Aids related deaths in South Africa: 1 881 188 at noon on Wednesday August 23.
A snip that could cut HIV: Sephiwe Shabange (22) sat patiently with four other men in a busy clinic in Mbabane, Swaziland. They were surprisingly calm considering they were there to be circumcised. ‘I do this to reduce the chance of getting HIV/Aids,” he said.
The procedure takes 30 minutes under local anaesthetic. The patient waits a further 30 minutes to monitor bleeding. An hour after the operation, a pleased Shabange left the clinic. ‘It’s painful, but really it is not so bad,” he said.
He is one of a growing number of Swazi men signing up for circumcision in the hope that they will not contract HIV/Aids. Waiting times in state-run hospitals are from six to nine months, but in private or NGO-run clinics — where the procedure is done each day — the wait is two to three weeks.
The demand for circumcision rose last year when local press reported the findings of a South African study showing circumcised men to be 61% to 75% less likely to be infected by the virus.
The study’s authors said the work showed two million new HIV infections would be averted if circumcision were introduced across Africa.
Two further studies are under way in Kenya and Uganda. The results will determine whether male circumcision is put forward as part of an HIV/Aids prevention package, along with abstinence, partner reduction and condom use.
No one is sure why circumcision is effective. One explanation is that the soft tissue of the foreskin is vulnerable to tearing and bleeding, and this can facilitate the spread of the virus. Another is that the foreskin contains a higher density of cells called Langerhan cells, which are thought to be the doorway for HIV to enter the body.
In Swaziland, with a population of about one million and an infection rate of more than 40%, it is no wonder the population is looking for ways to beat HIV.
‘The scientific community hasn’t come out and said it definitely works,” said Dr Mark Mills, head of the Mbabane private clinic, but somehow, he said, the population heard it on the news and ‘it’s spreading like wildfire”. Demand at the clinic has risen from about one request a month last year to 50 to100 a month.
‘Everybody is interested because of this epidemic,” said Musa Dwane, as he waited to be circumcised. ‘[The] problem is for those who are employed it is affordable, for those who are not it’s too much. In government hospitals it is affordable but the queue is very long.”
There are voices of caution. Prudence Mkhatshwa is chief nurse in charge of promoting male circumcision for the Family Life Association of Swaziland, addressing companies and communities about the benefits. Her message is that male circumcision helps prevent many sexually transmitted infections, HIV is just one of them. But she is careful not to promote the procedure for HIV.
‘For HIV we emphasise behaviour change. If it’s a young man who’s not married he must abstain,” she said. ‘We tell them … circumcision is not a cure.”– Leila Lak
Source: