KENYA, UGANDA: Men regret being cut, denounce campaign

BlackNews.com
November 30, 2016

Africans Speak Out Against the Mass Circumcision Campaign

by Max Fish
“We respect science honestly, but we do not support what science brings to finish us, to defile our cultures, defile our rights.” — Prince Hillary Maloba

— Since 2008, western public health giants* have been circumcising Africans by the millions to slow the spread of HIV/AIDS. American taxpayers are funding the effort through the President’s Emergency Plan for AIDS Relief (PEPFAR). An estimated 12 million men and boys have been circumcised to date. The world has not heard a word from them until now. —
 
Nationwide — The VMMC Experience Project recently sent cameras into Uganda and Kenya to document the realities of the mass circumcision program. Local investigators conducted interviews with 90 affected men and women and found:
1. Africans are told circumcision conveys immunity from HIV. 2. Condom use is at an all-time low, and AIDS is on the rise.
3. The program is killing the very people it is supposed to help.
4. No follow-up post circumcision (cut-and-release approach).
5. Resentment and outrage among Africans.
The “Voluntary Medical Male Circumcision” (VMMC) public health program is the first mass surgical campaign in human history. It targets Africans exclusively, leading some to question whether there are underlying racial motives. For centuries, western stereotypes have held that African men are lascivious or hypersexed, unable to control their sexual urges. Compulsory African-American male circumcision campaigns were proposed as early as the nineteenth century.

Prince Hillary Maloba is a native Kenyan, director of the VMMC Experience Project, and the driving force behind the investigation. “Male circumcision,” he explains, “as a project that has been applied for we [sic] Africans, has failed to reduce HIV the way we were told. Two, we view it as a violation of human rights. How target only one race in the entire world?”

Bishop Cleophas Matete, another native Kenyan, agrees: “I believe the entire process of trying to test it in Africa was wrong from the beginning.”

The mass circumcision campaign was introduced to reduce the incidence of HIV in fourteen sub-Saharan African countries that did not initially practice genital cutting. However, UNAIDS data indicate that the African HIV epidemic has only worsened since 2010—shortly after VMMC was implemented. For the first time since the war on AIDS began, HIV is back on the rise.

The World Health Organization claims that male circumcision curbs female-to-male HIV transmission by up to 60 percent and provides lifelong partial protection against HIV and other sexually transmitted infections. Their conclusions derive from a process of contentious surgical experimentation on Africans.

Opponents allege that the targeting of impoverished Africans constitutes a racial and human rights issue. Comparisons are made to the Tuskegee syphilis study. Others argue that the program results in a dangerous false security. The present investigation confirms that men, women, and teens are abandoning condoms out of a belief that they are already protected by circumcision. This in turn increases the spread of HIV.

Prior to the VMMC Experience Project investigation, none have consulted or followed up with the men and women who have been directly affected. Many are living in rural poverty, invisible to the developed world. They have had no platform or voice in the circumcision agenda. Maloba’s investigation is the first to shed light on the African side of the story.

African men and women say the campaign is violating their rights, confusing their cultural identity, and profoundly worsening the AIDS epidemic. They implicate the program in the spike in HIV cases we have seen in recent years. Seven respondents in Maloba’s investigation said that they had acquired HIV because of misinformation around circumcision.
 
“I blame those who told me that if I get circumcised I won’t get HIV,” said one respondent, “and I got HIV already!”

Others mourned the loss of friends, brothers, relatives, and neighbors to AIDS following the procedure they believed would protect them.

“These people are dying of HIV due to ignorance,” a respondent explained.

“If we don’t stop this thing,” Maloba warns, “this community will not have a generation that will take care of the old people.”

Instead of mass circumcision, Africans want funding for sustainable medical facilities, anti-retroviral medications (ARVs), more durable condoms, HIV education, and poverty reduction initiatives.

Many cite AIDS-related tragedies from the VMMC program. They seek an end to the circumcision campaign as a public health disaster and a form of cultural imperialism from the West. “It is something that has been imposed on us,” a reverend explained in his interview. “If I could get a forum to fight it, I could fight it very hard.”

*VMMC-promoting institutions include the Bill & Melinda Gates Foundation, the World Health Organization, UNAIDS, USAID, PEPFAR, Jhpiego (Johns Hopkins University), and numerous NGOs.

About the VMMC Experience Project The VMMC Experience Project is a 501(c)(3) nonprofit effort to document the effects and aftermath of the world’s first mass surgical campaign. Its aim is to empower the most frequently overlooked contingent in the African circumcision regime: Africans.

BOTSWANA: Men refusing genital cutting

GABZ
October 20, 2016

Numbers of males enrolling for Circumcision worrisome

The declining rate of men enrolling for the Safe Male Circumcision SMC is said to be worrisome.

Addressing a new directions global health workshop in Gaborone yesterday, the Gaborone DHTM representative, Dr. Martin Azama, said that they have a target of 5 thousand 305 men to be circumcised in the period of 2016-2017, but have however only achieved circumcising 868 men. [This was to be expected: they have picked all the low-hanging fruit.]

Dr Azama further urged men to come forth and be circumcised as the exercise is aimed at reducing the rising rate of sexually transmitted infections in Botswana

UGANDA, KENYA: ARVs and education send HIV down, genital cutting gets credit

Deutche Welle
July 15, 2016

Africa's progress in the fight against HIV/AIDS

by Hilke Fischer
The South African city of Durban is the venue for the 2016 World Aids Conference. Sub-Saharan Africa will feature prominently on the agenda, a region where the infection rate has decreased by over 40 percent since 2000.

Which strategies are most effective in the battle against HIV/AIDS? DW looks at how four African countries are responding to the challenge.
...
Kenya: compulsory HIV/AIDS education
Fewer than six percent of Kenyans live with HIV/AIDS. That's about 1.5 million people. The number of new infections also fell significantly in recent years. In 2005, 28.3 percent of infected mothers transmitted the virus to their children. Five years later, that figure had gone down to 8.5 percent.
Meanwhile, more than 90 percent of all pregnant Kenyan women go for AIDS tests. In 2000, there were only three health facilities where Kenyans could consult medical practitioners and get tested for HIV. In 2010, the number of health facilities offering HIV consultations had increased to more than 4,000.

