Circumcision And HIV

I HAVE watched with a mixture of appreciation and anxiety the NBC morning programme of ‘Good Morning Namibia’ discussing the results of medical research that proved circumcision can be used as a HIV-prevention strategy.

I do not at all dispute the correctness of such a finding but I have a whole problem with this finding being advertised and popularised as a HIV-prevention strategy. There are, fundamentally, two types of scientific findings, namely a mere academic discovery and a practical breakthrough.I am of the opinion that this circumcision finding falls into the former category.This is for obvious reasons such as certain issues and factors were overlooked during research, the practical applications of such finding carry low levels of efficiency and practicality and, politically speaking, such a finding being politically incorrect.The chances of a circumcised man not contracting the HIV virus from an HIV-positive female are 40 per cent.That means that for every ten times a circumcised man is having sex with a HIV-positive woman, four of such sexual encounters are likely to result in him being infected with HIV-AIDS or put differently and crudely, for every 10 minutes that a circumcised man is continuously having sex with a HIV-positive woman, four minutes of such an encounter may be HIV-transferring minutes.Is this level of efficiency and practicality reliable to have us promote circumcision as a HIV-prevention strategy? Would it be ethical in the medical world to promote the medicine that expose a patient to a 40 per cent chance of death? Even in mechanical concepts an inventor of an engine with 60 per cent efficiency would hardly consider it as an economical invention, as such an engine wastes too much resource/input energy.Now extrapolate that efficiency level to the life-saving tool where every life lost counts as much as every life saved.Is this really acceptable? Now, let us the look at the issues that might have been overlooked during this circumcision research.The findings are from communities that are mainly traditional, as we know that in Africa circumcision is normally practised in communities with high degree of adherence to traditional practices and such practices involve a subservient role of a woman in the community, including the home.Did these researchers take into account the fact that in some of these communities a woman is not supposed to be excited during the enjoyment of conjugal rights and sexual encounters? For some of these communities, where research might have been done, the biological excitement of women during sexual encounters might be too low and a man might not be exposed to so much of a woman’ excitement.Can it be possible that in a non-traditional environment, the circumcised man may indeed be exposed to a high level of risk than in a traditional environment? I fully appreciate the dermatological benefits that come with the removal of the foreskin from the man’s member, but can it not be possible that such benefits may also depend on the length of time a person have been circumcised? Would a man who got circumcised four months back really enjoy the same HIV protection as the man who has been circumcised since childhood? As we all know of the biology of women, this finding is too gender-biased, apart from low level of efficiency, as only men are directly benefiting from this practice at the likely disadvantage of women.Moreover, among the communities with low levels of literacy, the circumcision strategy may be used to increase the level of infection among women.A HIV-positive man who got circumcised after HIV infection will tell the poor illiterate women that I am circumcised and HIV-free and the epidemic goes on unabated.The circumcision finding is neither a scientific breakthrough nor a reliable HIV-prevention strategy, but a common sense finding legitimated by a systematic medical inquiry and most likely to hinder the HIV-prevention efforts in developing countries rather than facilitate them.After all, a massive state-sponsored circumcision programme may not be the wisest of the public investments with regard to HIV-AIDS prevention.D. Uuyuni wa Kamati MarientalThere are, fundamentally, two types of scientific findings, namely a mere academic discovery and a practical breakthrough.I am of the opinion that this circumcision finding falls into the former category.This is for obvious reasons such as certain issues and factors were overlooked during research, the practical applications of such finding carry low levels of efficiency and practicality and, politically speaking, such a finding being politically incorrect.The chances of a circumcised man not contracting the HIV virus from an HIV-positive female are 40 per cent.That means that for every ten times a circumcised man is having sex with a HIV-positive woman, four of such sexual encounters are likely to result in him being infected with HIV-AIDS or put differently and crudely, for every 10 minutes that a circumcised man is continuously having sex with a HIV-positive woman, four minutes of such an encounter may be HIV-transferring minutes.Is this level of efficiency and practicality reliable to have us promote circumcision as a HIV-prevention strategy? Would it be ethical in the medical world to promote the medicine that expose a patient to a 40 per cent chance of death? Even in mechanical concepts an inventor of an engine with 60 per cent efficiency would hardly consider it as an economical invention, as such an engine wastes too much resource/input energy.Now extrapolate that efficiency level to the life-saving tool where every life lost counts as much as every life saved.Is this really acceptable? Now, let us the look at the issues that might have been overlooked during this circumcision research.The findings are from communities that are mainly traditional, as we know that in Africa circumcision is normally practised in communities with high degree of adherence to traditional practices and such practices involve a subservient role of a woman in the community, including the home.Did these researchers take into account the fact that in some of these communities a woman is not supposed to be excited during the enjoyment of conjugal rights and sexual encounters? For some of these communities, where research might have been done, the biological excitement of women during sexual encounters might be too low and a man might not be exposed to so much of a woman’ excitement.Can it be possible that in a non-traditional environment, the circumcised man may indeed be exposed to a high level of risk than in a traditional environment? I fully appreciate the dermatological benefits that come with the removal of the foreskin from the man’s member, but can it not be possible that such benefits may also depend on the length of time a person have been circumcised? Would a man who got circumcised four months back really enjoy the same HIV protection as the man who has been circumcised since childhood? As we all know of the biology of women, this finding is too gender-biased, apart from low level of efficiency, as only men are directly benefiting from this practice at the likely disadvantage of women.Moreover, among the communities with low levels of literacy, the circumcision strategy may be used to increase the level of infection among women.A HIV-positive man who got circumcised after HIV infection will tell the poor illiterate women that I am circumcised and HIV-free and the epidemic goes on unabated.The circumcision finding is neither a scientific breakthrough nor a reliable HIV-prevention strategy, but a common sense finding legitimated by a systematic medical inquiry and most likely to hinder the HIV-prevention efforts in developing countries rather than facilitate them.After all, a massive state-sponsored circumcision programme may not be the wisest of the public investments with regard to HIV-AIDS prevention.D. Uuyuni wa Kamati Mariental