ZIMBABWE continues to promote male circumcision as an HIV and Aids prevention method despite research that questions the practice, meaning tens of thousands of circumcised people could be at risk.
To underline the importance that has been put on male circumcision, more than 10 legislators had the surgical snip last week, reportedly setting an example that others should follow so as to reduce the HIV scourge.
However, new researches are questioning the link between HIV reduction and circumcision, with some studies showing that HIV was more prevalent in circumcised Zimbabweans than those uncircumcised.
A USAID report indicates that out of 15 countries surveyed, the result between circumcised males and the uncircumcised was negligible, with only Kenya having a substantial difference.
"In 10 of the countries - Cameroon, Guinea, Haiti, Lesotho, Malawi, Niger, Rwanda, Senegal, Tanzania and Zimbabwe - HIV prevalence is higher among circumcised men," reads the USAID report, which was published in 2009, effectively questioning the efficacy of male circumcision.
The study was carried out between 2003 and 2005 in the 15 countries and in Zimbabwe 5 848 men took part in the research, ahead of a World Health Organisation and UNAids recommendation in 2007 that circumcision could be used as an HIV preventive method.
Yet more scholars continue to question the method, instead advising that the world bodies should have waited longer before recommending the procedure.
Two medical scholars last November also questioned the usefulness of circumcision, describing it as a dangerous distraction in the fight against HIV and Aids.
It is believed that circumcision reduces transmission rates by 60%, but Gregory Hill and Gregory Boyle, in the Australian Journal of Law and Medicine say the snip only reduces transmission by no more than 1,3%, which they say is statistically insignificant.
"Examination of epidemiological data shows that male circumcision does not provide protection against HIV transmission in several sub-Saharan African countries including Cameroon, Ghana, Lesotho, Malawi, Rwanda and Tanzania, all of which have higher prevalence of HIV infection among circumcised men," Hill and Boyle said.
The two also questioned research that led to the adoption of circumcision, saying WHO had taken it without critical questioning, as the study was fraught with problems, among them inadequate equipment, selection bias and the studies were stopped before adequate data could be analysed.
"Evidence suggests that mass circumcision programmes may exacerbate the HIV epidemic among women (and) under these circumstances it would be irresponsible and unethical to advocate mass circumcision programmes in southern Africa," the two scientists noted.
Instead, they advised that more emphasis should be put on promoting condoms, which are 80% effective. The two also pointed out that HIV prevalence is higher in America, where a significant percentage of the male population is circumcised, compared to Nordic countries where most men are intact.
Another study, appearing in the Journal of Public Health and carried out by Robert Van Howe and Michelle Storms, says circumcision is a costly sideshow, which in the end might lead to an increase in HIV prevalence.
The report was published last year.
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Scaling up male circumcision will NOT reduce new HIV infections!
Circumcision (sexual-reduction surgery) does NOT reduce the female-to-male transmission of HIV by 60% as misleadingly claimed. This is a relative figure only. The actual (absolute) risk reduction was only 1.3% which is NOT clinically significant. http://www.salem-news.com/articles/december112011/circumcision-hiv-rg.php http://www.circumcision.org/hiv.htm Up to 50% of HIV infections are through NON-SEXUAL sources such as medical treatment and cosmetic skin piercing procedures. Alarmingly, in a parallel Ugandan study by Wawer et al. (2009), there was a 61% relative INCREASE (6% absolute increase) in male-to-female transmission of HIV. Several women in the trial became infected with HIV after having sex with their newly circumcised partners. Circumcision can only worsen the HIV epidemic because: 1) Some men may become HIV infected from the circumcision procedure itself when surgical instruments are inadequately sterilized. 2) At least 25% of men engage in sexual intercourse before their circumcision wounds have healed (half as early as 3 weeks). http://www.aidsmap.com/Quarter-of-men-resume-sex-before-wounds-from-circumc ision-fully-healed-in-Zambian-study/page/2227154/ 3) Many circumcised men mistakenly think that they have a "natural condom" so they believe they are "immune to HIV infection" and can be promiscuous with impunity. How wrong they are!
Flawed African Studies into Male Circumcision and HIV Sexual Transmission
Ref: Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns. J Law Med 2011;19:316-334.
The Journal of Law and Medicine, has published a critique of those three randomized clinical trials from Africa that have purported to find that male circumcision reduces female-to-male sexual transmission of HIV by 60 percent.
This critique finds numerous flaws in the execution of these studies and shows that the actual (absolute) reduction in HIV transmission was only 1.3 percent, not the claimed 60 percent (relative figure only). The 1.3 percent is not considered to be clinically significant.
This is offset by a 61 percent relative increase (6 percent absolute increase) in male-to-female HIV transmission when the male partner is circumcised (Wawer et al., Lancet, 2009). They reported that "Circumcision of HIV-infected men did NOT reduce HIV transmission to female partners...Condom use after male circumcision is essential for HIV prevention" (p. 229).
Given this, the African RCTs should not be used in the formulation of public health policy. http://www.salem-news.com/articles/december112011/circumcision-hiv-rg.php
Just as female circumcision (genital mutilation) is a despicable atrocity intended to permanently reduce the sexual sensation of women, so too, male circumcision is nothing but penile-sexual reduction surgery (genital mutilation) intended to permanently reduce the sexual sensation/function of men. Circumcision under false pretences (without FULLY INFORMED consent) is a human rights’ violation. Non-therapeutic circumcision of defenceless children is criminal sexual assault and child abuse. http://www.cirp.org/library/sex_function/ http://www.cirp.org/library/legal/