The main reason for the reduction in the HIV/AIDS prevalence in Kenya is the supply of ARVs. In 2003, only 6,000 people had access to the medication. Ten years later, that figure increased to more than 600,000.

The Kenyan government also regards voluntary male circumcision as a weapon in the fight against AIDS. This reduces the risk of infection among men by about 40 percent, according to studies. Since 2003, HIV/AIDS education has been a compulsory element in school curriculums. About 70 percent of the cost in fighting HIV/AIDS in Kenya is footed by external donors.

[Could it be that the education and the ARVs are entirely responsible for the reduction?]
...
Uganda: 'Abstinence, faithfulness and condoms'
In Uganda, the AIDS epidemic reached its peak in the 1990s. Approximately 18 percent of the population was infected with the virus. The Ugandan government and international aid agencies launched ambitious and expensive educational programs with the slogan "Abstinence, faithfulness and condoms."

The campaign was a success. In 2000, only five percent of the population was HIV-positive. But, in the meantime, a contrary trend is emerging. The number of new infections in Uganda is rising again for the first time in ten years. The HIV prevalence rate in the country is now about seven percent of the population.

Surprisingly, a major reason for this is the widespread usage of ARVs and the circumcision of men. Many Ugandans believe that the ARV therapy can cure the disease completely and that male circumcision rules out any risk of infection - as a result, more people are abandoning the use of condoms.
[This is NOT surprising - in fact we predicted it, years ago..]

WINDHOEK, NAMIBIA: Men are resisting genital cutting

Namibian men aren't buying it...

Coastweek.com
July 2, 2016

Namibia’s male circumcision initiative to prevent HIV faces headwind

WINDHOEK (Xinhua) -- Circumcised and ready for action?

These four words that are part of a radio advertisement currently gracing the airwaves have aroused mixed feelings among Namibians.

The advertisement is being run by the health ministry as part of a campaign to educate and encourage men to opt for voluntary medical male circumcision.

Namibia aims to circumcise 330, 000 men by 2025 but since the program was officially launched in 2014, just above 30, 000 have taken up the offer.

Most Namibian men, like Windhoek security guards Simeon Hafeni and Gottlieb Kalandu, are refusing to let go of their foreskins.

Hafeni, who is from the northern regions of the country where circumcision is not compulsory under tribal beliefs, says he does not see any reason for him to be cut.

“What if I get the cut now, and then tomorrow another disease that needs the foreskin comes by?” he asks.

His workmate, Kalandu quips: “God was not a fool to create men with a foreskin.”
[These are not the best reasons to stay intact. The best reasons are that the foreskin is valuable, and that the protection offered, even if true, is insufficient to substitute cutting for the vastly more protective condoms.]
 
These two could symbolize the difficulty the health ministry’s campaign faces even after rolling out the program as far back as 2009 when the World Health Organization and the United Nations AIDS Organization (UNAIDS) recommended circumcision as one of an HIV preventative measure.

Namibia went on to train more than 260 health care workers to provide deal with circumcision, while 33 district hospitals were made available for the program.

A national strategic plan for 2010/11-2015/16 drawn up and revised in 2013 lists six core program to prevent and control the spread of HIV in the country including circumcision.

The strategic plan states that there is need to reach out to HIV negative adult men and initiate services for adolescents.

Although health ministry spokesperson Ester Paulus said that circumcision is a “low-cost medical intervention”, the strategic plan shows that more than 200 million Namibian dollars (13 million U.S. dollars) was set aside for the first three years.

“Male circumcision is a one-time, low cost medical intervention, which has been recommended by the WHO as part of a comprehensive package of HIV prevention.”

The country also carried out a pilot project in Aug. 2009 in capital Windhoek and at Oshakati, in the north of the country about 700 kilometers from Windhoek.

Realizing that fewer men were volunteering, the health ministry has been on an aggressive campaign. Apart from the advertisements, the health minister, Bernard Haufiku, has also been vocal about the need for men to get the cut.

When the advertisements were launched in May, Haufiku said in high HIV prevalence countries like Namibia, circumcision will at least prevent one in five infections as it reduces the risk of contracting HIV by 60 percent. [This is a dangerously false way of applying this already-misleading statistic.]

Hafeni and Kalandu say they have heard the advertisements, which they think are humorous.
“But radio is radio. I don’t believe everything I hear on radio,” Kalandu says.

SOUTH AFRICA: Another botch

Cape Times
March 6, 2016

Op left teen without tip of penis

by Zelda Venter
PRETORIA: It was meant to be a routine circumcision, but the procedure left a Pretoria teenager without the tip of his penis.

His mother had taken him to the Soshanguve Community Health Care Clinic on May 2, 2014 for the circumcision. The mother said when they arrived, her 16-year-old son was taken to a room where a doctor was to perform the procedure. However, the doctor mistakenly amputated the tip of the penis during the operation.

Thereafter, the tip was placed on ice in a plastic bag and taken to the Dr George Mukhari Academic Hospital, along with the boy. There doctors tried to reattach the tip without success.

The botched circumcision has resulted in a R1.1 million [$US72, 180] damages claim against the Gauteng MEC for Health.

The teenager’s mother, who is unemployed and lives in North West, instituted the R1.1m damages claim in the high court of Pretoria on behalf of her son.

According to the mother, it took three months for the private part to heal and doctors have told the boy that it is still too early to do reconstructive surgery.

The series of operations required will cost around R150 000 [$US9,840], the court heard.

The mother is blaming the doctor for her son’s deformity, saying the doctor was negligent.

She also charges that had the reaction been quicker, and the tip of the penis placed on ice and delivered to another hospital sooner, it was possible it could have been reattached. She said the doctor took his time in placing the penis tip on ice and arranging for her son to be taken to hospital.

If the tip and her son were rushed to hospital, his private part could have been saved, she said. Aside from the disfiguration, the boy suffered severe psychological shock and trauma, and had lost out on one of the “amenities” of life. She claimed R380 000 for his future medical expenses and R600 000 for trauma.

His lawyer, Greyling Erasmus, said the matter had been postponed to a date still to be determined.

SWAZILAND: More cut men have HIV than whole men

Why are we not surprised?

Star Africa
November 29, 2015

Swaziland: HIV infection higher among circumcised men – Survey

by APA
A study has shown that circumcised men have a higher HIV infection rate than uncircumcised men since 2007 when the Government of Swaziland introduced a policy on male circumcision, APA reports.

The study availed to APA Sunday morning [and available on this site since 2009]  states that out of the 305 circumcised men who were interviewed 21.8 percent were HIV positive compared to the 19.5 percent of uncircumcised men who were also interviewed and tested.

AIDS activist Vusi Matsebula told local media that most circumcised men are infected with HIV because of their behavior as they fail to use protection after undergoing the procedure because they believe circumcision is a preventive measure.

An official of Population Services International (PSI), Mandla Matsebula said; “The survey was conducted before the circumcision campaign was intensified. If they could conduct another survey now the results would be totally different.”  [Why should a more "intense" campaign have any different outcome? This is grasping at straws.]
 
Male circumcision, which is offered for free in Swaziland’s public hospitals, was introduced as a measure to minimize chances of infection by about 60 percent. [And still they chant their theoretical "60%" mantra, in  the face of real-world data that shows an increase in infection - using their own arithmetic - of  11.8%]
 
During school holidays the campaign gains momentum as male pupils are often the main targets for the free procedure funded by the government.

MALAWI: Genital cutting is undermining condom use

The Maravi Post (Malawi)
August 30, 2015

Is voluntary male medical circumcision de-campaigning Condom use?

by da Kazembe
Blantyre, August 29, 2015: Seventeen-year-old Homic Muluwani of Bangwe Township is excited that at last he has had the most taunted voluntary male medical circumcision (VMMC) which to him certifies him to having unprotected sex now that he presumes he will be safe.

He is one of the more than 2000 males circumcised in the recent VMMC campaign which according to the Blantyre district VMMC coordinator, Jean Mhango was a success.

Much as the figures indicate the campaign as being successful, it is the mindset of the VMMC clients which seem to defeat the intended purpose for VMMC which is 60 percent risk reduction of HIV infection in HIV negative males who undergo the procedure.

Homic Muluwani and his friends tell the dangerous story as they wait for their turn to get circumcised at South Lunzu VMMC camp.

“I have had a girlfriend for the past two years and we have been having protected sex for fear of the HIV virus but this time I am going to enjoy unprotected sex since I am sure of my safety following the medical circumcision,” says Muluwani.

The 60 percent HIV risk reduction that follows after VMMC is surely misconceived in most males who are flocking for the procedure for they take it as a guarantee to having unprotected sex.

This leads to the query as to whether condom use is not being de-campaigned by VMMC promotion.

The Ministry of Health spokesperson, Adrian Chirumba says much as the opinion may arise from such sentiments, a study has not been carried out to validate this.

“Our implementing partners in VMMC such as Banja La Mstogolo (BLM), Population Services International (PSI) also have no records to validate the opinion,” says Chikumbe.

According to PSI one of the Ministry of Health’s implementing partners in VMMC, Malawi is working to scale up 605 coverage of male circumcision among negative males ages 10-34.

PSI national communications coordinator for VMMC, Lionel Chipeta points out that Malawi is working to scale up to 60 percent coverage of male circumcision among HIV-negative males aged from 10 to 34.

“VMMC is recognized as a high priority intervention in the Malawi National HIV and Aids Strategic Plan 2015-2020 and the National HIV Prevention Strategy 2015-2020,” explains Chipeta.

Martha Kamela of Mbayani Township finds her husband is better off uncircumcised due to the same misconception of the 60 percent risk reduction for she thinks once he is circumcised he will be at liberty to have unprotected sex with other females.

“Since my husband will know that he is safe from contracting the virus, chances are he will be cheating more as compared to now where he is afraid of contracting the virus,” says Kamela.

Kamela states that most men want to go under the knife as a guarantee to go and have unprotected sex without fear.

According to the VMMC South Lunzu site supervisor, Joseph Mdzinga, males aged between 10 and 19 patronized the services.

Looking at the age group, one can easily conclude that those accessing VMMC are still in the youthful exploring age hence the danger in the misconception.

The World Health Organisation HIV prevention package includes Abstinence Being faithful and Condomise (ABC), Post Mother to Child Transmission (PMTCT) as well as VMMC and if the later seems to be defeating the condom use as per the perception, one wonders whether VMMC will yield the intended results, come 2020.

MALAWI: HIV rising despite cutting, says Medecins Sans Frontiers

Malawi24
August 4, 2015

Malawi: Circumcision Disaster - Malawi HIV Infection Rate Doubles

Following up the reports that Malawi24 released on 25 July that circumcision does not help in the reduction of HIV but exacerbates it, reports have emerged that have agreed with the facts that we had earlier established. 

Medecins Sans Frontieres (MSF), one of the world's renowned NGOs working on public health, has released statistics showing that HIV infection rate in Malawi has doubled in recent years despite a range of interventions put in place to tackle the spread of the virus that have included relentless campaign on condomisation and circumcision. 

According to the statistics by MSF, HIV rates have doubled in Malawi moving from 10% to 20% in 1 year. Strangely, this has been the same period that Malawians have been manipulative forced to go through circumcision in masses with the promise that it reduces the contraction of HIV. 

The results which were published on BBC and revealed that of every 5 people, 1 person is HIV positive have pitted Malawi as the country worst hit by the HIV pandemic of all countries in the world. 

Commenting on the development some Malawians trashed the results claiming they were sensationalised and exaggerated for the sake of tarnishing the image of the country to the international world to achieve what they called MSF's own hidden agenda. 

Others faulted the BBC, saying it was one of the broadcasters' crusades against the African continent which they have tirelessly aimed to present in a negative light.

Medecins Sans Frontiers denies having had anything to do with this information. However,  these figures do bear the claim out:

Proportion of males  aged 15-54 with HIV	cut	intact
2010	10.3	7.9
2014	13.2	9.5

Source: Demographic and Health Surveys National Statistical Office,
Zomba, Malawi and ICF Macro, Calverton, Maryland, USA

SWAZILAND: More "Circumcise and Conquer" clients at HIV clinics

The Swazi Observer
April 30, 2015

Soka Uncobe got more men on HIV services

by Winile Mavuso
WHILE most HIV positive Swazis do not enroll for pre-ART services because they feel well and don’t see the need to go to the clinic, the Soka Uncobe Male Circumcision campaign ran in 2011-12 saw more men enrolling for HIV care services.

This is contained in a study conducted by ICAP in 2011-2012 with support from the Centre for Disease Control (CDC) and the President’s Emergency Plan For AIDS Relief (PEPFAR). The study was presented to stakeholders during a breakfast meeting at Mountain Inn yesterday.

The objective of the study was to evaluate whether key linkage procedures were implemented in accordance with the new set of standard operating procedures on linkage and retention (National SOP) introduced by the ministry of health. The study explored early enrollment and retention in HIV care among clients newly diagnosed with HIV from two HTC settings (home- and MC-based HTC), as well as finding client, clinic and SOP characteristics that might be associated with early enrollment and retention in care.

Hence, the National SOP was implemented in the Soka Uncobe Male Circumcision campaign during which testing was facility based and the Swaziland HIV Incidence Measurement Survey (SHIMS) during which testing was home based.

HIV testing was a requirement for men to get circumcised and those who took up the services also got to know their HIV status. According to the study, from 13 Soka Uncobe sites visited, it was found that many MC files of HIV positive clients included completed readiness assessment forms.

“Interestingly, although similar enrolment rates were observed between study-gender groups overall and within 18 months of diagnosis, proportionally, more Soka than SHIMS clients enrolled in HIV care within three to six months,” reads part of the document.

This could be attributed to the fact that many Soka sites were co-located at HIV care facilities, hence clients were easily linked to expert client counselors.

[Or could this be because more Soca Uncobe ("Circumcise and Conquer") clients got HIV?]
...
Earlier story

UGANDA: Cutting men does increase the HIV risk to women

Medindia
April 29, 2015

Male Circumcision Curbs HIV Spread but Risk of Transmission High While Wound Heals
Real news: Male Genital Cutting INCREASES Risk To Women

by Bidita Debnath
While circumcision reduces the risk of human immunodeficiency virus (HIV) transmission by infected men [that has NOT been established], there is actually a possible increased risk of infecting female sexual partners while the circumcision wounds heal, warns a new research.

The World Health Organization (WHO) recommends male circumcision (the surgical removal of foreskin from the penis) [for consenting adults] which reduces HIV acquisition by 50-60%. [They have to include their mantra.]
 
"There is a window of a few weeks after circumcision when the risk that an HIV-infected man could transmit the virus to a female partner actually increases," said the study's first author Aaron Tobian, associate professor of pathology at the Johns Hopkins University School of Medicine. "During that time, more HIV-infected men are shedding the virus, and on average they are shedding greater amounts of it, than before circumcision," he noted.

However, scientists report that a new study of HIV-infected men in Uganda has identified a temporary, but potentially troublesome unintended consequence of the procedure: a possible increased risk of infecting female sexual partners while the circumcision wounds heal.

[See the weasel-words and euphemisms: infecting more women with HIV is exactly contrary to what this whole campaign is supposed to be about.] 

The study examined 223 HIV-positive Ugandan men who were medically circumcised. Circumcision reduced the number of HIV-positive men who were shedding the virus more than five-fold over the long term, but it had the opposite effect in the weeks right after the surgery. Case by case, the likelihood of HIV transmission from a newly-circumcised man to his female partner is less than one-tenth of one percent, the researchers estimated.

But with the WHO seeking to circumcise nearly 29 million men, the study projects that this small increase could add up to 17,000 new infections among female partners of newly circumcised HIV-infected men.

"Although we're counseling men not to have sexual intercourse while their wounds are healing, we know that they are," Tobian said.

The solution, he says, may lie in another one of the study's findings. "If the men are on anti-retroviral drugs, this reduces the risk of their shedding the virus by about 90%," he pointed out. The study was published in the journal PLOS Medicine.

[But if the men are known to be HIV-positive, WHY CUT THEM? It is TOO LATE. This just underlines how this whole campaign is not about preventing the spread of HIV/AIDS, but promoting the spread of male cutting.]
 
Source: IANS
[Wawer et al. started to find this six years ago, but they cut that study short "for futility" - it didn't find benefit - before it could be confirmed.]

SWAZILAND: "Circumcise and Conquer" slogan increases risk

Is anyone surprised?


Swazi Observer
March 29, 2015

Soka Uncobe: Circumcision slogan gone wrong?

by Welcome Dlamini
A social and behaviour change communication campaign aimed at encouraging at least 80 percent Swazi adult males to circumcise within a one year period seems to have been misinterpreted by some of those it targeted.

A study by two university lecturers; one from the Department of Anthropology at the University of the Witwatersrand and the other from the Department of Theology and Religious Studies at the University of Swaziland, reveals concerns of how the slogan used in the campaign led people to behave in a way that could have put them at risk of contracting HIV/AIDS.

The campaign’s main aim was HIV prevention, seeing that Swaziland has one of the virus’ highest prevalence rates globally.

The slogan for the campaign was ‘Soka Uncobe’ – which should translate to ‘circumcise and conquer’.

believing
It turns out that this slogan led people into believing that once they had been circumcised, they had conquered HIV/AIDS as well as their sexual partners and, therefore, could sleep around without using protection.

The campaign conducted awareness and advocacy with royalty, traditional leaders, unions, businesses, religious groups, schools, and government to create awareness of and understanding of MC, using interpersonal communications, mass media, especially radio, and educational print materials.

The project was a collaboration between the ministry of health (MOH), Swaziland National AIDS Programme (SNAP), National Emergency Response Council for HIV/AIDS (NERCHA), Population Services international (PSI) and Pulse.

