected with HIV by 60%.

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