Safe male circumcision an avenue to curb HIV infection
Jun 23, 2011
UGANDA is one of the countries in sub- Saharan Africa that are now taking the fight against HIV to the next level. These countries are being guided by new and scientifically tested HIV prevention and treatment approaches which have come with some levels of success.
By Michael Ochora
UGANDA is one of the countries in sub- Saharan Africa that are now taking the fight against HIV to the next level. These countries are being guided by new and scientifically tested HIV prevention and treatment approaches which have come with some levels of success.
On the prevention front, one such approach is the safe male circumcision (SMC) which is currently being rolled out to every eligible male (15-49 years old) in several health centres around the country. This follows a successful trial conducted in Uganda between 2005-2006 which showed that HIV acquisition was reduced by 51% in men who became circumcised compared to their uncircumcised counterparts. This is because of the protective effect that comes with circumcision.
Yes, the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended SMC as an important strategy for the prevention of heterosexually acquired HIV infection in men although with caution that it is not 100% protective and must be used alongside all other prevention strategies.
In a country like Uganda where over 75% of HIV infections occur through sexual intercourse between men and women; this comes as a big opportunity to reduce risk of acquiring HIV in men. However, this excitement and opportunity should involve all key stakeholders, community mobilisation, and packaging of correct and consistent message on benefits of SMC for HIV prevention alongside all other traditional approaches, supplies and logistics as well as the human resources needed for this venture. Already, SMC is now being rolled out but the pace is slow partly due to some of the concerns above.
The implementers, therefore, need to realise and move fast to involve religious and cultural leaders, spouses of males as beneficiaries and also as immediate supporters if more males are to access circumcision for its protective effect against HIV. Bringing cultural and religious leaders on board will help their flock to know that SMC is not meant to convert a man from another religion to Islam. Secondly, religious and cultural leaders need to be involved to give them assurance that this campaign will not decampaign the traditional religious and cultural practice of circumcision.
This will certainly require Government to work together with leaders of these institutions to come up with relevant and workable laws, regulation, policies and programmes to ensure safety and voluntary access to circumcision services under these traditional institutions or providers.
The women too should not be left out as they are actually very critical stakeholders in the whole exercise right from decision-making at household level, supporting the male in the healing process as well as coping with the behavioural strategy of abstinence during this period.
Involving women at the onset of the programmes should also help to address other reproductive health concerns that would otherwise arise. Community mobilisation and awareness should be able to create demand for SMC among uncircumcised men while addressing issues of stigma especially among young people in schools and family levels. Community mobilisation needs to match actual service availability.
That calls for effective collaboration and cooperation between health communicators, programmes and the service providers to ensure that people are not referred to facilities that are not yet prepared to offer circumcision services.
The writer is the information and behaviour change communications manager with Northern Uganda Malaria, AIDS and TB programmes
UGANDA is one of the countries in sub- Saharan Africa that are now taking the fight against HIV to the next level. These countries are being guided by new and scientifically tested HIV prevention and treatment approaches which have come with some levels of success.
On the prevention front, one such approach is the safe male circumcision (SMC) which is currently being rolled out to every eligible male (15-49 years old) in several health centres around the country. This follows a successful trial conducted in Uganda between 2005-2006 which showed that HIV acquisition was reduced by 51% in men who became circumcised compared to their uncircumcised counterparts. This is because of the protective effect that comes with circumcision.
Yes, the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended SMC as an important strategy for the prevention of heterosexually acquired HIV infection in men although with caution that it is not 100% protective and must be used alongside all other prevention strategies.
In a country like Uganda where over 75% of HIV infections occur through sexual intercourse between men and women; this comes as a big opportunity to reduce risk of acquiring HIV in men. However, this excitement and opportunity should involve all key stakeholders, community mobilisation, and packaging of correct and consistent message on benefits of SMC for HIV prevention alongside all other traditional approaches, supplies and logistics as well as the human resources needed for this venture. Already, SMC is now being rolled out but the pace is slow partly due to some of the concerns above.
The implementers, therefore, need to realise and move fast to involve religious and cultural leaders, spouses of males as beneficiaries and also as immediate supporters if more males are to access circumcision for its protective effect against HIV. Bringing cultural and religious leaders on board will help their flock to know that SMC is not meant to convert a man from another religion to Islam. Secondly, religious and cultural leaders need to be involved to give them assurance that this campaign will not decampaign the traditional religious and cultural practice of circumcision.
This will certainly require Government to work together with leaders of these institutions to come up with relevant and workable laws, regulation, policies and programmes to ensure safety and voluntary access to circumcision services under these traditional institutions or providers.
The women too should not be left out as they are actually very critical stakeholders in the whole exercise right from decision-making at household level, supporting the male in the healing process as well as coping with the behavioural strategy of abstinence during this period.
Involving women at the onset of the programmes should also help to address other reproductive health concerns that would otherwise arise. Community mobilisation and awareness should be able to create demand for SMC among uncircumcised men while addressing issues of stigma especially among young people in schools and family levels. Community mobilisation needs to match actual service availability.
That calls for effective collaboration and cooperation between health communicators, programmes and the service providers to ensure that people are not referred to facilities that are not yet prepared to offer circumcision services.
The writer is the information and behaviour change communications manager with Northern Uganda Malaria, AIDS and TB programmes