The study by the two lecturers is titled ‘Christians’ Cut: Ecumenical Perspective on Male Circumcision amid Swaziland’s HIV Epidemic’ and it focused on Christian members of the kingdom’s three main church organisations, namely the League of African Churches in Swaziland (LACS), the Council of Swaziland Churches (CSC) and the Swaziland Conference of Churches (SCC).

Part of the study’s focus was on how the Christian religion (given that a majority, about 90% of Swazis are Christian) influences acceptance, rejection or understanding of male medical circumcision (MMC).

A number of those interviewed for the study pointed out to that people participated in circumcision because of the material incentives that were being handed out and the branding of the MMC campaign such as the free literature and gifts distributed at circumcision clinics and NGOs.

They said such gifts and literature “seductively clouded peoples’ own critical examination of the procedure and its effects on gender identities and sexual relations”.

drawn
States the study: “One Zionist LACS member noted, ‘some young men are drawn by pull factors such as T-shirts, juice bottles, tracksuits which are distributed as incentives to every male that visits the clinics to circumcise. These material pull factors are branded with the circumcising NGO or clinic, and more widely under the banner Soka Uncobe, which several people across churches saw as unappealing or dangerously inciting male sexual proclivities and broad licences to no longer use contraception.”

Quoting another study on socio-cultural aspects of MMC by Khumalo (2014, page 135), the study notes that there are those who argue that some men misinterpreted the Soka Uncobe slogan to mean once circumcised they had conquered HIV and AIDS or perceived themselves to be sexual conquerors of their partners.

This view, according to the study, was echoed across several church members and was strikingly highlighted by one woman from an SCC church who narrated the following: “I have a younger brother who is 18 and he is circumcised.

attributes
Ever since he performed this surgical procedure he has been sleeping around with many girls of his age. His friend partly attributes this behaviour to the manner in which circumcision is promoted in the schools.”

The woman informed the study that her brother’s friend told her that MMC promoters who visited their school would use a metaphor of a bush knife in their illustrations to explain that circumcision also strengthens your manhood.

“There is the misconception that the ‘bush knife’ (penis) is sharpened by circumcision, and young men develop insatiable sexual appetite. Such language can be destructive because it dupes young men to think that they are justifiable to sleep around because their ‘bush knives’ are now sharpened,” further states the study.

It further found that the language used by the promoters and the advertisements as well as slogans for circumcision were also persuasive and indirectly manipulative.

conqueror
“For example, ‘lisoka lisoka ngekusoka’, which implies that you are not a real man unless you are circumcised; and ‘soka uncobe’ which depicts a circumcised man as a conqueror. Some adverts would even state that once you circumcise you become ‘lichawe’- a hero,” study points out. It goes on to add: “For both women and men we spoke to, the branding of the MMC campaign was problematic. It potentially shored up male sexual supremacy and forms of violent masculinity, pointing to the otherwise ambiguous facets of general patriarchy, which in Swaziland endures as part of everyday life and “Swazi Culture.”
...

ZAMBIA: Circumciised man with HIV misses the point

The Post (Zambia)
October 23, 2014

Circumcised activist with HIV cautions men

by Fridah Nkonde
A 56-YEAR-OLD activist says he contracted HIV despite having been circumcised since birth.

Supporting musician Danny Siulapwa's statement that some young men are rushing to get circumcised for the wrong reasons, Danny Lungu said being circumcised does not exempt one from contracting HIV.
[The question arises whether it has any effect whatsoever.]

"You can contract HIV and AIDS even if you are circumcised. Here I am, I was circumcised when I was a baby but I am living with the virus. I contracted HIV when I was 25 years old.

The information I had that 'when you are circumcised, you cannot contract HIV' misled me," he said. "I used to womanise in the 1990s but I got infected and I came to learn that whether you are circumcised or not, you can still contract HIV."
[So one of the reasons he got HIV was that he was circumcised....]

Lungu, who is married with five children who are all free of the virus, has been living with HIV for the past 24 years and has been on antiretroviral treatment for 14 years.

"My advice to young people is that being circumcised does not give them a passport to sleep around because they can still contract HIV. If you are not circumcised, get circumcised and then continue using condoms," he advised. "There is information on HIV and circumcision everywhere now. In the 90s, we had no such information on issues of HIV and circumcision. I think that somehow contributed to me contracting the virus."

He said circumcision only reduces one's chances of contracting HIV and that it is not a preventive measure.

"It is not automatic that when you are circumcised, you cannot contract HIV. Young ones should go for circumcision and have safe sex by always using condoms or abstaining. We still need the new generation," said Lungu.

Danny observed that some men think they cannot contract HIV once they get circumcised.

ZAMBIA: Cut men think they don't need condoms

October 19, 2014

Young men are getting circumcised for wrong reasons - Danny

by Abigail Sitenge
Danny Siulapwa, also known as Danny Kaya, says young men are rushing to get circumcised for wrong reasons.

Danny, a father of three, observed that most men think they cannot contract HIV once they get circumcised.

“I’m an open person hence I talk to many young people who tell me they don’t need to use condoms during sexual intercourse because they are circumcised. But that’s very wrong. I think there is need to sensentise people more on this issue,” he says.

Danny wonders what type of message is being put across regarding circumcision. He urges young men to avoid practicing unprotected sex regardless of whether they are circumcised or not.

A few years ago, Danny who is deemed a controversial artiste in Zambia, released a hit song called Live which advocates the use of condoms.

He says because of such perceptions, the number of people being infected with the virus has kept on rising.

He has since called on people spearheading male circumcision campaigns to emphasise the fact that the practice did not obliterate the chances of contracting HIV but merely reduced them.

“Personally I’m not liking the way the anti-HIV campaigns are being done, suddenly there is this hype of male circumcision. It is a good practice but what is ringing in most young people’s minds is that once they are circumcised, they cannot contract HIV,” he says. ...

