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Why The Caribbean Must Reject Circumcision As A Method For HIV Prevention

January 29th, 2012 Posted in Medical

There is news in the medical world that one of the new ways to fight the HIV/AIDS pandemic is male circumcision. Proponents of this method point to three studies conducted in Africa arguing that the HIV infection rate was reduced for circumcised males. However more accurate and objective findings show the research methods and results to be at best flawed[i] and at worst a calculated misinformation campaign designed to promote the genital mutilation of males in Africa and other susceptible countries. With its relatively high rates of HIV infection, the Caribbean population needs to be aware of the facts and equipped to reject the use of circumcision as a tactic in the prevention of the HIV/AIDS virus.Circumcision is the practice of removing the male foreskin. The foreskin is a delicate prepuce of skin designed to protect the glans of the penis from abrasions and infections. With over 20,000 nerve endings, the foreskin increases sexual sensitivity and pleasure. Women also report increased sexual pleasure from an uncircumcised male.[ii] The foreskin also offers valuable immunological protection from urinary tract infections[iii] and many sexually transmitted diseases[iv]. There are many other functions of the foreskin[v] and besides all males are born with a foreskin so they were obviously intended by nature to be there. The non-religious origin of circumcision is believed to have started as a method to discourage sexual activity and over the years the procedure has been touted as a way to prevent male masturbation and cure diseases such as penile cancer and epilepsy[vi] (none of which have been proven under rigorous scientific tests and medical peer reviews)[vii]. It continues largely because of cultural stereotypes, tradition and myths[viii]. As many informed doctors insist, circumcision is an unnecessary, painful, cruel practice[ix] that causes long term physical and psychological damage[x] and is essentially a solution in search of a problem – meaning that there is very rarely any medical reason to ever circumcise. Unfortunately ignorance abounds and circumcision is still one of the most widely non-medical surgical procedures performed in the USA.

Since most circumcision is conducted on babies, it is a human rights issue. An uninformed parental choice will affect a boy for the rest of his life, altering his genital integrity forever. Intactivists (someone who believes in keeping a penis intact) insist that a child’s body is his own and infringing on these rights is abuse. A recent article in the Guardian newspaper states that ‘Just as we call sex without consent ‘rape’, circumcision without consent or reasonable justification should be called ‘mutilation’.’[xi] Rates of circumcision for non-religious reasons are declining all over the world[xii] except now in countries where the propaganda linking circumcision & reduced HIV is widespread. Circumcision is one of the latest trends to be foisted upon the African continent with an almost evangelistic zeal and needs to be examined in the harsh light of real science and neo-colonialist critique.

Campaigns across Africa have already resulted in thousands of males getting circumcised to reduce their likelihood of being infected with HIV but the results of such an initiative are not proving successful for two main reasons. The first is that the original studies were far from conclusive that circumcision really is effective and secondly when it circumcision is performed it affects sexual behaviour to the extent that disease transmission becomes more likely.

Let’s start with the studies. Three separate studies were conducted – in South Africa, Uganda and Kenya. All involved a group of men who signed up wishing to be circumcised.

  • In South Africa a total of 3,274 men were divided into two groups where 1,582 were left intact while 1,546 were circumcised. At the end of the trial, 45 of the intact men had HIV while 20 of the uncircumcised group were HIV+.
  • In Uganda, researchers randomly divided a total of 4,996 men into two groups. 2,474 men were circumcised while the other group of 2,522 men was left intact. After 24 months, both groups were tested for HIV infection. Of the circumcised men, 22 tested positive, while 45 in the uncircumcised group tested positive.
  • A similar scenario took place in Kenya where studies began with 2,784 men with 1,391 undergoing circumcision and 1,391 left intact. Two years later there were 22 new infections in the group of circumcised men and 47 among those left intact.

On face value the studies do appear to show that circumcision has a slightly positive effect on reducing HIV infections. However some of the flaws of the study include: Continue to article

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