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Africa Science News Service
August 15, 2008
Policy on male circumcision will curb misconceptions around HIV/AIDS and the male cut
Written by Mildred Barasa
Although circumcised men stand 60 per cent [less] chance of not contracting the HIV virus through virginal [vaginal] sex, still there are misconceptions around the new finding that might be detrimental to the public, if not checked. [Without the word "less", this is itself a misconception. With it, it may or may not be true.]
Due to the fact that circumcised men are much less [no, somewhat less, perhaps] likely to get HIV compared to the uncircumcised, some people think being circumcised is rendering them immune to the HIV virus.
Timon Otieno a young man in his early twenties and a resident of Kisumu city, Kenya’s 3rd largest after Nairobi and Mombasa, had this to say: “What I have heard is that a man who is circumcised cannot get HIV/AIDS. Once circumcised, the male organ becomes hard, and the virus cannot therefore penetrate…even other sexually transmitted diseases (STDs) are very rare in circumcised men.”
Asked whether he is circumcised, Otieno quickly said, “Yes, I am circumcised already and this was done in order to keep away STDs including HIV/AIDS. I will convince other people to go for circumcision as it is of benefit to them and the public.” Otieno is among young men who believes by being circumcised, he now has a natural condom, something that can really be harmful to his life and to others.
Unlike Otieno who is advocating for his Luo tribemen, traditionally, a non-circumcising community, to be circumcised in big numbers, Emmanuel Ochieng’, who repairs bicycles on the outskirts of Kisumu town dismisses the idea.
“I have very many friends who were circumcised and some of their stories are not encouraging. One of them says that ever since he was circumcised, he no longer enjoys sex because a gland was cut off from his penis. He can not erect like before. That makes me dislike circumcision and I have also heard that the fore skin that is removed during circumcision is sold abroad. This means that business is now being conducted using people’s skins? My foreskin cannot be sold for purposes that are not known to me, no!” Yells Ochieng.
Daniel Ochieng’ Okumu, a 23 year old from Kolwa location, Kisumu district admits that he is aware of the fact that circumcision minimizes [no, reduces, perhaps] one’s chances of contracting the HIV virus, but confesses that he dislikes the idea of circumcision.
“I am a big person and can therefore control myself in terms of prevention from contracting the HIV virus. If there is one thing I hate in life, it is circumcision. The process that is involved is scary and very painful, so I cannot undergo it at all. I am also aware that a circumcised man loses sexual pleasure as his sexual organ is interfered with after the operation is done. During circumcision, there is a gland that is cut and removed from a man’s sexual organ, which reduces his chances of enjoying sex. That alone is enough reason for me not to be circumcised,” emphasized Okumu.
He is not alone in the dark world of pessimism, as Olwa Melkizedek, another young man from his village says, “Some of my friends say, what the project of Universities of Nairobi, Illinois and Manitoba (UNIM) researchers are telling people around are just mirths [myths] and nothing that should be taken seriously.”
For Olwa, he has heard that circumcision reduces the rate of one to contract the HIV virus and says that he got the information from a seminar that he attended in Kisumu town, but did not believe the story.
“I know that the HIV virus is transmitted through body fluids, in the seminar I attended, we were told that the fore skin keeps the virus, but according to my studies, I know that a virus cannot survive for more than one minute in the fore skin without dying, hence the story of people getting AIDS through that is not true,” he said. [This has neither been confirmed nor refuted.]
He therefore holds that there is no need of being circumcised, yet he can use a condom and at the same time control himself.
“The condom is the better option here, and not circumcision that we (Luos) do not practice,” he stressed. Asked whether the information on HIV and male circumcision was well disseminated to him, he was cynical and admitted, “I can only embrace the idea, after getting the full information about the relationship between HIV/AIDS and male circumcision, but for now, I still do not accept the idea. The medical practitioners who are sensitizing people about the new research should be in a position to publicize more information on the topic, for us to buy it, but for now, we still do not trust what they are saying.”