ZIMBABWE: Men resist being cut

Weekend Post
October 17, 2014

Men still hesitant to be circumcised

by Wendy Muperi
GOVERNMENT has bemoaned limited demand for voluntary medical male circumcision half a decade after its introduction.

Owen Mugurungi, director AIDS and TB Unit in the ministry of Health, said thousands of men are still avoiding the nip owing to false beliefs surrounding the procedure — making the fulfilment of national targets a tall order which demands community involvement.

“The programme experiences limited demand in some areas due to religious, cultural issues as well as some misconceptions regarding male circumcision,” said Mugurungi.

“The responsibility is not for the ministry alone. If we rally behind male circumcision as part of the HIV prevention strategy we have in Zimbabwe, we will jointly be able to, not only meet the target, but influence the reduction in HIV incidence”.

A number of weird stories about circumcision have widely been circulated in Zimbabwe. Recently, the ministry allayed fears that foreskins are being illicitly sold to the global cosmetics industry and traditional healers which are rife in Zimbabwe.

Zimbabwe launched the programme in 2009 to circumcise 1, 3 million young men in eight years in an effort to reduce HIV infections — which stand at 57 000 annually.

As of June, a total of 98 245 males aged 13 years and above got circumcised against an annual target of 217 800.

Since the programme’s inception in 2009, a total of 302 555 males have been circumcised against a 2017 target of 1, 3 million men.

A report by UNAids and the World Health Organisation (WHO) said the risk of HIV infection among men could be reduced by 60 percent.

Currently, the country has 1, 2 million people living with the virus....

UGANDA: Men resist being cut

Aids Ark
October 9, 2014

Uganda's flagging male circumcision drive

SHAREKAMPALA, 8 October 2014 (IRIN) – Limited funding and personnel, as well as misconceptions and cultural beliefs, are some of the challenges hindering Uganda’s goal of circumcising at least 4.2 million men by 2015 in a bid to lower the country’s HIV/AIDS incidence.

Just 26 percent, about 1.4 million, of the men targeted under the Safe Male Circumcision (SMC) programme – launched in September 2010 – had been circumcised by the end of 2013, according to Uganda’s AIDS Commission (UAC) mid-term review report of the National HIV/AIDS Strategic Plan (2011-2015).

The US President’s Emergency Plan for AIDS Relief (PEPFAR) and the joint UN Programme on HIV/AIDS (UNAIDS) indicate that circumcising 4.2 million Ugandan men in 2011-2015 could help to halve the country’s HIV incidence. Uganda’s HIV prevalence rate has risen from 6.4 to 7.3 percent over the past five years.

The 4.2 million target represents 80 percent of the estimated number of uncircumcised men in Uganda. “I don’t think we will achieve the 80 percent target by 2015. The service is limited to a few areas mainly because of the limited funding from donors and government. PEPFAR contributes the biggest portion of this fund out of the many donors supporting health related projects,” Sylvia Nakasi, policy and advocacy officer, Uganda Network of AIDS Service Organizations (UNASO), told IRIN.

“Other factors affecting demand are the mixed messages on SMC, limited coordination of the private and public SMC service providers which affects timely reporting and quality assurance of the service provided, limited training of health workers to do SMC surgery, inadequate SMC supplies, lack of SMC champions and limited health workers.”

According to the UAC report, about 14 districts (out of 112) had reported no SMC activities by March 2013.

“We have had challenges in building capacity and putting systems in our health facilities for the service,” Joshua Musinguzi, the programme manager of the AIDS Control Programme at Uganda’s Ministry of Health, told IRIN. “We are now focused to consolidate and scale up SMC to try to achieve our target. We have harmonized communication materials to create demand, uptake, fight behavioural disinhibition and dispel myths.”

Myths and misconceptions
The UAC report noted that limited mass awareness on SMC may lead to risky sexual behaviour. “Disinhibition” implies the loss of inhibition on behaviour that had been restrained.

“The circumcision disinhibition might cause men to abandon previous risk reduction behaviours such as partner reduction or condom use. There are reports of local misperceptions that SMC is a magic bullet to prevent HIV, a belief that is likely to inhibit safe sex practices,” it stated.

The report added that the preference for traditional circumcision among some ethnic groups, such as the Bamasaba and the Bakakonjo, is affecting government efforts to scale up SMC. SMC is medically carried out under hygienic conditions to prevent the spread of infectious diseases, which are risk factors in traditional circumcision.
...

Myths abound. “There are many misconceptions and myths which surround this intervention. It’s also [a] frightening procedure. Men think of the risks involved, the pain and how long it will take them to heal,” added Sarah Kayagi, the chairperson of Uganda’s HIV/AIDS parliamentary committee. “Some women don’t want their husbands circumcised on grounds that they will become sexually weaker… Some think it’s meant to convert people to Islam."

[Not to mention - never to mention - that men may refuse to be circumcised because they know the value of their foreskins and that the claimed benefits are insufficient to justify it.]
...

ZIMBABWE: Sex workers shun circumcised men - "They take too long"

September 9, 2014

Sex Workers in Mazabuka avoiding sex with circumcised men

Some Sex Worker in Mazabuka town in Southern province are allegedly avoiding attending to men that are circumcised.

The Sex Workers complain that the circumised men ‘take too long’ during sexual encounters and that this is bad for their business.
[And will they insist that intact men use condoms, which may also slow them down? This throws "circumcision to prevent HIV" into disarray.]

Quoting March Zambia, a local Non-Governmental Organisation, Zambia Daily reports that the Sex Workers have complained of losing business when they encounter men who are circumcised than those that are not as it is ‘short time’ on the latter.

March Zambia deals with HIV/AIDS programmes.

Studies have shown that men who are circumcised prolong sexual encounters than those that are not.

UGANDA: Prostitutes take more risks with cut men

The Observer (Kampala)
September 2, 2014

Uganda: Circumcision Promoting Risky Behaviour - Report

by Racheal Ninsiima
A new study of 314 female sex workers (FSWs) in Makindye division found that more than half of respondents falsely believe that once a man is circumcised, protection is not necessary during sex.

The International Health Sciences University (IHSU) study was titled: "Understanding the dynamics and practices of female sex workers with both circumcised and uncircumcised men in Makindye division."

