More circumcised men are HIV positive

The Times SUNDAY can today reveal that government has known this for close to three years.

It is contained in the Swaziland Demographic and Health Survey (SDHS) of 2007 which still prevails.

This report summarises findings of the 2006 survey carried out by the Swaziland Central Statistical Office (SCO).

The report places the infection rate for circumcised males at 22 per cent while for those uncircumcised stands at 20 per cent.

HIV stands for Human Immuno Deficiency Virus. It is the virus that can cause the acquired immuno deficiency syndrome (AIDS).

The report states that the protective aspect of male circumcision is based in part because of the physiological differences that increase the susceptibility to HIV infection among uncircumcised men. However, the relationship between HIV prevalence and circumcision is not in the expected direction.

"It is worth noting that the relationship between male circumcision and HIV infection may be confounded by the fact that the circumcision may not involve the full removal of the foreskin, which provides partial protection," stated the report.

But additional analysis is needed to determine if this lack of a relationship between male circumcision and HIV infection is a result of confounding factors or represents the true situation.

In 2007 government introduced a policy on male circumcision, which has a goal of halting the spread of HIV infection to achieve an HIV-free generation.

Cited in the report is that to meet this objective, male circumcision services, as part of the national comprehensive HIV prevention package, would have to be availed to men of all ages.

To maximise the health benefit for HIV prevention, the primary targets of the services are men who are HIV-negative, in the age bracket of 15-24 and also newborn babies.

Additional information collected by the SDHS in the 2006 to 2007 period revealed that eight per cent of men age 15-49 were circumcised.

"Older men are markedly more likely than younger men to have been circumcised, which the rate peaking at 20 per cent among men aged 35 -39 years. Urban men (13 per cent) are more than twice as likely to be circumcised compared with rural men (six per cent)," said the report.

Also discovered is that the rate of circumcision among men is slightly higher in the Hhohho and Manzini regions compared with the rate in Shiselweni and Lubombo.

Meanwhile, the belief that circumcision can provide a considerable measure of protection against HIV infection has been questioned by academicians and medical professionals of repute.

Last week Occupational Health Specialist Dr Cleopas Sibanda questioned the rationale of circumcision to justify it being adopted as part of the national HIV and AIDS prevention strategy.

"What exactly happened in Uganda as far as HIV and AIDS and population demographics are concerned to correctly attribute the observed previous decline in their national HIV and AIDS statistics to wholesale male circumcision?" Sibanda was quoted as having asked.

But he noted that circumcision for the wrong reasons can be very dangerous, in fact it has increased episodes of diminished consistent use of condoms and increased incidences of HIV and AIDS affected populations.

* PSI’s Litsemba Letfu Clinic in Matsapha

* Family Life Association (FLAS) Mbabane

*Manzini Nazarene Hospital

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