From a wide range of individuals especially those without or with limited education, it is essential that information on male circumcision and HIV/AIDS is disseminated carefully. And incase the procedure is promoted as a way of preventing one from contracting HIV; some men might think they are immune to the virus.
The main fear is that, if promoted as a means of prevention from HIV infection, men will believe that they are immune to HIV after circumcision. Fortunately, the UNIM team in Kenya says it offers relevant information to their clients and anyone who was interested in their project, hence it informs the public that circumcision is not a means of prevention against one contracting the HIV virus. [Without this assurance, how will they persuade men to be circumcised?]
“We have been offering the necessary counseling to people before they are circumcised in our study, but we have never told anyone that once circumcised, then they have a natural condom. This simply means that there is need for more counseling and we need to reemphasize on educating people on the matter,” clarified Dr. Mathews Onyango, one of the researchers in the UNIM project.
Due to the fact that the project is yet to roll out a program on sensitizing the entire public on the new research, it is acknowledged that the general public will receive information from wide sources, some that might not be true or helpful to them.
Dr. Onyango however said that the project is yet to receive the government’s policy on how to disseminate the information to the people. “We are waiting for a go ahead from the government for us to start sensitizing people, as we want to work with the government and not be ahead of it,” said Dr. Onyango.
He disclosed that even though most people joined the research with full information of what it entails, some did so with their own pre-construed misconceptions.
“Some people got circumcised, because they thought by doing so, it would enhance their sexual prowess. Such people require more education on male circumcision, for them to understand exactly what it is,” said Dr. Onyango.
Kenyans are not alone in harboring such misconceptions in regard male circumcision and HIV/AIDS, as individuals the world over share their position.
During the just ended HIV/AIDS international conference in Mexico, there were heated debates on the issue. “Will increased risk behavior after male circumcision negate its protective effects,” asked Alvaro Bermejo of the International AIDS Alliance.
Some cultures believe in a "whole man" and that circumcision makes men "incomplete", while others, just like some Kenyans believe that it reduces sexual pleasure, according to some delegates who attended the conference.
But the evidence of lower HIV rates in countries where more than 80 percent of the men are circumcised is hard to ignore. []
During the Mexico HIV/AIDS conference, Supreme Mfalapitsa from EnGender Health South Africa called for health officials to consult traditional and community leaders in their countries before promoting male circumcision.
Aside from a rite of passage from boyhood to manhood, it could be seen as a “blood sacrifice to the ancestors”, said Mfalapitsa.
Given such misconceptions from the public, it is evident that once a policy on male circumcision is ready, Kenyans will have their fears and questions answered.
The Policy on Male Circumcision in Kenya 2008 calls for the procedure to be provided to all willing males.
According to the policy, male circumcision will become the fourth part of the ABC HIV prevention approach -- which stands for abstinence, be faithful, use condoms. The new approach will be ABCC, with the last C representing circumcision.
The proposed policy notes that circumcision will not replace current effective HIV prevention methods and that it should be considered as part of a comprehensive prevention package.
Under the policy, the government will provide training on circumcision to health workers. The policy says health facilities must "ensure that male circumcision is performed by well-trained practitioners in antiseptic settings under conditions of informed consent, confidentiality, risk-reduction counseling and safety."
Facilities from the dispensary to the district hospital levels are to be strengthened to handle the increased demand for the procedure. In addition, those implementing the policy will be required to establish laws and supervisory mechanisms that make circumcision services safely accessible without being discriminatory.
The policy calls on the Ministry of Health to "strengthen health systems to ensure that male circumcision programs do not interrupt or divert resources from other primary health care services."
The health ministry will have to integrate the management of reproductive, sexual health and HIV prevention programs to provide male circumcision services.In addition, a male circumcision task force is expected to help guide the circumcision efforts.
The proposed task force will help: Advise the health ministry on development programs for expanding quality male circumcision services;Provide professional, technical and administrative assistance during the effort; Ensure accurate and appropriate dissemination of information; and Promote male circumcision within the context of the general enhancement of health care services.
Courtesy of the Internews, Kenya
Last Updated ( Friday, 15 August 2008 ) | 