Male Circumcision in South Africa and Uganda Essay (Critical Writing)

Abstract

Male circumcision is a term used to refer to the process of cutting and removing the foreskin found at the front of the male reproductive organ exposing the gland penis. In some parts of the world, the practice is done as passage of rite. However, in certain communities female circumcision is performed to ensure that they reduce their sexual activity and preserve the virginity of girls until marriage. Male circumcision has numerous benefits ranging from hygiene and improved sexual satisfaction. Research has also proven that male circumcision minimizes the chances of contracting HIV/AIDS and other STIs by half.¹ This essay focuses on study that was done by and UNDP and WHO in South Africa and Uganda with an aim to promote male circumcision on the notion that it was an effective way to reduce the chances of contracting any sexually transmitted diseases.

Importance of the study

The study on the effect of male circumcision to reduce the chances of contracting HIV-1 virus among the heterosexual segment of the population was very important.² The following points will support the benefits of this issue:

It was necessary to educate people about the benefits attached to male circumcision, aimed at ensuring that people make informed decisions on the matter concerning male circumcision. This study provided those who were undertaking it with very important information necessary for designing the project. Such information includes individuals’ opinion to male circumcision and its effects in reducing one’s vulnerability to infection with HIV-1.³ Its aim was to establish the information gaps that needed to be addressed before embarking on the full version of the project. In this sense, it laid down the facts that were relevant to the objectives of the project.

Key outcomes

There were major outcomes in this study that include: The sero-negative individuals accepted to take part in the circumcision process, mainly prompted by the acceptance of the fact that it would reduce the possibility HIV infection by half. However, those already infected were against the male circumcision, because they believed that undergoing circumcision would not reduce their chances of being infected with the virus.⁴ Another outcome was the highest number of people who turned up and accepted to undergo circumcision from the tribes that did practice circumcision. The Muslims had the lowest number of participants who went for circumcision because almost all Muslims circumcised their males. A great number of women were for the idea of their husbands to be circumcised.⁵

Data

The authors could not use the data collected to make a justified conclusion. This was due to the reason that some details were not verified and some crucial steps of the study were skipped. The sample size was not representative to enable the researchers to collect adequate data for the study. It is likely that the information collected was not objective because the subjects of the study were biased. ⁶ Therefore, the credibility of the source of data was questionable and the results were not error free.

Strengths and weaknesses

The study had the following weaknesses: it did not have the required surgical equipment to undertake the circumcisions at their clinics, and most clinics were forced to offer referral services to those who wished to be circumcised to an appropriate facility.⁷ There was a need to train people to sensitize the communities on the importance of and benefits of circumcision. There was insufficient data that was required in the disbursement of knowledge and the people would not relate the outcomes of the trial test with their real life situations.

Strengths

The study was well equipped to cover its scope from the nature of its analysis. The analysis was testing the result of circumcision on HIV infection on males. The susceptibility level of the circumcised men was found to be low by fifty percent. ⁸ This kind of analysis was inclining towards motivating more men to accept circumcision. The study was also covering the reason as to why a man may choose circumcision. These two issues are well addressed in the designed questionnaire

Implications of the study

The broader implication of the study was that those people who had prior knowledge of circumcision as a way of lowering their chances of HIV infection were willing to take it as the best option.⁹ This case was more applicable to those who were not infected. However, people who were already infected were less interested in benefits of circumcision so this study lacked any significant importance to them. The outcomes of the study showed that if the public was well educated about the benefits of male circumcision to curb HIV infection rate, they would be more likely to engage in the procedure.¹⁰ Consensus between married couples was important for care and support during the healing process. The study further showed that it was essential to avoid engaging in any sexual activity after circumcision until the wound was completely healed.

Future studies should include a follow up program to evaluate and establish the actual effect of circumcision procedure to those peoples’ lives. It should focus on addressing the misconception that people might have that circumcision is a proof plan against HIV infection. Some men might take it that circumcision is a ‘natural condom’ that will give the liberty of having sex with everyone without the fear of HIV infection.¹¹ Future studies should also incorporate a thorough educative program that will cut across all cultures. A broader variety of alternatives should be the focus of future studies to address the problem of HIV infection in the communities that circumcise their males but have high prevalence of HIV.¹²

Conclusion

In conclusion, male circumcision can be a good way of lowering chances of HIV infection among the non-circumcising communities. The method is more effective when incorporated with other measure that will address the pandemic. More knowledge on the subject is essential in improving the effectiveness of this method of curbing HIV.

Reference list

Bailey RC, Moses S, Parker CB, et al, 2007,Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Nairobi, P 56-67.

Dunkle KL, Stephenson R, Karita E, et al,2008, New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data, Kigali,P 371-380.

Gray R.H, Kigozi G, Serwadda D, et al, 2007, Male circumcision for HIV prevention in men in Rakai, Uganda, P 657-670.

Janz N.K, Becker M.H. The Health Belief Model: a decade later. New York, 1984. p 354-362.

Muula A.S.2007.Male circumcision to prevent HIV transmission and acquisition: what else do we need to know?Kampala p P357–363.

Petersen M.R, Deddens J.A. 2008,A comparison of two methods for estimating prevalence ratios, BMC Med Res. Methodology, Washington, D.C,8-12.

Sawires, S. et al. Male circumcision and HIV/AIDS: challenges and opportunities. Cape Town, 2007. p 802-810.

Weiss H.A, et al.2008,Male circumcision for HIV prevention: from evidence to action, Pretoria,P 22-34.

Westercamp N, Bailey R.C.2007. Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: a review, London,P 341–355.

WHO, 2009,Country experiences in the scale-up of male circumcision in the Eastern and Southern Africa Region. Web.

Footnotes

• 1 – Sawires, S. et al. Male circumcision and HIV/AIDS: challenges and opportunities. Cape Town, 2007. p 802-810.
• 2 – WHO, 2009,Country experiences in the scale-up of male circumcision in the Eastern and Southern Africa Region.
• 3 – Janz N.K, Becker M.H. The Health Belief Model: a decade later. New York, 1984. p 354-362.
• 4 – WHO, 2009,Country experiences in the scale-up of male circumcision in the Eastern and Southern Africa Region
• 5 – Dunkle KL, Stephenson R, Karita E, et al,2008, New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data, Kigali,P 371-380.
• 6 – Petersen M.R, Deddens J.A. 2008,A comparison of two methods for estimating prevalence ratios, BMC Med Res. Methodology, Washington, D.C,8-12
• 7 – Muula A.S.2007.Male circumcision to prevent HIV transmission and acquisition: what else do we need to know?Kampala p P357–363.
• 8 – Dunkle KL, Stephenson R, Karita E, et al,2008, New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data, Kigali,P 371-380.
• 9 – Bailey RC, Moses S, Parker CB, et al, 2007,Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Nairobi, P 56-67.
• 10 – WHO, 2009,Country experiences in the scale-up of male circumcision in the Eastern and Southern Africa Region
• 11 – Westercamp N, Bailey R.C.2007. Acceptability of male circumcision for prevention of HIV/AIDS in sub-Saharan Africa: a review, London,P 341–355.
• 12 – Weiss H.A, et al.2008,Male circumcision for HIV prevention: from evidence to action, Pretoria,P 22-34.