It was done in the Kampala suburbs of Kabalagala, Kansanga, Makindye II, Kibuye, Katwe, and Ggaba, between July and August 2013. Although there is no significant difference in sexual practices between circumcised and uncircumcised men, there is a misconception about the advantages of male circumcision among FSWs.

Of the interviewees, 17.7 per cent preferred having sex with circumcised men because they believe the risk of HIV infection is nil. Some 20 per cent of the 60 FSWs that reported to be HIV-positive had not used a condom in their last sexual encounter before the interview. One interviewee summed up the misconception of using circumcision as a 'natural condom' this way:

"A man who is not circumcised takes long to ejaculate and at times such men want to have sex with you without a condom such that they can infect you. But a man who is circumcised can even rape you without a condom and you do not get infected."

With regard to condom use, 187 (72.5 per cent) said they used condoms with steady clients every time while 67 (26 per cent) said they used condoms occasionally.

"Meanwhile, four FSWs (1.5 per cent) said they never used condoms with their steady clients and three of these did not think that circumcised men could infect someone with HIV yet they had had STIs in the past three months," the report partly reads.

The report notes that the 60 per cent protective effect from HIV/Aids that is associated with safe male circumcision (SMC) is likely to trigger a high propensity for risky sexual behaviour and worsen the incidence of HIV.

...

MALAWI: "Voluntary" circumcision to replace force?

New Times Africa
August 25, 2014

Malawi shifting away from forced male circumcision

Forced male circumcision sparks debate in Malawi
by Moses Michael-Phiri
BLANTYRE, Malawi (AA) – It was around sunset on a chilly day in the populous Ndirande Township in Blantyre, Malawi’s commercial hub, where a group of cheering boys had gathered around a dusty pitch to watch some of their peers play football. That’s when they pounced.

Picking one of the smallest boys on the touchline, mysterious men dragged their seven-year-old victim away, undisturbed by his efforts to break loose, only leaving behind a dusty trail as they disappeared with their prey into the bush.

The boy tried to cry for help. But only a muffled sound came out of his mouth as one of the men had gagged him until they had brought him into a grass-thatched hut.

That very moment, the other boys realized that their friend had been taken for circumcision. They all took to their heels – some to alert the boy’s parents.

A traditional initiation ceremony – or “chinamwali,” also popularly known as “jando,” in which circumcision is carried out – was taking place quietly in the nearby hut.

Between May and August, local circumcision ceremonies swing into full gear in most parts of the country.

Trespassers are abducted, circumcised and ordered to pay hefty “fees” to elders, locally known as “ngaliba” (surgeons).

Local elders occasionally send boys to capture other boys suspected of not being circumcised in an effort to increase the number of initiates – and raise money.

Elders demand 7000 kwachas (about $18) in fees for the “initiation” of a seven-year-old boy.

“We tried to settle the matter amicably, but the initiation elders were not moved,” the relative of the boy told Anadolu Agency, asking not to be named.

“They demanded their fees be paid in full before they could release the boy,” he said.

“Village headman Mtambalika, the local chief of the area, paid 1000 kwachas [about $2] for the boy’s release,” added the relative.

The parents declined to talk to AA, but the relative suspected that they were in favor of the boy’s circumcision.

“It’s tradition; boys have to be circumcised, especially in the Muslim communities in this area,” he said. “No wonder the parents are quiet about it.”

-Abducted-
But one of the country’s most prominent lawyers, Zwelithini Chipembere, has decried the practice.

“Those who forced circumcision on the boy have to pay the price,” he told AA.

“This is total abuse of human rights. No one should be forced to be circumcised,” Chipembere insisted.

“This was an innocent seven-year-old boy who went out to have fun.”

He asserted that the initiation hut had been intentionally built near a school playground, where children can often be found playing.

“It is a serious matter; I am still trying to get more information from the parents and police so we can open a court case,” the lawyer said.

“All I want is to find out who abducted the boy to be circumcised,” he added.

So far, he lamented, no one had been arrested over the incident.

-Debate-
The incident has added fuel to an already raging debate across the country about circumcision ceremonies.

Initiation huts have sprung up to target schoolboys on holiday (May to August), which is a cold season in Malawi – a climate said to make circumcision less painful and make wounds heal quickly, according to a local initiation elder.

The Malawian government is already under fire for moving too slowly in providing free male circumcision services at state facilities.

Earlier this month, the government announced it would scale up a voluntary medical male circumcision (VMMC) program.

Health Ministry spokesman Henry Chimbali told AA that a massive, six-week VMMC campaign – targeting 45,000 people in six districts – had begun.

“The VMMC campaign is running in the districts of Blantyre, Lilongwe and Nkhotakota [in central Malawi] and in Zomba, Phalombe and Mulanje [in the southern region],” he explained.

Malawi launched its VMMC initiative in late 2011 as an HIV prevention strategy after being convinced by results of three random clinical trials that had shown that the service led to HIV prevention rates of 60 percent.

The campaign also aims to curb forced or unsafe male circumcisions carried out during initiation ceremonies.

The World Bank has agreed to fund the program – to the tune of some $15 million – for the next four years.

“VMMC also benefits the recipient in terms of hygiene, prevention of cervical cancer in female partners, and prevention of penile cancer,” Chimbali said, adding that over 140,000 men in the country had undergone VMMC.

Frank Chimbwandira, director of the Health Ministry’s HIV/AIDs department, said that while the government had excluded some districts in the northern region from the campaign, the project was focused on areas known for high HIV prevalence rates.

But, he insisted, people should understand that VMMC is not a 100-percent HIV/AIDS prevention measure.

“We encourage those who have undergone VMMC to still use condoms in order to stay safe from contracting HIV,” Chimbwandira told AA.
[Then what possible difference can having been circumcised make?]

VMMC facilities have been opened in primary schools in order to make the service available to the people, especially the young, he said.

The campaign has received an overwhelmingly positive response, the official asserted, with people flocking to the facilities to receive the service.

