For your consideration:
37- year old Mukasa is not circumcised but is considering it seriously. “I have heard that if you get circumcised, you cannot catch HIV/ Aids. I don’t have to use a condom or worry about all those other ways of keeping safe. I finally get a method that suits me…” he says. Mukasa is obviously oblivious of the almost negligible but very important fact surrounding the hyped circumcision as an option to HIV/Aids prevention.
I don’t want to give the impression that I think this is a common perception anywhere. I don’t think it is. But it highlights a key point in all the recent discussions of circumcision and HIV. When the United Nations or the World Health Organization or the New York Department of Health and Mental Hygiene touts these studies, it can only control the message it puts out. It can never control how that message spreads and the misunderstandings people will create.
These studies have only said this: voluntary adult circumcision reduces female-to-male HIV transmission by 50-60%.
It said nothing about male-to-female transmission. It said nothing about male-to-male¹ transmission. It said nothing about infant² circumcision. Researchers don’t even know for certain how circumcision appears to reduce HIV transmission. Given the gravity of HIV and circumcision, any recommendation has serious implications. That includes the understanding that people may make a leap not supported by evidence or marketing. I’ve seen enough examples to know that it will occur.
When we focus exclusively on the collective public health “benefit”, we ignore how this affects individuals. The male who gets HIV from dirty surgical instruments in Africa and the boy who loses his penis in the United States aren’t just unfortunate sacrifices for the public good.
¹ In the case of the New York Department of Health, Commissioner Frieden touted a conclusion not even studied in Africa, much less proven.
² Infant circumcision differs greatly from adult circumcision.