Sunday March 18 2012

Male circumcision: Effects that people should know

I would like to join the debate on whether or not male circumcision reduces the risk of HIV acquisition in men and to point out the consequences of removing the foreskin. The debate was triggered by a publication by Daily Monitor news paper of Tuesday 6, 2012 with a headline “Circumcision doesn’t reduce HIV spread”.

There are two major scientific publications that have led to this controversy. A study by Gray RH et al (Lancet 369 – 9562:657-66) suggests that male circumcision reduces the risk of heterosexually acquired HIV infection in man by up to 60 per cent. It is from this study that Uganda drew up a male circumcision programme to check the spread of HIV/Aids. However, other researchers, Gregory Boyle and George Hill, reported that male circumcision could only reduce HIV transmission by 1.3 per cent at most.

Other responses by a Nyasa Time reporter says, “…….Something the men are not being told is that circumcision increases their chances of developing sexual problems over time which is actually what research in Denmark and elsewhere had found. The foreskin is an important erogenous organ containing over 20,000 erogenous nerve endings and specialised mucosa. It acts as a natural buffer and lubricant during sex.” He argues that why remove a natural organ when you still have to use a condom?

One of the greatest arguments against female genital mutilation is based on the fact that the female sensitive sexual organ is removed leaving her with no means to enjoy sex. In the name of HIV prevention there is no justification to remove foreskin containing erogenous organ. Men in Uganda deserve more information about the male circumcision programme and possible consequences in their lives.

More objective research is needed. In Uganda we need to look at the cultural and religious institutions that practice male circumcision to see if transmission rates are comparatively lower in these communities. Dr Sam Mugisa in his letter to Sunday Monitor dated March 11, 2012, stated that though United States is advocating and practicing male circumcision to reduce the HIV pandemic , ironically it has the highest HIV prevalence in the Western World.

Europe, Cuba and South America which do not do this procedure have lower rates of HIV than the United States. The same view is shared by Marc in Nyasa Time Report, March 8, 2012.
In conclusion, I think it is not right for the people in authority to ignore issues of national importance and call them reports based on rumours. God speaks through people – usually ordinary simple people.

Dr Josue Okoth, (PhD) is a scientist