Aids experts have called for a mass circumcision programme in South Africa, condemning a "deafening silence" from policymakers since studies suggested it sharply cut infection rates.
As scientists this week questioned a lack of movement on using
male circumcision as a preventative method, delegates at South
Africa's national Aids conference called for the rollout of a mass
Earlier this year, the World Health Organisation (WHO)
recommended the procedure after three studies in Africa showed it
reduced chances of contracting HIV by up to 60%.
Nothing done in SA
But although countries such as Kenya, Malawi, Swaziland,
Zimbabwe, Mozambique and Tanzania have drawn up plans for
widespread circumcision, the South African government has done
nothing to date.
"I think by now I would support people starting to think about a
mass circumcision campaign," said Neil Martinson of the Perinatal
HIV/AIDS research Unit.
Martinson said concerns over whether South Africans thought it
was a culturally acceptable practice that would lead to risky
sexual behaviour were not proven to be valid.
"In South Africa, high proportions of men and women find it
acceptable to be circumcised, people (in the studies) weren't going
around and sleeping around more because they didn't have a
Focus on prevention
With an Aids vaccine years away, the focus has turned to HIV
prevention and the conference aims to build consensus about ways to
"I am surprised there is no action on male circumcision. Where
are the male activists? Studies show a 60% reduction (in
risk) but there is silence," Glenda Gray, who will oversee the
first HIV vaccine trials run in the country, told a panel
discussing prevention research.
The primary investigator into the first circumcision trial held
in South Africa, Bertran Auvert of the French Institute of Health
and Medical Research, told AFP it was time for implementation.
"It's not even my opinion. It's now a WHO recommendation," he
The circumcision debate revealed one of the biggest challenges
was getting the message across that being circumcised was not
In some cultures in South Africa, circumcision is seen as a rite
of passage into adulthood, and boys go to initiation schools where
they are circumcised with a spear-like instrument.
Don’t rush in
Critics of the mass use of male circumcision to combat HIV, like
Tim Quinlan from the University of KwaZulu Natal's Health Economics
and HIV/Aids Research Division (HEARD), said there were dangers of
jumping into the use of male circumcision without it forming part
of a larger package of measures.
He questioned the fact that circumcision only protected men, and
not women who were at greatest risk of contracting the virus.
However Professor Alan Whiteside, also based at HEARD, called
for the "routine offer of circumcision for every male child born in
a public hospital."
"It is so blindingly obvious that there are real reasons for
circumcision. It is going to happen. What we need is informed
advocacy and communication."
Circumcision involves the removal of
the foreskin which contains cells to which the HI-virus clings more
South Africa has the second highest number of HIV sufferers in
the world, after India, with some 5.5 million people living with
A deafening silence
"There has been a deafening silence from policy people in this
country, what else should we do, what else is there?" asked
"The protective effect is long lasting, it's almost like a
He said that research may be needed on how to increase the
demand for circumcision.
"Must we target sexual partners, so women say 'I won't sleep
with you if you are not cut?" – (Sapa-AFP)
UN backs circumcision for HIV