Friday, April 13, 2007

To circumcise or not to circumcise?

An interesting piece from Imatong:

Eyebrows were raised when the recent randomised control trials in Uganda and South Africa were stopped prematurely because of ethical reasons. The trials show that male circumcision has massive protective effect against HIV transmission. You may wonder what these had to do with the youth . . .

Circumcision is a controversial subject in South Sudan. For most people it is an Islamic religious requirement for induction into Islam. For the Zande (correct me!) is a cultural thing that all males be circumcised. And if you transfer that to the Eastern Equatoria you will be labelled a "Jallaba" if they know you are circumcised.

Why should it be a dilemma for the young people? For town folks, it is no big deal as peer pressure guarantees that it is performed before the other boys find out. You will not go to swim in the river with your peers as you will be the subject of ridicule!

Now with AIDS continuing to spread like wild fire and all prevention methods don't seem to do much, a much subtle approach seems to be promising. The trials showed the protective effect that circumcision can be promoted as one intervention for controlling HIV. The dilemma is: how can such an interventions be promoted in a traditionally non-circumcising community without raising controversy?

Culture and religion aside, male circumcision has some medical advantages: cleanliness, reduced chances of viral infection like human pappiloma virus and sexually transmitted diseases.

Mind you it doesn't mean the circumcised can go play around. It is an added advantage but does not replace the condom. While the world continues to debate the ethics, the question remains: to circ or not to circ?


Daana Lost in Translation said...

I read about those trials a few weeks ago in MSNBC, but I never knew that circumcision was culturally unacceptable to some people. Anyways, yes truly Islam and Judaism both require male circumcision, but it has become such a widespread practice almost everywhere in the world now. Here in the states most boys are circumcised at birth regardless of religious or cultural customs (of course there are some people people who don't want that performed to their children however it is still widely practiced). Now the problem for us in Africa is lack of education, and fear of non-conforming with cultural values or fear of being called names. We need to educate the public about such issues including giving them info about HIV virus and ways of spreading and possible methods of protection. I know that this seems to be very hopeful and unrealistic due to lack of government programs and limited resources, but it is the only way to stop HIV from spreading even further.

Black Kush said...

It is strange but true in South Sudan. Male circumcision is frown upon. Some tribes never practice it and consider circumcised males as step to Islamizaton.

It is easy to circumcise in the towns, but to promote it in areas not circumcising will be a big issue.

TLC Tugger said...

Careful. That new research is not so definitive. In Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Tanzania, AIDS is markedly more common among the circumcised. The *success* of the cut men in Uganda was that they CONTRACTED HIV at a rate SIX TIMES HIGHER than the rate for African-American men.

The studies said the cut men were MORE likely to transmit AIDS to a partner. Also, it was recently published that African youth (not yet sexually active) are MORE LIKELY to have AIDS if they were circumcised.

Two weeks ago, the British Journal of Urology published a study demonstrating that the foreskin is the best part of the penis, and that cut men give up a lot of satisfaction.

90% of the half-million American men who have died of AIDS were circumcised at birth. Circumcision does not prevent a man from getting AIDS (and it certainly doesn't protect his partner or prevent pregnancy like condoms do).


Aaron in South Sudan said...

Let's push condoms to deal with the problem at hand.

Black Kush said...

I think the current hype around male circumcision is too early too. Considering that the WHO has given its backing to promote circumcision has added to the controversy.

Ron, I am not aware of the details you raised, but if true, then the circ promoters will have to go back to the drawing board.

For the moment, I agree with Aaron: push the condom!

HalalHippie said...

As an uncut infidel I'm in no position to opine anything, but still :-)

Promoting (male) circumcision as a "prevention from HIV" could make more harm than good. Think of all the myths, like jumping a virgin. It could lead ppl to think as long as they're circumcised, they're safe.

I read a statistic about 2 African countries ( can't remember their names) where one Muslim country was measured against a Christian/ Animist country: there was no difference in the % of HIV.

Daana: you "never knew that circumcision was culturally unacceptable to some people" In DK it's not unacceptable, only very rare ( I'd say 1-2% - and they're all Muslim/Jewish). HIV rate it very low, because when the first gay men started dying in the 80es, there were massive campaigns to educate ppl. Homosexuality is not a big taboo here.

My personal view (and no offense to anyone's tradition here) is a person should choose for himself. If I had my way it would be a crime to cut an underage child. [not talking FGM here (ugh!) it's strictly illegal in DK] I even read an online fatwa somewhere that if an adult wishes to convert to Islam , circumcision is not mandatory.

I say roll down the rubber, don't listen to the Pope or a sheikh. It's life or death.

Black Kush said...

This is bound to be a big issue when WHO will push it as an option. I agree wiht HH. All who are cut mat think that they are safe to play around! False sense of security.

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