Washington Post Examines Use of Circumcision in Swaziland To Prevent HIV Transmission
The Washington Post on Dec. 26, 2005, examined the "dramatic and swift" shift in attitudes toward circumcision in Swaziland, which has one of the world's lowest rates of the practice and one of the highest HIV prevalence rates. Although circumcision was "once widely viewed as unmanly," it is making a "sudden comeback" in the country since the publication of a South African study that finds the practice could reduce the risk of contracting HIV (Timberg, Washington Post, 12/26/05). According to the study, which was published in the November 2005 issue of PLoS Medicine, male circumcision might reduce the risk of men contracting HIV through sexual intercourse with women by about 60% (Kaiser Daily HIV/AIDS Report, 11/28/05). Hundreds of Swazi men have been circumcised in recent months, and hospitals that once rarely performed the procedure are circumcising 10 to 15 patients weekly and keeping two-month waiting lists, according to the Post. Circumcision advocates, UNICEF Swaziland representative Alan Brody, and USAID researcher and technical adviser Daniel Halperin have "aggressively pushed news" of the study by incorporating messages about the protective effects of circumcision into public education campaigns and meeting with Swazi physicians to discuss the research, the Post reports. In addition, Swazi legislator Marwick Khumalo advocates the practice in "Swazi terms" by telling parents that their paternal bloodline depends on protecting their sons from HIV. However, some circumcision advocates say that newly circumcised men might believe that they are "totally protected" from HIV and engage in high-risk sexual behavior, when in fact they are more vulnerable to HIV in the weeks after circumcision when the virus can enter the wound before it heals, the Post reports.
Some Swazi health care providers say that if the country's health system does not keep pace with the demand for circumcision, the surgery might increasingly be performed in "unhygienic, ritual settings or hastily established operating rooms," the Post reports. The country's health care system already is "overwhelmed" with providing HIV/AIDS care, distributing antiretroviral drugs and retaining its "short supply" of health care workers. To address the issue, Brody said that mobile military hospitals should be established in villages to provide circumcision at no cost to males between the ages of 10 and 24. "This is a crisis," Brody said, adding, "The science is in place to say, 'Let's move forward,' at least in Swaziland and also in most of Southern Africa. Let's not delay." However, the largest international supporters of HIV/AIDS prevention have "treated the results cautiously" and are waiting for results from similar studies in Uganda and Kenya before deciding whether to offer circumcision more widely in countries with high rates of HIV, the Post reports (Washington Post, 12/26/05).