Circumcision and risk to women

Call it catch-up weekend. I found this article from a Ugandan source that gives a reasonable assessment of circumcision and HIV and the dangers circumcision may pose for women.

Male circumcision may not reduce HIV

UGANDAN men rushed for circumcision after studies conducted in South Africa, Kenya and Uganda revealed that male circumcision can reduce the risk of acquiring HIV. However, preliminary results from another study in Rakai District show that HIV-positive men who are circumcised are more likely to pass on the virus to their uninfected female partners than men who are positive but not circumcised.

The infections from circumcised men could have occurred because they had sex before their circumcision wounds had fully healed. The findings point to a possible danger that making male circumcision available to all men in Uganda without prior HIV counselling and testing may result in more new HIV infections than those it averts.

According to the National HIV Sero Behavioural Survey of 2004-5, only 11% of Ugandan men aged 15-49 years know their HIV status. This implies that the majority of men undergo circumcision when they don’t know their HIV sero-status, yet many may already be infected. Further more, it is not mandatory that people are tested for HIV before undergoing any medical operation or circumcision — whether the circumcision is done in a hospital or not.

Whereas warnings against having sex before the wounds have healed can help, male circumcision should be tagged to HIV counselling and testing to ascertain one’s status before circumcision. Only then should it be added to the ABC strategy as a key measure to curbing HIV spread, for men who test HIV negative.

Male circumcision does not benefit men who are already infected with HIV, yet it increases women’s vulnerability to HIV infections. Therefore, the practice has the potential to increase HIV infections. Women are already more vulnerable to HIV infections due to biological and social factors. We need to be particularly careful about anything that can put them at a greater risk of HIV.

How can one verify that the wounds have healed? Who is at bigger risk of HIV infection because of these partially healed wounds?

About two million people in Uganda have HIV, majority of them women aged 15-49. To reduce new HIV infections, preventive strategies should benefit both men and women.

The writer is a Fellow at the Institute of Public Health/ Centers for Disease Control and Prevention — HIV/AIDS, Makerere University

Reference

Nakisinge, Anne. Male Circumcision May Not Reduce HIV. The New Vision. March 26, 2007.

http://www.newvision.co.ug/D/8/459/556302

About David Wilton

Fronterizo, defense lawyer
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