Residents of the tiny former British colony of Belize are not sold on circumcision in the efforts against HIV infection. Belize is on the east coast of Central America.
Dr. Marvin Manzanero was asked whether he thought circumcision would catch on in Belize. “Knowing the way we go here in Belize, I don’t think even if you give out that males would be more circumcised than before, I don’t think so.”
Dr. Lisa Johnson of Belize’s Universal Health Services stated, “For every study that has supported circumcision there is an equally good study that takes away support, that does not support circumcision and actually the position of the American Academy of Paediatrics is that they neither recommend circumcision nor do they say that it is a bad thing.”
In a Channel 5 news report, four out of six people on the street informally polled against the procedure.
Dr. Manzanero stated, “The fact that you are circumcised does not mean that you can go ahead and engage in high risky sexual behaviour. That is not the case. You might have one risk factor less, but still you have to still use a condom, still practice safe sex every time you have a partner. We go back to the same issues, the abstinence, the be faithful, the condom
usage, and we have to wait for further studies for us to give conclusive evidence [before we] try to start promoting male circumcision as another means of preventing HIV/AIDS.”
Verbatim transcript from the broadcast after the jump.
Study shows circumcision reduces HIV risk
In the world of AIDS prevention, much of the focus these days is on new ways to stop transmission of the virus. Among the scientific initiatives being pursued are microbicides, improved male and female condoms, and even vaccines. But recent research has offered solid evidence that one possible way to slow down the spread of HIV comes, not from any new technology, but from a source practiced by the ancient Hebrews and Muslims. Kendra Griffith reports.
Dr. Lisa Johnson, Surgeon, U.H.S.
“Circumcision is a procedure in which the foreskin of the penis or the prepuce is removed from the shaft of the penis. It is quite an old procedure, one of the oldest medical procedures in human civilisation.”
Kendra Griffith, Reporting
Practically from the time the first circumcision was performed, it has been a controversial practice.
Dr. Lisa Johnson
“I have performed circumcisions on children and adults.”
Dr. Lisa Johnson, a surgeon at the Universal Health Services, says that a circumcision is done for many reasons … but that medically there are conflicting studies on the custom.
Dr. Lisa Johnson
“For religious reasons, for reasons of a progression into manhood, for reasons of marking people who have been conquered and for reasons of inflicting pain and mutilation. It really became medicalised in the 19th century as surgical techniques developed. For every study that has supported circumcision there is an equally good study that takes away support, that does not support circumcision and actually the position of the American Academy of Paediatrics is that they neither recommend
circumcision nor do they say that it is a bad thing.”
Recently, the results of clinical trials conducted in Africa in 2005 and 2006 have put the issue back in the media and medical spotlight. Circumcision, it seems, may make a big difference in your chances of contracting H.I.V.
Dr. Marvin Manzanero, Director, National AIDS Programme
“They found out that people or that males who were circumcised have a risk reduction of around fifty to sixty percent of getting HIV/AIDS over the general average period of two years. Both studies were actually cut short because they found a greater benefit than the
uncircumcised groups. For ethical reasons, that’s what you do normally in a study. You have to also take into account that in sub-Saharan Africa you have rates of seventeen, twenty, twenty-four percent, so they are basically trying to use any public health measure that they can to try to reduce the incidence of HIV and spread of HIV.”
Director of the National AIDS Programme, Dr. Marvin Manzanero, explains how circumcision might affect HIV transmission.
Dr. Marvin Manzanero
“The fact that you have foreskin there, that you have smegma, which is a secretion that is coming around the glands area, has always been thought of as a reservoir for the HIV virus for example, so the fact that the foreskin is no longer there could be a contributing factor for those patients having less HIV. The other thing is the foreskin is also rich in some cells called Langerhans cells, which could be harbouring also the HIV virus. The fact that it is no longer there means you have less viral load at that specific area. Maybe those men who were circumcised were more hygienic after that because they had to take care of a wound, they were counselled, they were probably a little bit more conscious of their sexuality around it after getting an intervention in the genital area.”
But would Belizean men or parents to be consider the surgery to capitalise on that perceived benefit?
Dr. Marvin Manzanero
“Knowing the way we go here in Belize, I don’t think even if you give out that males would be more circumcised than before, I don’t think so.”
Like Dr. Manzanero, we had our doubts and took to downtown Belize City to find out. The results were mixed.
“Would you consider having circumcision if you knew that it would reduce your risk of contracting HIV?”
“No, I don’t think that’s supposed to be a method used to reduce the HIV rate. I think we should be mature and know what causes HIV and the preventative methods to put in place to reduce the HIV rate right now.”
“Right now the ratings dah Belize really rough, so if that dah wah safe procedure fi mek we circumcise—it has to be from a young age though, then it would be safe I guess.”
“So you wouldn’t consider doing it as an adult?”
“Not at this point, no cause I noh need fi through that again.”
“I agree because your first concern is for your child, so I think that you would definitely consider. At least me, I personally would consider it.”
“It noh really make sense.”
“Because regardless of anything, you could still catch it any way, so I wouldn’t.”
“Would you consider getting the procedure performed on your sons?”
“Yeah I would do it for them, because I know they di think wild and I noh actually settle like me. But I settle myself, so I noh need fi goh through that.”
“You would still have to take preventative measures such as using a condom and being safe, would you still do it?”
“Sure, why not.”
But before anyone gets too excited, Dr. Manzanero cautions that there are no quick fixes when it comes to HIV prevention.
Dr. Marvin Manzanero
“The fact that you are circumcised does not mean that you can go ahead and engage in high risky sexual behaviour. That is not the case. You might have one risk factor less, but still you have to still use a condom, still practice safe sex every time you have a partner. We go back to the same issues, the abstinence, the be faithful, the condom usage, and we have to wait for further studies for us to give conclusive evidence and try to start promoting male circumcision as another means of preventing HIV/AIDS.”
Kendra Griffith reporting for News Five.
Estimates used by the medical community are that less than twenty percent of Belizean males are circumcised.
Griffith, Kendra. Health: Study shows circumcision reduces HIV risk [transcirpt]. News 5, Channel 5 Belize. January 18, 2007.