As to whether the campaign would bring an end to traditional circumcision ceremonies, Chimbwandira said: “Maybe, because it [traditional means of circumcision] is barbaric; it has to end.”

© 2014, .

KENYA: Circumcision Secretariat Closes

The Star
August 25, 2014

Kenya: Circumcision Secretariat Closes

by John Muchangi
The secretariat that coordinated all voluntary medical male circumcision in Kenya the last six years has closed.

The Male Circumcision Consortium (MCC) started in 2007 in Kenya and has been key in promoting the male cut to prevent HIV in Kenya.

It was the body that reached out to the Luo Council and of Elders and Former Prime Minister Raila Odinga to popularise male circumsion Nyanza, where it is not traditionally practised.

Voluntary medical male circumcision has reached almost 700,000 men, up from 7,000 in 2008 when it was officially adopted in Kenya, according to the Ministry of Health.

MCC was the secretariat of the national taskforce on VMMC and linked the different groups carrying out medical male circumcision in Kenya.

It was funded by Bill and Melinda Gates Foundation and was initially planned to close in 2012 but was extended by two more years.
[Rather typical of Western interventions in Africa. Come in with a hiss and a roar - "We're going to save you!" - then leave with their tails between their legs, having achieved - what?]

"MCC was instrumental in forming the Nyanza Provincial VMMC Task Force that spearheaded the rollout of VMMC from the start, when the ground was shaky, to the present when we are firmly on solid ground," said Prof Kawango Agot, director of Impact Research and Development Organisation. "I believe that without MCC, Kenya would not have led the rest of Africa in VMMC rollout."

Officials said they sought other funding sources in vain and the closure of MCC was likely to slow down the momentum in Kenya.

Male circumcision has been proven to cut the risk of men acquiring HIV by about 60 per cent and remains a key prevention strategy in Kenya.
["Proven" - based on 73 circumcised men who didn't get HIV less than two years after 5,400 men were circumcised, while 64 did. And "a key prevention strategy" when condoms are known to be much more effective.]

At least 1.5 million Kenyans are living with HIV and 58,000 die every year after reaching the Aids stage.

The consortium brought together representatives from the ministry of health, FHI 360, EngenderHealth and Nyanza Reproductive Health Society, representing the University of Illinois at Chicago.

Dr Athanasius Ochieng', who sat on MCC as the VMMC programme manager at the National AIDS and STI Control Programme (Nascop), says. "The government provides policy direction and infrastructure. However, our partners help in implementation of services, and therefore there is need to have a coordinated approach. The MCC has helped to ensure this."

The MCC has convened the task forces regularly -- monthly at first and later quarterly -- since the programme began in 2008.

Dr Elijah June Odoyo, currently the technical lead for VMMC at the US Centers for Disease Control and Prevention (CDC) in Nairobi, says that through these studies and dissemination of their results, "the MCC has cultivated a culture where evidence guides programming."
[So without the MCC there will be no evidence? And then how will they know whether male genital cutting is causing HIV to fall, to rise, or having no effect?]

MCC Senior Manager Mathews Onyango said the task force approach championed by the MCC is now considered a "best practice." He adds that "it is now being applied in scaling up interventions to address other health issues, such as prevention of mother-to-child transmission of HIV, tuberculosis and leprosy, and HIV/AIDS care and treatment."

SOUTH AFRICA: Prepex device not suspended

Mail & Guardian (South Africa)
August 21, 2014

Department refutes political link to Israeli circumcision product approval

by Mia Malan, Amy Green
An Israeli male circumcision product has not been put on hold, says the South African health department.

The health department has denied media reports in a national newspaper last week that plans to introduce the non-surgical medical male circumcision device, PrePex, to the government’s medical male circumcision programme, have been put on hold because it’s an Israeli product.

According to the department’s medical male circumcision programme manager, Dayanund Loykissoonlal, no decision has been made yet. “The minister will make his decision on the basis of our research findings, which will be concluded in February 2015. We need to make sure that whatever device we implement in the country must be safe and effective for South Africans to use. It must do what it’s supposed to do – it must be effective for HIV prevention.”

PrePex consists of an elastic band that compresses the foreskin, restricting blood supply until the foreskin dries and can be cut off after a week of the device being administered, without stitches, bleeding or anaesthetic.

Endorsed by WHO
Trade union Cosatu has called for a boycott of Israeli products and has voiced its objection to PrePex because of its Israeli origins. But Loykissoonlal says research results, and not politics, will determine the department’s decision on whether or not to introduce the device. PrePex was the first non-surgical male circumcision device to be endorsed or ‘prequalified’ by the World Health Organisation (WHO) in May 2013.

Research has shown that medical male circumcision – the removal of the entire foreskin of the penis – can [perhaps] reduce a male’s risk of contracting HIV through heterosexual sex by [up to] 60%.
South Africa first introduced medical male circumcision in 2010, and has since circumcised 1.4-million men. The government’s national strategic plan on HIV for 2012 to 2016 aims to have medically circumcised 80% of men between 15 and 49 – or 4.3-million men – by the end of the 2015/2016 financial year.

Modelling studies published in the medical journal Plos Med in 2011 showed that if South Africa reaches this target, more than 20% of new HIV infections – or one million could be averted by 2025. According to study projections, about five medical male circumcisions are needed to prevent a single case of HIV infection. [This "modelling" is all based on a total of 73 circumcised men who did not get HIV, while 64 did, out of 5,400 circumcised in three trials.]

South Africa is however not on track with reaching this target, and, is looking at ways to speed up the programme. The introduction of a non-surgical device, in addition to surgical procedures where doctors cut off the foreskin, is one such way.

PrePex is currently being tested in eight pilot sites in Gauteng, Mpumalanga and North West to test the feasibility of introducing the device as part of its medical circumcision campaign.

“We have completed the first phase of the research, in line with WHO recommendations, looking at the pilot implementation of the device. We still have the other two phases, the passive and active surveillance, left to do. Active surveillance is putting the device out there in the actual health settings and doing about 1 000. PrePex placements on clients and following them up rigorously. And passive is looking at another 9 000.”

Earlier story